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CHOOSE AN AREA OF THE FACE AND CONCERN AND CHECK OUT YOUR SKINCARE AND TWEAKMENT OPTIONS

CheeksEyesForeheadLipsLower FaceNeck/DecolletageNose face

Ask Alice

I have been offered fillers for an unsatisfactory result of a facelift and fat graft. Please can you recommend someone in London?

Have a look at our Practitioner Finder to find someone we trust near you. Pretty much every practitioner on there offers dermal fillers, so you shouldn’t have any trouble finding someone. It may be wise to let the results of your facelift and fat graft settle for some time though before you go in with injectables. Make sure you visit your practitioner for your follow-ups and to discuss why you’re unhappy with the results from these procedures – dermal filler won’t replicate the intended results of a surgical facelift.

Hi Alice, could I please ask what your thoughts on threads are? I could do with some help with my jowls and under my chin. Many thanks! X

Hiya, editor Georgia here. Threads can achieve great lifting and tightening results in the right hands and providing you’re a suitable candidate. There are different types of threads and some are better suited to certain indications than others (e.g. the degree of skin laxity). You can also have bio-stimulating threads which help stimulate collagen within the skin, so you also get a gradual improvement in skin firmness. Threads are deemed ‘minimally-invasive’ but they aren’t for the faint-hearted, and things can go wrong. Plus, the results don’t always last as long as advertised. It’s really important to find someone who knows what they’re doing and gets consistently good results that age well. Use our Practitioner Finder to find someone near you who specialises in threads, and set up a consultation. In the meantime, Alice wrote a really in-depth factsheet on threads which you can download for free here.

Monthly Hydrafacial or monthly Caci? I’m 43 with skin in reasonably good condition but starting to notice some signs of ageing, so planning to treat myself to a monthly facial.

Hiya, editor Georgia here. In an ideal world, budget permitting, you’d do both! HydraFacials are more geared towards extractions and hydrating the skin, improving surface issues like breakouts or dry skin. You do get some collagen stimulation from the LED light element but if your main concern is signs of ageing then I’d go for monthly CACI treatments instead. CACI is specifically for combatting signs of ageing by stimulating the facial muscles using electrical microcurrent. If you’re new to CACI, you’ll be advised to book a course of treatment and to have the first few treatments a fortnight apart. Find out more here.

Is fractional laser better than a peel for sun-damaged pigmentation?

It really depends on the type and severity of your pigmentation. In theory, there are lots of tweakments that can clear pigmentation, but the right one for you is hard to determine without seeing a pro. Your best best is to have a consultation with a brilliant practitioner near you who can properly assess your skin and discuss your options. It may be that you need to layer a few different treatments to really tackle the pigmentation, or it could just come down to practitioner preference or your budget in terms of what they advise you go for. You can find out lots more about sun damage in our in-depth factsheet, downloadable on this page.

What is your advice on filler removal? And which practitioners would you recommend, as it is difficult to search out this treatment?

Hiya, editor Georgia here. Your first port of call should be the practitioner who injected the filler in the first place, as they’ll know exactly how much they injected, where and which product they used. If this isn’t an option (maybe you had a bad experience and you don’t want to go to them again) use our Practitioner Finder to find someone near you who we trust. Any practitioner who does dermal filler will be able to dissolve it, and will also be able to advise on any follow-up treatment to meet your needs. If you know – or can find out – the details of your previous treatment as mentioned above, that will make the dissolving easier for the practitioner.

Toxin for some reason doesn’t work on me. I recently had soft fillers around the eyes and that made minimal difference. Is there any other treatment you would recommend? My practitioner can’t understand why it doesn’t work because I still have muscle movement.

Hiya, editor Georgia here. It could be that you are resistant to the drug (botulinum toxin), but this is really quite rare. Manufacturer clinical trials showed that no more than 1.5% of patients develop ‘neutralising antibodies’, and the figures are something like 1 in 10,000 that it doesn’t work for. Usually, if the treatment doesn’t work, it can be because of the dosage (not everyone’s the same, and some people need a higher dose) or the dilution of the product. You could try another practitioner if yours perhaps isn’t quite so experienced. Toxin and fillers around the eyes will usually do different things (sometimes both are an option for the same indication), so this could be why you haven’t seen much of a result with your concern. I’d suggest finding a new practitioner and starting afresh with whatever your concern is – you don’t mention exactly what it is that bothers you about your eyes – and they can use their best judgement about what’s most likely to work.

Hi Alice, which is better for skin tightening (especially around the eyes and nasolabial) – Morpheus 8 or ULTRAcel? Which will give longer lasting results and give a greater skin tightening effect please? Kindest regards.

