CheeksEyesForeheadLipsLower FaceNeck/DecolletageNose face

Ask Alice

Find the answers to some of your most frequent questions.

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.

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.

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.

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 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.

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.

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.

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.

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 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.

Love to hear your views on CACI

It is a great treatment, you need to have a lot of them! Here is a Tweak of the Week video I did about the CACI treatment.

Hi, just wondering if you’d heard of Jalupro & Sunekos, and what your thoughts are? I’ve heard they’re comparable to profhilo, but am unsure of how or if they differ?

Jalupro I don’t know; Sunekos I’ve tried. It is made with concentrated amino acids to stimulate growth/repair in the skin, whereas Profhilo, Juvederm Volite, Teoxane Redensity 1, Belotero Revive and Restylane Skinboosters—which are all different brands of ‘injectable moisture treatment’, or ‘skinboosters’ as they are collectively known—use a fluid form of hyaluronic acid gel to hydrate the skin from the inside and encourage it to produce new collagen and elastin. So Sunekos and Profhilo (and the other HA Skinboosters) are aiming at similar effects, but via different routes.

Sunekos didn’t work for me—I had four sessions, with terrible bruising from the first, and unfortunately saw no noticeable improvements, and the brand asked me not to post the video I made about the procedure.

Is bruising normal for lip filler?

Yes, there is always a risk of bruising with any needle-based procedure, however good your practitioner is. If the needle nicks a tiny blood vessel… it’s just bad luck.

How many millilitres of lip filler should you get?

I’d leave it to your practitioner’s artistic judgement. There’s a popular saying in aesthetic medicine, that why you go to see a great practitioner is because you are paying for ‘the skill, not the ml’. ie you want them to use their artistic eye to judge what is appropriate for you, bearing in mind the size of your lips, and what the rest of your face looks like, rather than just using up what they have in the syringe, regardless.

What treatment has been the most successful for you?

That is so hard to answer. Most of them are successful in their own way, i.e. a successful lip treatment is great but very different from a successful course of microneedling. Totally depends on what you’re after and what success looks like to you…

What do you think about Ulthera for skin tightening? Or just ultrasound in general?

I prefer Ultherapy (Ulthera) to other types of HIFU skin tightening as it has a visualiser in the device so the practitioner can “see” into the skin and position each pulse at the right depth so it hits the collagen layer, not the fat.

I absolutely love your brows! What do you do and where do you go?

Thanks so much for your kind words, at the moment they’re laminated by @suemarshlondon – which involves perming and tinting them to give them more volume and, er, presence! One day I will go to @iamrachelpitman who does very superior microblading.

In my upper inner arm the skin look puckered – have you any suggestions how to improve it?

What about Profhilo or one of the other injectable moisture/skin booster treatments? They are meant to have a slight tightening effect? That or BodyTite, which uses radiofrequency energy to tighten the skin.

Do you know of any non surgical treatments for a slight underbite?

Sorry, but no. If you have a retrognathic chin, i.e. overbite/weak chin, you can have fillers to advance the profile a bit, but not the other way round.

Are there any non-surgical breast enhancement treatments available?

Short answer – no, there are no non-surgical breast enhancements. There used to be one  – called Macrolane, like a mega-density filler, launched in 2008, but it was taken off the market a few years later because of all the problems it caused.

Has the use of sunscreen depleted/contributed to our very low vitamin D levels?

We’re all usually short of vitamin D by mid-winter and the best thing to do is to use supplements as a matter of course – as they’re cheap and helpful. In the UK, the sun is only strong enough to create vitamin D in the skin between April and September, and then you have to weigh up whether you prefer to go with your face unprotected and take the damage that may cause to the skin. Using sunscreen doesn’t contribute much to low vitamin D as very few of us are scrupulous enough with our application of it to stop vitamin D synthesis altogether. I prefer to protect my face and, when it’s warm enough, expose my arms and legs to the sun, but whenever I’m tested, my vitamin D levels are always low.

Have you heard about threads for ankles?

