17 Apr The mysterious world of cosmetic medicine- where do I start?
Cosmetic treatments; where do I start? There are those who are keen to maintain and enhance their appearance with the help of a cosmetic clinic, availing themselves of today’s industry expertise and technological breakthroughs, but don’t know where to begin.
Others may have already tried a medically supervised care routine or procedure then think, “What do I do next?”
All kinds of people come to a professional cosmetic clinic:
- The novice mystified by the plethora of options available.
- An existing fan of cosmetic enhancement who is eager to take the next step.
- The person who is conflicted about a physical issue that is seriously impacting their self-esteem
- Someone who is simply curious about brakepadding the effects of ageing because that milestone birthday is coming up.
These are just some examples, but they all have one thing in common – the need for professional guidance to make the right start.
I am committed to giving every person who walks through the door at MUSE Clinic quality time and premium care, but sometimes it is reassuring for people to know more before they make that first step. Also, existing patients like to stay on top of the latest developments in evidence-based cosmetic care and maintenance. These blogs are where I’ll explore the questions I get asked most often and the topics I like to explore with my ongoing clientele one-on-one. A virtual consultation, if you will, that will hopefully inform and illuminate this brave new world of cosmetic enhancement.
WHERE DO I START? LET’S START WITH SKIN
From a physical, practical perspective, I believe the quest for one’s personal best always starts with beautiful skin. Even if that’s the only thing that you ever do to look after yourself and optimise your appearance, it’s the best possible first step. Someone can focus on adding volume to their lips or creating razor sharp cheekbones, but if they have wrinkly, pigmented, dull looking skin then they are still not looking their absolute best. Transforming the skin surface so that it looks as healthy and glowing as possible is priority number one.
But I already have a cupboard full of cosmetic beauty products…
People are becoming more jaded about the big business of beauty, marketing and PR. We have all bought expensive skincare products from department stores and then been underwhelmed by the results. The fragrance smells nice, the packaging looks pretty and the celebrity draws us in, but superficialities prove to be ineffective when it comes to any real impact on skin. There is a huge difference between the temporary plumping effect of commercial cosmetic skincare and real, dermatology-grade products that defend against lifestyle, pollution and ageing.
A professional can guide you, tailoring treatments around the key ingredients that address your specific needs and combine products with scientifically proven ‘actives’ for maximum effectiveness, creating an excellent regime for you to follow. Not everyone wants to go down the route of lasers, injectables and – in some cases – surgery.
And to those people who are ready to go the next step and progress beyond that, there is a lot that we can do now in the contemporary landscape. With guidance, we work through the next step together, and then the next step after that. We work at the pace that suits you.
At the cosmetic clinic, we have state of the art tools that allow us to go beyond lotions and potions alone.
When dead cells have accumulated on the skin’s surface due to sluggish renewal, contributing to blocked pores, blackheads, breakouts, and a dull, non light-reflective texture, the aesthetic appearance is compromised. Dead cells also block the efficacy of skin care, which just doesn’t get absorbed properly. So how do we speed up the process of cell renewal to reveal all those beautiful, fresh cells lying underneath the dead ones?
I am a big fan of chemical peels. Yes, I know that peels can still have that ‘Ab Fab’ connotation to the novice, with the extreme of a red-faced Patsy running around for comic effect. In reality, those days are long gone. The technology of peels improves all the time. Today’s peels penetrate much deeper, with less down time, and the new skin coming up looks so healthy and ‘baby’s bum’ fresh.
This is because the benefit is twofold. Not only does a peel encourage the top, damaged layer of skin cells to shed off more rapidly, the newer peels are also designed to allow the active ingredients to penetrate more deeply, so the next layer of skin coming through is of better quality as well.
There are also other non-invasive cosmetic treatments to freshen up skin faster, and reduce the effect of fine lines and minor skin blemishes. Microdermabrasion simultaneously uses a diamond-tip abrasive wand to remove dead skin cells on the face and then vacuum them up. Gentler lasers are another good option – a non-aggressive way to stimulate self-repair in the skin.
HOW DO I KNOW WHICH OPTION TO CHOOSE?
Once we meet you, we can determine what will suit your skin best. The first consultation is key. Even if I see someone for the very first time and we don’t do a treatment on that appointment, the effort to understand what your concerns and expectations are, is time very well spent. I want to know what brings you to the clinic at this moment in your life? What are you trying – and willing – to achieve, and what are you realistic about? My aim is to get to know you and what is motivating you to change.
