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Hi Alice, I have been using Carita My CLE facial device which is a microcurrent plus LED device. I understood I should not use this on toxins-treated areas which makes sense as this would work against the effect of toxins. But what about after fillers?

Hi, oddly enough, microcurrent devices work really well on faces treated with toxin – because the microcurrent helps keep muscle tone in the muscles while they aren’t being worked by the usual facial expressions (toxin doesn’t do anything to the muscles; it disables the neurotransmitters that send messages to the muscles to contract. So, microcurrent is not directly counteracting the treatment). All the device manufacturers suggest you wait for two weeks before using microcurrent after toxin injections, and the same after filler injections (after two weeks, the filler will be properly settled).

Posting on behalf of my beautiful 65yo mum. Despite good skincare she has jowls, a drooping chin and a “turkey” neck. She has an autoimmune disorder, so Drs won’t do injections on her. What other tweakments could she look into, please?

When you have an autoimmune condition, tweakments aren’t necessarily off the cards. Many practitioners are happy to treat patients with autoimmune conditions BUT they will want a thorough consultation with your mum first; it might be possible to have injectables such as filler at times when her condition is well under control (but not when she’s had any flare-ups). Same for other treatments like radiofrequency microneedling, which can help with jowls and slack skin. Her best bet is to set up a consultation with a great practitioner in her area who will listen and talk her through suitable and safe options.

Hi, I am 64 and feel that the lines above my top lip are making me look old and tired. What treatment would you recommend and could you recommend a practitioner in the Nottingham area please?

Hi, take a look at our free factsheet on treating barcode lip lines – downloadable here – which will give you all the options. To find a great practitioner in your area, go to our practitioner finder and put in your postcode, which will come up with our trusted practitioners in your area.

How do I get rid of downward lines on my forehead? Vertical at the sides of my face I think from squishing my face into the pillow at night. toxins? I have regular toxins for my frown lines on my forehead so I don’t appear to be cross when I’m not but my practitioner says no to doing them for my vertical lines as it will make my eyebrows drop. I hate these lines but won’t have surgery. Any advice?

If your practitioner says toxins won’t work on these lines, maybe that is because they’re being made by the way you sleep, as you suggest, rather than by muscle movement. It might be worth trying something simpler than tweakments, like the Dr Harris Anti-Wrinkle Sleep Mask, which looks like a normal sleep mask but has small silicone bumps on the inside that press on muscle receptors in the face to relax them (it’s clinically proven to relax frown lines between the brows). These slight bumps are set in a pattern that goes over the eyebrows and around the sides of the eyes, and they grip the skin very gently and I find that these stop me from scrunching up my face when I sleep – Dr Harris, the inventor, says the same. It’s a lot cheaper than toxin, so it might be worth a try!

Can you recommend a good concealer and foundation which provides the best coverage and radiance for an older skin please?

Two products I’m loving just now because they give my skin a brilliant finish: the Pat McGrath Skin Fetish foundation which is v v expensive but completely fabulous, and Monica Blunder’s Blundercover which looks like a concealer but is a foundation and goes on with a brush. They’re both lightweight but you can build them up where you need them, which I think looks better on any skin than piling on a thick layer.

Please can you recommend the best at-home treatments for a sun-damaged neck? Would at-home micro needling make a difference?

Start with good, active skincare – a vitamin C serum, a moisturiser and a sunscreen in the morning, and a retinoid in the evening – and see what difference that makes. I’m not keen on home microneedling because most skincare products are not designed to be bombed deep into the skin through needled holes, and also most of us are not very careful about needling all areas of the skin equally, and gently. I’d prefer you stuck with skincare and when your skin is acclimatised to the retinol or retinoid that you’re using, moving up to a stronger product, to keep stimulating your skin to renew itself.

I had an Endolift treatment under my eyes in August. I believe I can see a slight improvement, but is it too early to get the final result?

Hi, I had Endolift treatment at the start of November 2020, and when I had ‘after’ pictures taken on a 3D Vectra camera three months later, you can see a small improvement in facial tightness, but it’s not huge. You can see the pictures on this post here. The results are meant to go on improving for up to a year after treatment.

I am interested in tummy and inner thigh fat freezing. I think you have had this done. Would you consider this a completely positive treatment and result?