Yes but I wish I hadn’t. If you ask me, it is completely mad that a treatment like this is even on offer. Do practitioners seriously think it’s a good idea to run multiple threads through the skin around the ankle? Have we all become so fixated on supposed imperfections that we are prepared to even contemplate something like this? Please, no!

Hello are the tweakments you suggest for each concern, in order of which one works best?

Hi, no they’re not – though if some tweakments are the gold-standard most obvious thing for a particular concern, I try to point that out. It’s always really hard to say what is ‘best’ for any concern – and it depends to some extent on how your face is looking, how much you are bothered by the particular concern, how much money you are looking to spend on treatment, whether you are prepared to try more aggressive treatments that require more social downtime, and so on. Find a great practitioner (lots on the website here), have a thorough consultation with them about what they’d suggest for your concerns, take time to think about the options, and go from there.

Could you please let me know when you expect a restock of Totally Derma

Very very soon! Also, you can place an order online ahead of the stock arriving, so you’re first in the queue

I’ve been taking Altrient C 3 x daily and it really works the snag is I can’t afford to continue. I could manage 1 x daily but would that have no effect? Any advice would be gratefully received

Hi, so glad to hear that Altrient C works for you, too, and yes, absolutely, you will still see results on 1 x sachet a day. Taking three doses daily for three months is the way to get the maximum results most quickly – that was the regime I followed when trialling the product, because that was the protocol for Atrient’s own trial with the product. But that trial found that after three months, there was no additional benefit to the skin of taking three a day so you might as well take two a day as a maintenance dose. One of my friends has only ever taken one a day but found that was plenty to strengthen her skin and help heal the cracked fingertips she always suffered with during the winter. And one a day is brilliant for supporting our immune systems, too.

Here’s the blog I wrote back in 2018 about trying Altrient

Here’s the link to Altrient C in the shop

Nearly two weeks ago I had Botox for the first time. It was by someone local to me who had been recommended. I’m 49 and had it in my forehead. Unfortunately (and now I’ve seen lots of references to this online and in your book) it has lowered my eyebrows and made my eyelids almost non existent. (Not eyelid droop. Just eyebrow droop). It has caused me huge distress, not the least because I didn’t tell my husband or anyone about it. No one has said anything but I’m extremely stressed and self conscious about it. I’ve read that it can sometimes be fixed (at least In part) by further Botox in a different part (that wraps around the eye) to lift it. I’ve also read that it should just be left. I wondered if you could suggest anything to help?

Your poor thing, huge sympathies, I completely understand how distressing this is. I would strongly suggest that you just leave well alone and let it wear off. Yes, technically a really skilled and experienced practitioner might be able to achieve some improvement – but the trouble is that the muscles that lift your eyebrows are already disabled for the time being, and nothing can change that. But hang on in there, your forehead muscles will regain their former movement. How long will it take? That depends on how much toxin the practitioner used, but your normal movement patterns should start to return between 6 weeks and three months.

Do you have a post or any advice on treating under eye hollows? I am terrified of looking fake, weird or done but on discovering this treatment is available i am very interested. Could you point me in the right direction?

Yes I do. I totally understand why you’re cautious about having filler in your tear-trough area to treat under-eye hollows, but if it is well done, this is a brilliant treatment to disguise the appearance of those hollows.

Take a look at this video where Dr Saleena Zimri is demonstrating a tear trough procedure

And take a look at this page which is all about hollow eyes and what you can try – scroll down the page to see all the FAQs

In your opinion is Dermalux able to tighten the skin enough I would not need Morpheus8 if I used it regularly?

Hi, short answer – no. these are two very different treatments. Yes they both work by stimulating collagen production in the skin, but they work in different ways.

The Dermalux Flex is using red LED light to gently rejuvenate the skin, by improving hydration, prompting the development of more collagen and reducing inflammation in the skin so it takes down redness and also reducing uneven brown pigmentation. As you say, the benefits are cumulative, so you need to use it consistently – and the more the better.