There are two general approaches to patient enhancement. The quick fix treatment: someone we have never met comes in and wants their lips done, for example, and then that’s the end of it. But the majority of relationships that we establish with people build on an understanding of the concerns and desires they have about their appearance – we then apply our skill, knowledge and assessments to formulate a plan to meet (and exceed) their expectations. We can plan over several months, or even years. A relationship with the doctor or cosmetic nurse keeps evolving; the more the trust and understanding builds, the better the treatment becomes.
My job is to help people look and feel better. My background is in general practice and public health, so I was always interested in preventative strategies. How do we prevent problems? How do we identify the risk factors? How do we get on top of an issue before it becomes a disease?
Doctors are trained to intervene to alter the course of the disease. Now we apply the same philosophy to ageing – with new technology and awareness.
I aim to identify the areas that are deteriorating then contain and reverse the process. I see myself as a proceduralist. I like the physicality, the creative process of injecting someone’s face and seeing its shapes and contours appearing. We look at the normal ageing pattern – sagging and the effects of gravity – and see when and where we should intervene on the face for a younger, complementary effect.
I DON’T LIKE THE FAKE CELEBRITY LOOK, SO WHY SHOULD I USE VOLUME?
I’m very keen not to try and pretend that someone is something or someone that they’re not. Rather than try and recreate a look that has nothing to do with the real you and which looks artificial, we should celebrate your best features – with subtle enhancement.
Why volume? People misunderstand dermal fillers and their volumising effect, which can actually be used to maintain structure, and elevation. We now understand that ageing isn’t just about lines and wrinkles. There are a lot of structural changes that happen to the face; even the shape of our skull changes as we age. One of the biggest factors that influences how the face sags is the movement of the fat pads that sit under the skin. Those give us contour and shape. As we age those fat pads reposition themselves and become smaller and more lax; ligaments also start to sag. There is a lot of downward movement, which is why jowls form on the face.
Volume is not just used to ‘plump’ out lines or create artificial shapes and change features – like your lip or cheek shape. It can also recreate some of the foundational structure of our earlier years. This difference is crucial. Carefully positioned filler in the right place, to the back of the face or along the jawline, can actually recreate the ‘lift effect’ of youth to the whole face.
In fact, the worst thing a practitioner can do is is add volume prematurely to somebody’s features when the foundation of their ageing face has not been initially targeted. The shape of the jawline and shape of the cheek area must be adequate to support more tissue. If we add volume onto really sagging skin, we’re just creating more heaviness. Adding weight to weight starts to look heavy. Foundation is key, and will always bring you better results. A builder will never put on a new roof if the walls are falling down!
This is why it is really important to work with a practitioner who has an aesthetic sense of the underpinnings of a youthful face.
THE DIFFERENCE BETWEEN A COSMETIC MEDICAL CLINIC PRACTICE AND A HIGH TURNOVER ‘WALK-IN’.
Many people who offer volumising injectibles don’t understand the biology of the ageing face; instead they use a colour-by-number approach. Non-medically trained practitioners may have learned a new technique at a workshop or course, then they just apply that technique to the next person in front of them. They don’t appreciate the individuality of each face, taking on board or actually diagnosing what the problem is.
I’m a doctor, so my training is to take a history, examine and investigate to understand. Sometimes the problem needs a solution that isn’t obvious at all, like applying subtle filler to create the support and lift it needs to maintain a more youthful, uplifted structure.
It is risky to go to a practitioner who has a convenient, high turnover business strategy but no in-depth diagnostic process. If they just jump in with brand new cheeks and lips for a big wow effect rather than a structure to build on, that’s when you get that telltale, reality show artificial look.
HERE COMES THE SUN. UH-OH, WHAT IF I DIDN’T SLIP, SLOP, SLAP?
There has been a huge shift in awareness around the consequences of sun damage: accelerated ageing and skin cancer.
I see a lot of people who regret what they have done to their skin in their teenage years and beyond. They are embarrassed that they allowed themselves to lie in the sun, baking in oil. Yes, it is the ultimate “what was I thinking?” moment, way beyond a bad ‘80s hairdo! But this Aussie lifestyle trend was forged in a time before we understood the ageing process of the skin and the effects of the sun, particularly in Australia.
The good news: yes, there are still things that we can do at MUSE Clinic to improve the quality of skin that has been over-exposed over the years. Our consultation will focus on targeting both the underlying damage and pigmentation that hasn’t come to the surface yet, and the tougher, coarser texture on the skin surface. Again, once we assess your skin we will know the best way to reverse the damage.
And of course, from now on, we can provide you with the high grade 50+ SPF sunscreen that will be your insurance against future damage!
Dr Stephen Lowe
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