Yes, I’ve had fat freezing both on my tummy and, many years ago in the early days of the procedure, on one of my inner thighs – and yes each time it worked well, without bruising or pain afterwards (which happens quite often). I never got round to having the other inner thigh treated so on the rare occasions I get to see both thighs stretched out equally – e.g. when doing Downward Dog in yoga), it’s clear which one was treated and which one wasn’t!

Is Ultracel the same as Ulthera, just with a new branding? Despite claims to the contrary, these treatments to seem to cause some facial fat/ volume loss?

I’m guessing you’re referring to Ultherapy here. Ultherapy and Ultracel are two different brands of High Intensity Focused Ultrasound treatment (HIFU). Ultracel is often recommended for reducing fatty jowls or bingo wings, so yes it can cause fat loss and often is deliberately used to do this. Ultherapy shouldn’t cause fat loss in the face – as long as the practitioner using it is well trained and is firing the bursts of energy at the right depth into the skin – but over the years I have heard a huge number of complaints from people who feel they have had fat loss following the treatment which are impossible to ignore.

Dear Alice, from what I can gather, I think you’ve had both radiofrequency with needling and also ultrasound treatments. My biggest problem area is my turkey neck and jowls. Which have you found to be the most effective treatment?

Hi, yes, I’ve had Ultherapy a few times over the past decade and it seems to have given me good results in tightening my lower face and neck, and more recently I’ve tried a couple of types of RF needling. The one that gave me the most obvious improvement was Profound RF, which is a hard-hitting, one-off RF needling procedure – there’s a picture on my blog showing the difference it made to my jawline 3 months after treatment.

I have been considering having Profhilo but another treatment called Pluryal skin booster has been suggested, have you tried the latter and is one better than the other?

Yes, I’ve heard of the Pluryal skin booster, it’s a good treatment – there are a great many brands of these ‘injectable moisturisers‘ (skin boosters are another term for the same thing) and they all do a similar job to regenerate the skin and improve its condition. If this is what your practitioner is suggesting, and you know and like their work, I’d give it a go. They will have their reasons for having chosen this particular brand, you should ask them what they consider to be its advantages over other brands.

Hello Alice, I did CoolSculpting 2 weeks ago and after the procedure they told me to do massages or LPG to get faster and better results in the future. Did you get the same advice?

Interesting! And no I didn’t get that advice, I just went home and left the treatment to do its work. I guess it sounds logical that further massages might help the lymph system eliminate the destroyed fat cells, but I’ve never even heard that suggested as a useful follow-up to fat-freezing. Personally, I’d save your money and focus on a healthy diet and exercise – those are the things that will really help you see results from fat freezing.

If I want multiple items – toxins, filler and Profhilo – but cost is an issue, what would the cost and results difference be between a great clinic like PHI in London and Skintique in Leicester?

The cost of procedures is less outside London; in terms of the results you’d get, what you really need to factor in is the skill and experience of your practitioner. They will discuss with you at consultation stage what your concerns are, what procedures would be beneficial for you, how much treatment you might need to move towards the outcomes that you’re after. That way you can decide, with their help, where your tweakments budget is best spent. The practitioner is crucial in all this, and the lead doctors at both PHI Clinic (as well as Dr Manav Bawa and Dr Amanda Penny who run clinics at PHI) and Skintique are very good and are on my list of trusted practitioners.

Which tweakment do you recommend for under-eye wrinkles?

First, a really good eye cream to hydrate and strengthen the skin, plus a sunscreen during the day to stop those wrinkles getting worse. Then maybe a type of radiofrequency microneedling, or a heat treatment like Tixel, that can be used close to the eyes to rejuvenate the skin, or an injectable treatment like PRP to regenerate the under-eye skin and smooth out the wrinkles. Find a great practitioner in your area, book a consultation and see what they can suggest that might help you.

What are your thoughts about radiofrequency microneedling? Does it really work, and if so, which one please?

Yes, RF microneedling is a great treatment which gives good results in smoothing and tightening the skin – there’s a page about this tweakment here, scroll down and you will see all the FAQs which will give you lots more info. There are many brands of RF microneedling, and they all work well in good hands. Every time I ask a practitioner why they chose the specific brand of RF needling device that they have in clinic, they say it’s because it is clearly the best, whichever brand it is. I would find a great practitioner who offers the treatment – there are many on the practitioner finder – and go from there.


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