Morpheus8 and other forms of radiofrequency microneedling  cause huge immediate damage to the skin, by creating thousands of pinprick holes with the needling (so your skin races into healing mode, to repair that damage which results in fresher, stronger skin), and by heating the collagen within the skin with radiofrequency energy, which causes it to shrink, and then regenerate over the next few months, so you get a much more drastic tightening and smoothing than with Dermalux

Having said that, Dermalux will – as you may have seen on my videos — give you terrific results over time and is something you can use as regularly as you have time if you have the device at home. And it’s great for accelerating the healing process after any other tweakments.

Q&As on Dermalux Flex here 

Why I’ve added Dermalux Flex to the shop on TTG

I am considering Profhilo but another treatment called Pluryal has been recommended, which would you suggest?

Hi, all of these injectable moisture treatments such as Profhilo and Belotero Revive and Juvederm Volite are great for delivering a deep and lasting hydration which enables the skin to rejuvenate itself  (make more collagen, tighten up a bit etc) and Pluryal is a decent brand though I haven’t tried it myself. It’s different in that it contains a cocktail of antioxidant ingredients as well as hyaluronic acid, which makes it a bit more like a mesotherapy mix, but a properly hydrating one. Ask your practitioner why they are suggesting that particular brand, and if you are satisfied with the answer give it a try.

I get awful bruising after every treatment, do you have any suggestions to help minimise the bruising?

Hi, yes, try Hirudoid cream – which you can find at a pharmacy or online. It’s brilliant for reducing bruising.

Other things which I reckon help to speed up bruising include Altrient liposomal vitamin C, very good for all sorts of healing; sessions of LED red light therapy eg Dermalux which you can find at salons and clinics or even buy your own for home use, and the NuFace Fix – it’s not an official use of the gadget but because it improves the microcirculation in the skin and lymph drainage I am pretty sure that it speeds up the dispersal of pooled blood that is causing the bruise, to send it on its way that bit faster.

What is your experience with HIFU? Is it not dangerous to the layers of muscle underneath?

I’ve had three successful treatments over the past 8 years with Ultherapy, which is a branded version of HIFU (which stands for High Intensity Focused Ultrasound).

Here’s a video where I’m talking about the treatment in general.

No, it’s not dangerous to the underlying muscle – it is aiming its focused point of ultrasound energy at the collagen layer surrounding the muscle, and it needs to strike that precisely in order to damage that collagen and stimulate new collagen growth, which is what delivers the tightening to the skin over time.

The thing with HIFU treatment is that you want to be treated by someone really experienced with the machine and the techniques needed. The Ultherapy device has an ultrasound scanner built into it, which helps because the practitioner can see exactly where/ how deep in the skin each shot of focused ultrasound is being delivered.

I chicken out of eye surgery for now, can you suggest anything else I can do for eye lids other than surgery?

Hi, there are a few treatments you could try to tighten the skin on the eyelids and around the eye area. None of these will give as quick, clean or definitive a result as eyelid surgery (blepharoplasty) but they could help.

  • Ping, a radiofrequency skin-tightening protocol put together by Dr Sach Mohan, which is specifically designed for non-surgical skin tightening around the eye
  • Laser skin tightening, with a fractional laser – practitioners including Dr Maryam Zamani can offer this with the Sciton laser, other practitioners will have their own favourites. You do need to wear intra-ocular shields for this procedure, which are like metal or plastic contact lenses slipped into the eye to protect it while the laser light works on the skin.
  • Tixel, which is a device that generates plain heat energy (as opposed to light energy or radiofrequency energy) can also be used on the eyelids as well as around the eye. I had good results from just one treatment of this a few years ago.
  • You could also try anti-wrinkle injections in the forehead, to raise your eyebrows a bit, which can make saggy eyelids look less saggy.

I’ve used both Rio 60 second facelift and recently purchased Nuface mini, have you tried both xand if so which do you prefer please?

Don’t know the Rio but I love the NuFace

I am 57, have regular Caci & RF treatments. I also use my Nuface Mini. Been reading up about Coolsculpting and considering it for jowl area. My skin is in pretty good shape overall and would love your advice. Also, I live in Brighton area, so ideally, would be great if you could recommend the best clinic near where I live.


