Cosmetic surgery, non-invasive procedure, treatment or tweakment: call it what you want, but throughout my decades-long career in beauty, no topic has ever been more divisive. The polarity between viewpoints is vast, and it seems nobody is without their opinion on the matter. Spoiler alert, courtesy of The London Lip Clinic, I am a hard and fast convert, a newfound advocate, and metaphorically signing up for the long run.
Since before the days of daily mask-wearing, I’ve had the general ease to go makeup-free, save for a little brow gel and Eyeko Black Magic Mascara. But on days when I did want to amp up my look, I found frustration at foundation settling into lines, despite religious use of Pür Cosmetics Hydrate and Balance Primer. No amount of my current holy grail lip balm Bioderma Atoderm, help from the Bybi Plumper or even bountiful water consumption ever allowed my skin the efforts of a full appearance. I was getting a little tired of, well, looking tired.
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As a Beauty Editor, my shelves are filled with lotions and serums claiming or working to replenish and renew the skin’s appearance in a multitude of different ways. I have reached for topical solutions to fine lines for years, the newest addition to my armoury being Environ Focus Care Youth+ Frown Serum. But as an average person, in the cold light of day and outside of portrait mode, I still desired something more. And so, here begins the story of how I found a little comfort, and a lot more confidence, in my reflection.
Photographer: Egle Vasi, Makeup: Naomi Lake
So what happens when you dip a toe or take the plunge into this arena of beauty? I was lucky enough to have Dr Rupesh Shah guide me through my first ever ‘refreshment’.
As with any treatment, a consultation is a must. Nestled in Harley Street, Rupesh’s bustling clinic is warm and welcoming. His treatment room, bright, clean and reassuringly clinical, has personal touches too, with chic soft furnishings, and certificates and accolades adorning one wall.
We chat about my skincare routine, lifestyle and aims regarding my appearance. Whilst on point with routine, I express my unease over persistent forehead lines, emerging crow’s feet, and depleted lips. I want a fresher look for sure, but most importantly, one that remains undetectably natural, which is Rupesh’s signature style and what his clinic is best known for. Across the variety of treatments offered at the clinic, Rupesh explains the top three for facial rejuvenation are Botox, Profhilo, and lip filler.
So where did we end up? Firstly, for the appearance of lines, the most immediate treatment is Botox. Taking it from the basics, this involves the injection of the Botulinum toxin to block nerve signals, preventing muscle contractions that cause wrinkles. It has to be prescribed in a face-to-face meeting by a qualified medical practitioner, such as a doctor, dentist, nurse prescriber, or pharmacist, such as the journey Rupesh took.
Different locations glean different results, of course, relating to which muscle groups are targeted. Baby Botox treats fine lines in the centre of the forehead, pesky ‘eleven’ frown lines and crow’s feet, by using an application across the middle forehead, between the brows, at the bridge of the nose, and high on the cheekbones. A fuller treatment is required for wider-reaching forehead lines, with a few more injection points added towards the hairline.
Rupesh Shah. The London Lip Clinic
For lips, very simply, filler was the only way to go. Using market-leading Juvéderm Volbella XC injectable gel, it offers softness and natural movement to the finished look on delicate areas. A supple and more pliable formula than its equivalents, it’s used to augment the lip shape and treat perioral, or ‘lipstick lines’, whilst firmer products in the range are used for more structural procedures such as non-surgical rhinoplasty or ‘nose-job’. Modified hyaluronic acid (a good friend featured in almost every skincare article) is the main ingredient behind Juvéderm, a substance naturally occurring in the body delivering volume and hydration to the skin.
With both treatments booked, very soon I am back and in the chair. My first-timer nerves melt away with Dr Shah’s easy bedside manner, professional demeanour and complete knowledge of every aspect of the treatment.
The first focus is lips, primed for treatment with an anaesthetic injected into the gums. Much like a trip to the dentist, this numbs discomfort and lasts for around an hour. Whilst it takes effect, the focus shifts to Botox. I’m asked to frown, raise my eyebrows and make other facial movements whilst Rupesh maps out points for treatment. It’s a bespoke map, using knowledge of muscle structure, noting my facial contours and accounting for the areas being addressed. There is no need for any numbing here, a little pinch over my nose, a little pressure on my forehead… I am trying to manage your expectations fairly here, but for me, I would go as far as to say it was painless.
To complete my session, we moved on to lips. It’s the clinic’s most popular treatment, and its namesake after all. Luckily, I was already happy with their general shape, so Rupesh aimed for organic volume and plumpness, which meant an overall application across the length of the lips, rather than specific areas to restructure.
Photography: Jake Ball. Makeup Artist: Naomi Lake. Nail Artist: Nata Ivanishaka
Using his preferred cannula method, Rupesh uses a small needle to create an entry point and then swaps to a cannula to move through the dermis layer of the skin to distribute the filler. It’s a safer option as a cannula can’t pierce any blood vessels, plus this method has been linked with more natural-looking results. Finally, massage of the lips fully disperses the gel to ensure its smooth sitting, overall making it a little different in sensation to Botox, with a feeling of dull movement and pressure as the treatment progresses.
The whole process is done in about twenty minutes, but it’s important to remember that swelling will occur to skew the overall finish at first look. However, I resolve to trust the process, because I trust Rupesh. Aftercare is simple: for 24 hours there must be no pressure on the area at all whilst the filler is setting and firming. But, if anything goes awry, I am reassured that dissolving is always a possibility, and the clinic and an out-of-hours number are on hand to allay any worries in the short term.
