Updated 21 January 2019

As time goes by

We are inundated with options to undo the facial footprint of time's relentless march. Here are the most effective and popular procedures available right now.

We are inundated with options to undo the facial footprint of time’s relentless march. LAURA TWIGGS of ELLE MAGAZINE reports on the most effective and popular invasive and non-invasive procedures available right now.

"Nature gives you the face you have at 20,' observed Coco Chanel. 'Life shapes the face you have at 30,' she added. 'But at 50, you get the face you deserve,' she concluded. However, with the flood of anti-ageing procedures and products on the market, it now seems that at 30, 40, 50 or 60 and beyond, you can increasingly get not the face you 'deserve', but the one you can afford. And afford them we do.

While there are no official statistics regarding the South African cosmetic industry, the numbers that come out of the UK and the USA are astonishing, and it is thought that the trends are not unlike those in South Africa. According to the American Society for Aesthetic Plastic Surgery, in 2007 close to 12 million cosmetic procedures were performed in the USA, with 18 percent being surgical and the rest non-surgical.    

They amounted to a spend of $13 billion, and the 10 preceding years saw a 457 percent increase in the number of cosmetic procedures being performed. There is a dizzying array of potential fixes, and of course, some are more dodgy than others. Dr Richard Halley-Stott,  Clinical Head Plastic Surgeon at the Wits Donald Gordon Medical Centre and spokesperson for the Association of Plastic and Reconstructive Surgeons of South Africa (APRSSA), warns that  while the newest and most innovative procedures may seem like magic bullets, it’s important to acknowledge that newest is not necessarily best.

Better long-term results 

'Around the world, it’s becoming more popular to administer testosterone, growth hormones and vitamin and mineral cocktails,’ he says by way of example. ‘That may not yet be prevalent in South Africa, but it is a worrying trend.  It’s common sense that treatments and products that have stood the test of time are safer and yield better long-term results. An injectable filler like Restylane, for example, has documented evidence that shows 50 million treatments without negative effects.’

He compares this lineage with the 'new' trend of Lipolysis for fat removal, a procedure in which fat-dissolving phosphatidyl choline is administered to localised regions of the body, noting that it has now been banned by the United States Department of Health and Human Services's Food and Drug Administration (FDA).

New breakthroughs and treatments show no signs of slowing. US dermatologist Dr Frederic Brandt to such stars as Madonna, Cher and Rupert Everett has pioneered the use of Botox to lift the tip of the nose and, also, to perform a lift to the neck. Hand lifts are on the rise in Hollywood, too. People are opting for cosmetic procedures younger and younger.

In South Africa there is now even First Health Finance which provides financing for procedures that are not covered by medical aid schemes including facelifts and tummy tucks (they report that the average applicant for finance is female and aged about 33; about 90% of clients are white women, and the number from other population groups is growing). Men are lining up for nips and tucks in growing numbers here and abroad, mostly to rid themselves of man boobs or 'moobs' a condition called gynaecomastia.

Predictably, as the rates of those seeking aesthetic enhancement grow, so too do the numbers of botch jobs and unhappy and dissatisfied clients. It’s becoming increasingly commonplace for doctors to perform cosmetic surgery without the necessary qualifications, to the degree that in October last year, the Health Professionals Council of South Africa vowed to crack down on this.

Plastic surgery  

Only specialists in plastic surgery may perform cosmetic surgery on those requiring it, HPCSA registrar Boyce Mkhize told The Sowetan. General practitioners are not allowed to perform cosmetic surgery. This statement was issued after a Carte Blanche exposé about women who were left scarred after having cosmetic surgery by unqualified surgeons. Also last year the Western Cape Dermatologists Independent Practitioners’ Association contacted Wendy Knowler of Consumer Watch to express concern about the increasing numbers of patients who have laser treatment performed by operators who aren’t trained to diagnose skin conditions.

Knowler reported that the SA Medical Association is of the view that only dermatologists and plastic surgeons are adequately trained to ‘optimise skin health and its aesthetic qualities’.

But there is no law governing the sale of laser machines. ‘The results can be costly, and yet the preponderance of untrained people administering all manner of anti-ageing procedures is  on the up,’ says Halley-Stott. 

So what then is this demon ageing that many of us are prepared to risk literally life and limb to postpone or diminish? It’s no more than the natural continuous process that, whether we like it or not, usually begins to show in our mid-20s. The factors that most negatively impact on the way we age are genetics, diet, hormones and external and internal environments (like sun damage, smoking, alcohol, excessive exercise and drug abuse).

What happens is that over time, collagen production in the skin slows, and elastin, which enables the skin to snap back into place, loses its efficacy. It’s never too soon to start managing these inevitable ageing factors, and a strict skincare routine should be de rigueur from puberty. As you age, you should adjust your beauty routine accordingly: what suits 20-year-old skin does not suit 40-year-old skin, and a radical surgery like a facelift, even though it can be recommended for certain people in their 40s and 50s, is clearly inappropriate for younger skins.

Forewarned is, as they say, forearmed, and there have never been more age-preventative measures than there are now. By employing these early on, you can stave off for years the need  for more dramatic intervention; even if it’s just a matter of starting to wear sun block, some minimal changes really can deliver big results.

Here, then, is just a little of what's on the menu

Read the rest of this article by clicking below

1. Botox, fillers and needles
2. Laser skin resurfacing 
 3. Peel back the time




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