Hi, it sounds like you are taking great care of your skin. I’d always suggest a consistent skincare regime with active ingredients like vitamin C serum in the morning to brighten and strengthen the skin, plus a hydrating sunscreen, and retinol or another kind of retinoid at night to stimulate collagen boosting and improve skin texture.

CoolSculpting aka fat freezing or crylipolysis can be really helpful for shrinking fat below the jaw – you need an expert practitioner to assess your face and jawline and see if you would be a good candidate for this. They also need to explain the potential complications of the procedure, which is something lots of people are asking about since Linda Evangelista has talked about how CoolSculpting went wrong for her.

When it comes to finding a practitioner in your local area, have you taken a look at the practitioner finder on the site here?  These are all people whom I would trust with my face. You can put in your postcode and see who comes up.

practitioners in the USA, is there anyone that is a safe choice who I could see for a consultation in the San Francisco Bay Area?

Hi I’m sure there are many great ones but with apologies my practitioner-network is UK only for the time being.

Lyma Laser: do you have an opinion on this device

Yes, and it’s not positive (I’ve been trying it for months with zero results). I’m currently gathering some opinions from professionals in the area before I do a bigger post about it.

Botox at Superdrug – Did you ever get a Botox treatment done at Superdrug and how did you find it? I am considering it but general feedback has been very negative (although not from people who have used clinics) because of it being a High Street Chemist

I think that negative feedback is so unfair. Let me explain.

I was sent by one of the papers to be the first person to get a Botox treatment at Superdrug  – and the only reason I didn’t get the treatment was because they (quite rightly) turned me down because, working through the very detailed questionnaire that you have to fill in before treatment, they discovered I’d had a toxin treatment only two months before and they correctly insist there should be a three-month minimum gap between appointments.

It maddens me that the feedback is so negative because Superdrug has done everything very correctly. They have partnered with the leading brand of botulinum toxin and fillers, they are only employing practitioners who are well trained in cosmetic injectables and have a good deal of experience, they check everyone’s birth-date and won’t treat under 25s and they insist on an initial consultation and a cooling-off period before they will treat anyone.

… all of which puts them streets ahead of all the non-medical and barely-trained people who are already offering injectable treatments in back rooms on the high street at other chemists, beauty salons and hairdressers.

People complain – wow, shocker – that this is bringing Botox to a high street chemist. They forget that Boots introduced Botox to its treatment offerings in leading branches back in 2002 (it was ahead of its time, wasn’t all that popular, and was dropped).

What these people don’t see is that Botox is already on their high streets, though it’s not usually offered in an upfront, clear, medically-based sort of way,


Here’s a link to the blog post I wrote about it at the time

Do you only sell skincare creams etc in bundles?

No, we sell everything individually, as well as the bundles. Try this link, it will take you to where the products are listed one by one. Browse all products in the shop

When you say practitioners should have a medical background, does that mean doctors only, not nurses?

Hi and goodness no, I’m not against nurses doing cosmetic injections, as long as they have lots of training and experience with relevant aesthetic products and techniques.

When I say that aesthetic practitioners should have a medical background – that’s a basic starting point. Whether these practitioners are nurses or doctors, surgeons or dentists,  what really matters is how much training they’ve done and how much experience they have notched up, putting that training into practice. Can they recognise and handle the complications that can occur with cosmetic procedures? If they inject filler into a blood vessel for example, and block it (which can lead to tissue necrosis, where the surrounding skin tissue dies, if not swiftly treated) will they spot what they’ve done? And do they have a prescribing qualification, in order to be able to obtain the prescription injectable product needed to dissolve that blockage? These are all things to think about and factor in.

I don’t want, say, my GP (who has a medical background) offering me injections of fillers etc unless or until she has really learned the art and science of medical aesthetics.  If you look through the practitioners section on the website you’ll see there are nurses, doctors, dentists and surgeons on there.

NB – There’s also a handful of top laser practitioners listed on the site here who don’t have a medical background, but who have years of experience so they are extremely good at what they do., which is why they’re on the list.

Can I put Retin A on my neck?