So where are we on the results? When chatting to a friend after everything had settled, I had a moment of revelation when they asked to see a before photo for comparison. Apparently, she hadn’t noticed my lines and deflated lips with quite the retina-burning detail as I had, and I realised I didn’t really have one. More than my Millennial upbringing lacking the availability of camera phones at the delicate habit-forming age, it was my face, up close and personal with aspects I wasn’t particularly keen on, that had affected my confidence and lack of self-portraits with any regularity.
My lips were an instant hit, and being able to see an immediate change is undeniably exciting. Swelling faded completely after a few days, as did slight bruising, and I’ve been obsessed with the results ever since. The body will naturally break down the gel, but Volbella is the longest-lasting product on the market, with results lasting up to nine to twelve months. What’s more, a welcome side effect is that my lips feel more hydrated too.
Photographer: Egle Vasi, Makeup: Naomi Lake
With Botox, after three days or so, my forehead started to feel a little cool and somewhat tingly between my brows. After a week, I noticed a slowness and dulling of movement with expressions such as frowning. Two weeks in, I could tell which areas were treated and which needed a little more attention for balance.
Now, my brows, somewhat uneven in their sitting, have levelled. Tension at the muscle groups between and above my right brow had been pushing it down, but the relaxation allows it to lift to a more harmonious position. My forehead is smoother and fresher, and makeup is sitting nicely if I fancy wearing any, and with a smile, crow’s feet no longer grasp over my cheekbones.
It’s a delicate procedure with placement, Dr Shah explained, as for some lines lower on the forehead, a relaxing of these muscles could cause a closing of the eye area, by dropping the brows. Lines around the eyes are easier to treat, however, as there isn’t any risk of drooping. It’s a balance between retaining the movement for emotion, versus smoothing creases, but any lines that remain at rest are the hardest to treat. Nonetheless, I was assured that with continual use of Botox, the most stubborn lines will in time soften too, with the maintained relaxation of the muscles.
Overall, it’s fascinating how one can appear so naturally refreshed with such a seemingly minor intervention. In all honesty, the final look is so familiar that nobody has been able to pinpoint a specific change, despite compliments on looking, really, well. It would have stayed my little secret if only I hadn’t been so excited to share it…
Photographer: Egle Vasi, Makeup: Naomi Lake
Now, I couldn’t with a clear conscience sing the praises of treatments such as these without delving into their assurance. As of Friday 1st October 2021, it was made illegal to give Botox and dermal fillers to under 18’s for purely cosmetic reasons. Take a moment, read that again. That is worryingly recent. And, where does it mention the regulations on who is administering these treatments?
To find out more about safety in the industry, I reached out to Ashton Collins, Director of Save Face, an independent national register of Accredited Practitioners providing non-surgical cosmetic treatments. I was keen to know her inspiration behind the company.
Ashton explained, “Eight years ago, I was considering getting lip fillers. I knew what I wanted, but I’d seen terrible work and read some scary articles in the press. The more research I did, the more apparent it became that finding someone to administer these procedures safely was like playing the lottery.”
“It likened anyone undergoing treatment with dermal fillers as having no more protection than buying a ballpoint pen. A central register was recommended, but the Government declined to create one.” Ashton decided to be the change, “with experience in accreditation schemes, I had a good understanding of what would be needed… I wanted something that I would feel confident in my mum or best friend using… to give confidence to those seeking treatments, removing the guesswork and reliance on [practitioners own] marketing and self-promotion.”
Ashton Collins, Save Face
At 25, she set in motion a business plan to change the industry, aiming, in her words, “to simultaneously help legitimate, responsible and ethical practitioners differentiate themselves, and provide a user-friendly way for anyone considering a treatment to find a practitioner they could trust”. Launched in 2014, Save Face was later accredited by Professional Standards Authority (PSA) in 2016 and was the first aesthetic register to be so. Now, it’s recognised by the Government, The Department of Health, NHS England and The Care Quality Commission. So, what does deliver to someone at home, who might be looking for their first, or next treatment?
“Our standards actually exceed the requirements set out by the PSA. Each practitioner and clinic is required to pass our rigorous 116-point assessment”. Ashton elaborates, “we verify that each practitioner is registered with a statutory regulator (such as the General Medical or Dental Councils), that they are appropriately trained in each of the treatments they provide and in managing medical emergencies and complications, are insured to carry out each treatment and have the appropriate policies, procedures, treatment protocols, consent forms and aftercare information.”
There’s more change called in the industry for 2022, with the launch of a petition to ensure the advertising of cosmetic surgeries and procedures is more upfront about potential risks.
I was eager to hear Ashton’s thoughts. She shared, “We have been campaigning for many years for the Advertising Standards Authority to tighten the rules around the advertising of cosmetic procedures, as too many people now perceive fillers and Botox to be low-risk beauty treatments as opposed to medical procedures that can cause serious complications.”
But it doesn’t stop there, as Ashon raises a further issue, “based on the data we have gathered over the past eight years, we are now growing increasingly concerned about the ‘organic’ posts and social media pages that are not subject to any rules or regulations.” According to Save Face records, over 80% of complaints they handle stem from practitioners found on social media, or ads offering budget deals and time-limited offers. “It’s these posts that fall under the radar and cause thousands of people to fall into unsafe hands.”
