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Ask Alice

Find the answers to some of your most frequent questions.


What happens if filler is accidentally injected into a blood vessel?

It’s a problem, and once that needs to be dealt with at once. If there’s a blob of filler in a tiny blood vessel, it may block it, which is bad enough – the area will look blanched, and it will be painful, and an expert practitioner will spot this straight away and will quickly inject the blockage with a substance that dissolves the filler. If it’s not treated, it may just look like a bruise but the skin tissue in the area will be dying, so it’s an emergency. If the filler gets into an artery where it can travel up towards the eye, it could cause blindness, so that is obviously an emergency, too.  Practitioners are taught to ‘aspirate’ when injecting – to pull back on the syringe once they have placed their needle into the skin, just to check that they’re not in a blood vessel, though plenty of practitioners have told me this is not completely failsafe. So it is really crucial that before your practitioner starts injecting you, you know that they have the skill and experience to spot a complication like this if it arises, and know how to handle it.

Have you tried the Hyaluron pen?

No, and I’m not going to, either. These pens are devices that shoot a blob of hyaluronic acid gel – the sort you get in an injectable filler – into the skin by using air pressure rather than needles. That means they’re a ‘no-needle’ treatment, but they’re also alarmingly imprecise, not least because they are usually used by people who don’t have the skills or training to use injectable fillers. Also, whatever the makers say about the filler from these devices not being able to cause complications by blocking blood vessels, this absolutely can and does happen. So just steer clear of these devices.

What’s the best treatment for a 50-year-old face?

Great question but there isn’t a simple answer. It totally depends on what your 50-year-old face is like, and what is bothering you about your looks, and what you’re prepared to do about it. Some people hate their frown lines. Other people are more bothered by a sagging jawline, or a weak chin, or pigmentation marks. So you need to be a bit more specific. Have a look around on the site, see whether skincare could help you, and if you are up for tweakments, you are in the right place to start your research. Then, your best bet is to book in for a consultation with a great practitioner (lots of them on here) and discuss your concerns with them, and see what they suggest.

How soon will I get results from collagen supplements?

You need to take them for three months to judge what they are doing for your skin. Some people claim results after two weeks, which always amazes me. If you’re lucky, you may see an improvement in the hydration of your skin within a month, but it takes a while for our skin to renew itself and for the new, improved skin cells to work their way up to the surface, particularly if we’re a bit older. So give it three months.

The person I’ve booked with turns out to be a dentist rather than a doctor, should dentists be doing these tweakments?

Yes – dentists make great aesthetic practitioners, as do nurses and surgeons. I don’t mind who does is doing the treatment as long as they are:

  1. medically trained
  2. have a lot of specialist training in aesthetic procedures
  3. have had a lot of experience putting that specialised training into practice
  4. they can recognise complications, and handle them if they arise and
  5. have an artistic eye, so you end up with results that are not just technically correct, but lovely to look at!

There’s more information in the Staying Safe section.

Do I need to take other supplements with Totally Derma… eg Vitamin C? Vitamin D? Camu camu? What’s the difference between that and vitamin C I am confused…?

No you don’t need to take vitamin C with Totally Derma as there is already vitamin C in the Totally Derma formula (but personally I like to take a high-strength vitamin C, Altrient, as well). Yes you do need to take vitamin D separately, we all need vitamin D. Camu Camu is a berry that is high in vitamin C. No, you don’t need to take this with Totally Derma either! There’s a video here where Anita from Totally Derma answers a whole heap of questions about the product on an Instagram Live.

Do you know about mjoule? Is it good?

mjoule isn’t a treatment, it’s a treatment platform, a new type of laser machine that can deliver different treatments including BBL (broad band light, a bit like supercharge IPL, which can reduce the visible signs of ageing eg wrinkles,) and Moxi, which is a fractional laser. And yes it’s good, it is the newest launch from an excellent US laser brand called Sciton which is just launching into the UK in summer 2021, and lots of top UK practitioners are working with it. Dr Maryam Zamani has the mjoule, as does Dr Benji Dhillon, and Lee Garrett has been offering Sciton’s BBL (broad band laser) treatment for years (see the video here).

Do collagen supplements work?

Yes, a lot of them really do help to firm up the skin – all over the body – and plump it up by improving skin hydration, too. What you need to look for is one that gives you 7,000-10,000mg of collagen per daily dose, and that collagen needs to be hydrolysed (ie to have had its large molecules smashed into tiny fragments that can be absorbed in the blood). If you can discover the size of the product’s molecules, the smaller the better. If that molecular size is 2 or 3 kda (kilodaltons), that’s terrific.

The brand I’ve chosen for my shop is Totally Derma, which is expensive, but it is particularly good at building collagen and hydration in the skin. This is because it has two patented-and-proven ingredients, one for regenerating collagen, joints and tendons, and another for improving hydration, so together they give particularly good results.

Hi Alice, I was told today that I should not use vitamin C or retinol from spring to autumn as I have the risk of hyperpigmentation.

Who told you that??! A good quality vitamin C and retinol will both help reduce hyperpigmentation, so keep on with them. You can read more about pigmentation issues here. What you DO need to do from spring to autumn is to be extra diligent with your sunscreen, and protecting your face from UV light as that is what will really kick off pigmentation in your skin.

After trying the Secret RF radiofrequency needling procedure, how do you think it compares to Morpheus8?

I think they are much of a muchness. The results depend on whether you’re the right kind of patient for it, and to some extent on the skill of the practitioner. All these types of radiofrequency microneedling can give great results.  I have yet to try Morpheus8 or Profound RF. Each practitioner I have spoken to about their choice of machine swears that theirs is the best, which leaves me none the wiser! Here’s the Secret RF video, if you want to see what treatment looks like.

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