Yes you can – but go carefully. Retin-A is prescription strength and STRONG. If you have been using it on your face, you’ll know that you need to start with tiny amounts, maybe mixed in with moisturiser, and only increasing the dose once your skin has learned to tolerate it.

There are fewer oil glands in neck-skin (one reason why it’s always drier than the face) and any retinoid, particularly Retin-A, will hit it hard, so you need to go extra cautiously. I’d suggest mixing a very small amount of the product in with a moisturiser, any moisturiser, so that it is spread very very thinly. Once that has absorbed, stick some more moisturiser on top. Twice a week at first, and see how you go before increasing either the amount or the frequency.

And if your neck just hates it (goes red, dry, itchy) with even minimal amounts, get an over-the-counter retinol or retinoid that isn’t so strong, and go gently with that.

PS have you asked whoever prescribed you the Retin-A about this? I have a lot of experience with skincare but I am not a doctor.

Read more about retinol and retinoids

Hi. My dermatologist is retiring. I have followed Alice for a while and so turned to her website for recommendations of a new practitioner after I’d seen her discussing with Trinny (I think it was) that Alice who happily be treated by anyone she links from her website. I put in my post code and found a local practitioner. She seemed good but when I mentioned how I’d found her she said “excellent, you pay for these things but you’re never sure if it’s worth it”. Have to say I was quite shocked and before I take it further with her , can you confirm how you select people to recommend please? Thanks in advance.

Hi Suzanne, I understand your concern but I can assure you people do not just pay their way onto the site. I only invite doctors/ derms/ surgeons/ nurses whose work I know, or ones who are members of BCAM, or who are key opinion leaders for leading brands of aesthetic technology, to list on the site. If they choose to list, they are charged a small administrative fee. I get approached the whole time by practitioners whose work I don’t know – I ask them to get themselves recommended to me by two people I do know, then I’ll consider them for the site. That’s why this is a short list of practitioners, out of the thousands who are out there and yes these are all people who I know, from my years in the business, do good work and that’s why I trust them. I don’t – like many businesses in this area – get paid on referral, either. Also, there are lots of well-known names who should be listed on my site but aren’t yet, because I have yet to persuade them to join. Hope that reassures you.

Transplant recipient with fat thighs buys cool sculpting at home packs will they work or be a danger to me?

Eek, I really wouldn’t. If it’s some random form of at-home fat-freezing that sounds horrific. Will it work? I very much doubt it. Is it dangerous? If you give yourself ice-burns from it. PS CoolSculpting is a high tech brand of equipment, they don’t sell at-home kits!

Can I ask your advice on treatments for a double chin? I have been offered various which include Emerald (laser) or Accent Prime X from one clinic and Ultracel Q plus combined with Exilis and hydra facial and possible filler.

It kinda all depends on your double chin, though I’d say Accent Prime might be your best bet – or perhaps CoolSculpting (fat-freezing)? Or Exilis and Ultracel QPlus though that’s going to get quite expensive. Hydrafacial is a deep-cleansing mechanical facial so won’t do anything for a double chin. Filler might help only by strengthening the line of the jaw to hide what’s underneath, but it’s not going to get rid of fat or tighten the skin. Take a look at my double chins page on the site – all the treatments I’d suggest are on here.

Hi Alice, I have lines below my eyebrows which l believe cannot be reduced by surgery. My dermatologist has recommended laser. Is there a risk of pigmentation post treatment?

Hi, yes, laser – in the right hands- might well be able to help these lines by tightening the skin. There is always a potential risk of hyperpigmentation if laser is used inappropriately, so make sure you’re in good hands. There’s more info on laser skin resurfacing here and there’s a Tweak of the Week video about one of the Sciton lasers here If laser treatemnt is done really close to the eye, you’ll need to wear a kind of metal contact lens to protect your eyes during the treatment.

I wanted to ask what level of Tixel treatment you had on your eye area that you describe in your book please. I’ve just had the open channel treatment but have since read this doesn’t actually tighten the skin. Can you advise please?