Hiya, editor Georgia here. You’re probably looking at much of a muchness here and it may well come down to downtime and/ or budget. Both Morpheus8 and ULTRAcel use radiofrequency energy along with microneedles to lift, tighten and address fine lines and wrinkles. But, ULTRAcel also combines HIFU (high-intensity focused ultrasound) for a really souped-up treatment. This doesn’t necessarily mean all three technologies would be used on you though – that would be up to your practitioner to decide. Morpheus8 can be used safely under the eyes right up to the lower lid. Find a great practitioner, set up a consultation and get their expert opinion on what would work best for you.

Hi Alice. I’m looking for a recommendation for clinics in London who offer lip filler (and potentially non-surgical rhinoplasty filler). There are so many that come up upon searching and I’m looking for a good recommendation.

Hi, do you mean there are so many that come up when you search on our practitioner finder? To narrow your choice down from there, go onto each practitioner’s website and look at examples of their work with lips and noses, to find someone who does a lot of the sort of work and gives the kind of results that you are looking for.

I was going to buy a Current Body LED face and neck mask. Is it worth the money? My skin looks good but I have a crepey neck and jowls. Thanks for your help.

I know a lot of people enjoy using these masks but I really don’t think they’re strong enough to make a noticeable difference to crepey skin – you need a clinic-strength LED light for that. You’d be better off with a skin-reconditioning treatment like injectable moisturisers, or in-clinic LED light sessions.

Hi Alice, I felt unwell this week with some specific and non-specific symptoms and now I have sore lumps appearing where I have previously had filler – chin, corners of mouth, right cheek and right nasolabial fold. Taking anti-histamines – do I need steroids?

Hi, it sounds like your immune system has taken a knock and your fillers are swelling as a result (it’s not that common, but one doctor friend tells me that’s how he knows when he’s about to go down with a virus – his fillers start swelling). Antihistamine should be enough to soothe them until they calm down. If not, ask your practitioner for their advice on what to try next. No, it doesn’t mean that you can’t have filler in future, but just that to be aware that this may be a recurring problem for you, going forward.

I was wondering how I could firm the skin on my neck and if you recommend a particular product, please?

Take a look at the Neostrata Triple Firming Neck Cream – it’s one of our bestselling products in the Tweakments Guide shop and there’s a reason for that – it does a great job.

Hi, I’m wondering what you think of plasma fibroblast for the eyelids?

All those non-surgical plasma treatments for hooded eyes really scare me (all those tiny burns! All that potential damage!) but my doctor and surgeon pals who use it say it is a great tool – and in their hands, really experienced, expert hands, I am sure that it is. I would not want it done by anyone who wasn’t a highly qualified aesthetic practitioner.

Hi Alice. I get RF facials done and I also had HIFU last September. I just had another round of HIFU done. What I want to ask is, I bought the Sensica Sensilift RF handheld tool mini version – has this had good results?

Hi the Sensica ought to give results if you use it enough, but as with all home-use devices you will need to be very consistent with it, follow the instructions to the letter and use it as much as they tell you to, in order for it to get a chance to work like it’s meant to.

I’m 56 years old – post-menopausal. My skin is ageing – fine lines, wrinkles and loss of volume. Bit nervous of treatments. Injectable moisturisers or radiofrequency? Any advice please.

Well, it slightly depends what result you’re after. Injectable moisture treatments are great for hydrating and re-conditioning the skin and will give a certain amount of smoothing and a bit of tightening. They cost around £400 a session and you’ll need two or three of them to see a result – click here to read our detailed article on the cost of these treatments. RF microneedling is better for skin tightening and smoothing – it’s a much more aggressive procedure that provokes wound-healing and remodelling of the collagen over the following three months – and it’s much more expensive, it costs between £850 and £1,500 per session, and you will need two or three sessions of it. Maybe find a great practitioner and get their opinion on what will most benefit your particular face.

Good morning Alice, I have just discovered you and your fantastic website through Instagram! I was wondering what you think of Institute Esthederm SPF? It doesn’t tell you what protection it is. I can be sensitive since menopause. THANK YOU.

Hi, it’s a great brand though, yes, it is really confusing because they describe their approach to sun protection in such a very different way to everyone else. Just pick one of the products that describes itself as High Protection or Very High Protection and you’ll be fine. Also, if your skin is sensitive since menopause, that may be because it is drier, and the skin barrier isn’t as good as it used to be, so give it a hand by using a hyaluronic acid serum after cleansing, then a moisturiser (preferably one with ceramides which are good at holding moisture in the skin and allowing it to rebuild that barrier) before you put your sunscreen on in the morning, and use the serum and moisturiser again in the evening.


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