It is likely that you have a strong opinion on Botox; almost everybody does. Depending on whether you are fiercely pro or violently anti, to your mind it is either the perfect cure for lines or a dangerous toxin that shouldn’t ever be injected. Botox, a brand name for the botulinum toxin that works by preventing muscles from moving, seems to divide opinion like no other injectable.
Even the experts are at it. When I asked a handful of them if they had noticed a decline in demand, I received some emphatic answers to say yes, it was absolutely being edged out by other advancements, while others said it remained as popular as ever.
One thing they all agreed on: gone are the days of anyone wanting Botox injections to create a blank, expressionless face, with Alice Hart-Davis, journalist and founder of The Tweakments Guide, telling me that “none of us want the sort of frozen face or wonky brows that lots of people think of when they think of Botox”.
Hear, hear. In fact, I find the idea of losing character and being unable to express myself through my features so intensely unappealing that I have not yet had a single Botox injection into my face for anti-ageing purposes (I have had some in my jaw to stop myself clenching it while sleeping, to help slow my gum recession).
My reluctance to have Botox is not to suggest for one moment that I’m not afflicted with vanity, so while I don’t mind the idea of ageing serenely like those women in river cruise adverts — all delicate lines and cashmere wraps — I would be horrified if all the stress and vigour of living in London became etched on my features.
At present, my wrinkles make themselves known when I move my face but aren’t deeply entrenched. In theory, would this be about the right time for me to have some “preventative” Botox? Dr Ash Soni, a plastic and reconstructive surgeon and the founder of The Soni Clinic, says: “I don’t think people should have it before lines develop… but it is preventative in so far as treating lines that are developing will stop them from bedding in.”
Instead of Botox, I have chosen to look after my skin well, to keep it robust and healthy. I also have treatments with my clinical aesthetician, Pam Marshall at Mortar and Milk, who uses microneedling or acids to “create a wound, which prompts a healing cascade, meaning skin behaves more youthfully”.Apparently, I’m not alone in this approach. Millie Kendall, chief executive of the British Beauty Council, says “people in the UK are increasingly using skincare correctly, applying SPF daily, and using products by brands like Medik8 that really impact the skin”.
Similarly, aesthetic doctor Dr Sophie Shotter has noticed that while Botox may not necessarily be on the wane, there are plenty of treatments gaining popularity for their ability to encourage the appearance of youth: “We now have techniques that can address the cellular causes of ageing rather than just fixing the signs of ageing that appear on the skin’s surface. These regenerative techniques help us to stimulate our own skin and tissues, rather than relying on something that has been injected in to give a result.”
However you feel about it, if you want to freeze muscles, Botox is the only thing that will work, but here are a host of other options that have an impact on the appearance of ageing. They should, of course, only be administered with someone who is qualified and experienced. Check on thetweakmentsguide.com or baaps.org.uk.
Polynucleotides
Polynucleotides contain fragments of DNA and are administered via multiple small injections. According to dermatologist Dr Elif Benar, they “promote cell turnover, enhance tissue repair, and stimulate the production of collagen and elastin, leading to improved skin texture and elasticity.” It’s worth mentioning that the quality of polynucleotides is essential to their success. When I decided to see if they would make the skin on my chest less weather-beaten (they did), I opted for DermaFocus Plinest, which is the UK’s first CE certified brand. Aim for two to three sessions, with maintenance every six to 12 months.
Microneedling
A classic way to prompt skin regeneration, but it should never, according to Pam Marshall, be attempted at home: “First, doing it that often isn’t good and can lead to redness and capillary damage, and, second, you could introduce bacteria from needles that aren’t fully sterilised.” In the clinic, however, it achieves softer, smoother skin, and can be performed every couple of months.
Byonik laser
This laser improves skin texture, treats scarring and strengthens skin. Having it is a pleasant experience — a sensor is applied to the tip of your finger so the laser pulses along with your heartbeat. Marshall uses it on clients at the end of a facial to augment results.
Sculptra
These collagen-stimulating injectables are on the rise, according to Dr Ash Soni, who uses them on the neck and face to tighten and to improve glow. “For sagging, it’s a favourite of mine,” he tells me. Because these injections prompt your skin to produce its own collagen, results start to kick in after about eight to 12 weeks. Maintenance injections are required every year.
Microcurrent
The way your face looks is largely down to muscle tone, not only because it affects contours and reduces sagging, but also because healthy muscles pump blood and therefore nutrients to the surface of the skin more readily. Microcurrent technology sends low-grade doses of electricity into the skin to stimulate muscles while also helping to increase collagen production and the energy in cells. The ZIIP HALO Facial Toning Device, £379 at currentbody.com, administers microcurrent easily and efficiently.
Morpheus8
This creates a big wound by combining microneedling with radio frequency. Dr Hassan Galadari, aesthetic doctor at Galadari Clinics, explains that as the skin heals, it leads to “tightening and rejuvenation”. This is not for the faint-hearted. Practitioners frequently mention the pain which, when I tried it at the very reliable Montrose Clinic, I certainly felt intensely. The wisdom is that you need two to three attempts to get rid of scars and soften skin.
Exosomes
These gained prominence this year for their ability to repair and regenerate skin. Plastic surgeon Dr Sofiane Rimouche explains they “are signalling messengers from stem cells and have a whole host of potential benefits and applications”, meaning they are ideal if you want to reduce inflammation and improve skin condition. You’ll likely need three to five sessions for the full results, with top-ups every six months to a year.