Hi, I had a straightforward clinical treatment to create damage in the skin in order to make the skin regenerate/ tighten etc which worked well (you can read about it here). An  ‘open channel’ Tixel treatment uses the Tixel on a very light setting to push serums or treatment products more deeply into the skin – but no, you don’t get the heat/ burning/ skin regeneration from that.

Hi, I’m due for a Botox appointment tomorrow but have got a horrible cold. Can I still get Botox while ill? I’ve got a negative PCR test. Thanks!

Get in touch with the clinic- they are the ones to answer this not me! Even if it isn’t Covid they may prefer you not to bring your cold into the clinic.

Hi Alice, I recently went for a consultation re cheek fillers at the Cosmetic Skin Clinic. I had a lot of research beforehand but was surprised to learn that blindness is a rare but possible complication. Please could you advise if there are stats on this

Good question. They are absolutely correct in telling you that blindness is a potential, though extremely rare, complication from injectable fillers. This can happen if filler is injected into a blood vessel and travels up through the face to block the optic nerve. It is good to know that they are advising you about all potential complications, however rare, because often popular treatments like filler are done very casually as if they were beauty treatments, when they are medical cosmetic procedures. Precise stats are hard to come by. Because of the lack of regulation around injectable fillers, anyone can perform the treatment and there is no compulsion for them to register complications though complications as bad as potential blindness are usually referred to top practitioners in the hope that they can sort them out.

Dear Alice- please could you remind me of the name of the hairdresser you featured on your Instagram some time ago – this gentleman was talking about his hair care brand which I would be interested to buy but I cannot remember his name. Many thanks

Absolutely, it was Michael Van Clarke.

Where is Tatiania lapa practicing because I want her to treat me

Dr Tatiana Lapa is practicing at her clinic in Devonshire Place, London. You can find out more information about her and her clinic here.

Hi Alice – I’ve seen a lot of press for the Lyma laser – have you tried this at all or have any feedback on it?

Yes, and it’s not positive (I’ve been trying it for months with zero results). I’m currently gathering some opinions from professionals in the area before I do a bigger post about it. And I am having the power it delivers assessed by an independent manufacturer.

I am considering the Newa Rf device for skin tightening. Is this a good investment 🤔?

Some of my friends have seen results with this device; I’m about to try out a new home use RF device called Orlaya which looks like it has much more potential as it is much more powerful than the other brands of home-use RF – so I’ll let you know how I get on with that in a month or two.

Is there a good alternative to lip fillers? I’ve been to two doctors (including Dr Harris) and both said no due to the line of my upper lip and it wouldn’t look natural. I don’t want a surgical lip lift (yet) and want to combat signs of aging…

If top docs are saying ‘No’… you need to listen to that. There are no-needle lip plumper treatments like Perk, which is an attachment to the Hydrafacial magazine, which exfoliates and super-hydrates the lips which gives a plumping effect. It doesn’t last long but that, plus clever makeup, may be your best bet for now,. .

Hi Alice, I am considering Profhilo for the first time at Dr Nestor in Edinburgh. I have had a consultation with him but still nervous about having needles in my face. Is there any other treatment you would recommend that doesn’t use needles?

I’d have another chat with Dr Nestor, or one of his previous patients, about the treatment and how they found it. He’s a fab practitioner, it is a very quick treatment and really not that painful. Profhilo is a great product and where it scores over the other ‘injectable moisturisers’ that do the same thing is that it only needs 5 injections on each side of the face to put it in place.  But I do hear what you are saying – there are loads of treatments that will hydrate the skin – but nothing that will give you the same sort of skin-regeneration from the inside out.

You might have had this question previously, but what are your thoughts about facial yoga? It seems rather time-consuming and I’m not convinced about the results.

Nnnngh, I never quite know what to say about facial yoga. I love the idea of it – of keeping your muscles pliable and strong through careful exercise. Do they work? I don’t know. You’d need to commit and try it for a while to be able to judge for yourself, and do it diligently. The one face-exercise system I’m really curious about and am going to try is facial pilates by Carme Ferre – the app is called FaceToned – as I know that she really knows her stuff for face as well as body.


Hi Alice, I watched your video on Secret RF, can you describe the results you got and how many treatments did you have? Thank you xx

Hi, I only had the one treatment (I was advised I’d need at least three to see proper results, at my age) so… I didn’t see much change in terms of tightening except in the texture of the skin, which was lovely – noticeably smoother and fresher. I’ve since tried a different brand of RF needling and I will post about that soon.

Is the FaceGym MediLift any good ? It’s very expensive but I like the hands-free design,I’d appreciate the benefit of your experience please? Many thanks

Hi – I haven’t tried it so can’t comment but yes it is expensive!

I have had regular Botox and now does not seem to work why is this? Is it the product injector (tried a few) or is it that body not accepting this anymore . Any suggestions?

It is really rare to become resistant to Botox but it’s not impossible. Do any of your practitioners have any suggestions about this?

Hi was wondering about having fibroblasts treatments. But am worried about scarring as I have pigmentation. The technician recommend a treatment called Sunekos, what do you think of this treatment please

Hi, by ‘fibroblast treatment’ do you mean something like the so-called ‘plasma pens’? I am not a fan of these, they are not likely to delivery decent results and the chance of scarring from burns is high. I’ve tried Sunekos (which is like an injectable moisturiser or skin booster, but works in a rather different way) but I didn’t see noticeable results even after four sessions

Hi Alice, are you able to do consults with folks in US (Pacific Time / Los Angeles)? Would love a provider neutral opinion on several procedures you discuss in your book. Thanks!

Yes absolutely, I am sure we can work something out! If you email tilly@thetweakmentguide.com, she will be able to help with this.

Can Lanluma be used on your face?

Yes, there is a version that can be used in the face to boost your own collagen to add fullness.

What are your thoughts on Cosmelan for treating melasma?

Cosmelan and its sister treatment Dermamelan are extremely effective professional programmes for treating all types of pigmentation, including stubborn melasma. Melasma can be particularly tricky to treat because it is hormonally driven, which means it can come back time and again. When it comes to melasma, treatment is more a question of managing it rather than fixing it. Cosmelan has been shown to give long-term clearance and can be repeated if necessary. It can be a slow and frustrating business, though. Find an expert practitioner and get them to assess you carefully before you get going on this. 

Read more about pigmentation issues and melasma

Hi could you recommend a high standard « natural » Botox place in Surrey? Am based in Guildford and trying to avoid another trip to London. Thanks

Take a look at the practitioner-finder here on the site. Put in your postcode and it will show who’s nearest to you among my trusted practitioners.

Hi Alice. My friend recommended your site. I am considering Aqualyx instead of Kybella/Belkyra. Are you familiar with this also? I suffer from anxiety so any opinions welcome

Hi Aqualyx works well to dissolve small areas of fat and it works in exactly the same way as Kybella/ Belkyra.

Take a look at my page on fat-dissolving injections, too, and scroll down to find all the FAQs around the treatment.

Then once you’re well-equipped with what you need to know, have a consultation with whichever doctor you have chosen to understand exactly how they would use the product in the face. These treatments need specialised injection techniques in order to get the best results.

Bear in mind that the treated area is going to be swollen and painful/itchy for up to a week after treatment, and you will need more than one round to treatment.


Hi Alice is it worth investing in mynuface as mixed reviews? What do you think is best for 50-year-skin especially with deep wrinkles above lips? Microneedling, fractional laser?

Hi, I love the NuFace and definitely think it’s worth investing in (get the small one, it has the same power output as the larger one, it just doesn’t have changeable heads). BUT it is not going to fix deep wrinkles above the lips.

For that you are going to need the sort of tweakments that can stimulate collagen production so, yes, clinical microneedling is good but Radiofrequency Microneedling is even better for this.

Laser – fractional is more tolerable than plain ablative laser – can also work wonders on lip lines but obviously the deeper/ heavier the treatment, the longer the recovery time is going to be.

And skin-booster/ injectable moisture treatments such as Profhilo, Belotero Revive or Juvederm Volite can also help by stimulating skin regeneration in the area – but do these after laser/ RF needling, rather than before.

Here’s a link to my page on treating lip lines 


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