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Ask Alice

Best skin-tightening option please Alice – HIFU (any sort?), Sofwave or Emface? I am 52 years old

Hiya, TTG editor Georgia here. It’s hard to say as they all work differently and have different merits depending on the exact indications and your individual face. I’d book in for a consultation with a practitioner who offers a good selection of options and get their opinion.

What can be done about dark/ age spots on the backs of my hands? Should I use my retinoid cream? Also, how can I improve the ruddy appearance of my décolleté?

Hiya, TTG editor Georgia here. I’d get a hand cream specially formulated for age spots on the hands that contains pigment-reducing ingredients. Opt for one with sun protection too and make sure you apply it liberally throughout the day. And whenever you’re out in the sun or on holiday make sure you’re slapping on the sunscreen, as sun exposure will only make the existing age spots worse and cause new patches to develop. Tweakments-wise, IPL or a professional skin peel can get rid of them. For your decolletage, try IPL or laser to reduce the redness, plus a couple of rounds of injectable moisturiser treatment to brighten the skin and improve its texture.

Hi there, which do you recommend for an over-55 year old – Tixel, microneedling or HIFU for nasolabial folds? Don’t mind a bit of downtime or pain. Don’t want to use fillers. Thanks!

Hiya, TTG editor Georgia here. Of those three, Tixel – in its most intensive mode, which is the ablative mode – would be most likely to have a good crack at softening nasolabial folds if you want to avoid filler. There’s quite a bit of downtime though, and (as with anything) you’d need a full-face treatment to contract the skin upwards away from gravity’s pull. Find a great practitioner who can advise you on what will be best for your particular face.

I’m looking to tighten my neck and jowls. Can you advise which gives the best results between the following treatments – Morpheus 8, Profound, and NeoGen Plasma? Also have you heard of Facetite (a fine probe in place under the skin to tighten).

Hiya, TTG editor Georgia here. What will give you the best result depends on your neck and jowls specifically – how much sagging you have, if it’s skin or fat – and other factors like budget, how much downtime you’re willing to deal with, etc. Morpheus8 and Profound are RF needling devices that can be used in a certain way to melt fat at the same time as tightening up the overlying skin via stimulating collagen production, but if there’s a fair bit of fat in addition to skin laxity, you’d be better off going with Facetite because liposuction can be done at the same time. Find a great practitioner who can advise you what will be best for your particular face.

Hi Alice. I have read about Ellevate for neck treatments. I think it’s quite new. Do you have any information on it?

Hiya, TTG editor Georgia here. It looks to essentially be a thread lift procedure to contour the jaw and neck, so could be a good solution for sagging skin in that area that needs some structural support and tightening. I don’t know loads about it but there are some TTG-registered practitioners who offer it, like Dr Munir Somji of Dr MediSpa in London and Essex.

Could you please tell me what is the best eye cream for crepey under eye skin? I use ZO skincare but a No7 eye cream and it’s not helping.

Hiya, TTG editor Georgia here. Eye cream can help hydrate the area and reduce the appearance of that crepiness some of the way, but it won’t eliminate it completely – for that, you’d need a tweakment like PRP, RF needling, or mesotherapy – something to build up collagen under the skin and smooth out its texture. Book in with a practitioner who specialises in the eye area and have a consultation to find out which is the best option for you. And you may want to try a new eye cream too – we really like both of these.

I’m considering an upper blepharoplasty – can you tell me how long it took for you to recover and when were you able to go out in public? Is the scarring easy to conceal whilst it’s healing? What do you recommend for this? Did you sleep upright in a chair, and if so, for how long? Thank you.

Hi, the full recovery takes about two weeks, with stitches out after one week. The more you can rest in that first week, the faster you recover. I didn’t sleep upright in a chair, just propped up in bed on a few pillows to reduce swelling. I went out and about after four days – with glasses on (can’t wear contacts for a couple of weeks) and a hat and it didn’t bother people, though I didn’t put myself in front of close friends. Once the stitches are out the scarring is minimal and heals fast.

Hey Alice, just recently I found your Tweakments Guide and it has become my best read. I wanted to ask your opinion. I’m 56 and take good care of my skin but I still have deep wrinkles in my forehead, some around eyes and clear…

Hiya, TTG editor Georgia here. Your question cut off, but to answer the part about wrinkles on the forehead and around the eyes – wrinkle-relaxing injections will easily sort these out.

What would you suggest for crepey skin on my upper arms?

Hiya, TTG editor Georgia here. This is one of the main indications for Profhilo Body injections – have a look into the treatment and some before-and-after pics.

Help! I’m 63 and I’ve just noticed a bit of a sag on my neck under my chin. Any tips or ideas? Thanks!

Hiya, TTG editor Georgia here. Have a read of our free downloadable e-book on jowls, which you can find at that link. Some tweakments such as ultrasound and RF needling can help tighten up the area.

I’m thinking of having a skin-tightening procedure (non-surgical) and I’m looking at two devices: Ultracel and Sofwave. I would be interested in hearing which one you would prefer. The areas of concern I have are upper eyelids and submental chin.

Hiya, TTG editor Georgia here. They’re both great treatments but slightly different – Sofwave is a newer technology that uses its own, patented type of ultrasound delivery and just works at the level of the skin and is great across the forehead and just under the brow, while ULTRAcel Q+ is a HIFU device. It can also be used to define the structure of the jawline by deliberately targeting fat tissue as well as lax skin, if that is what you’re after for the area under the chin. Find out more about both on those links.

Hi, can I please ask for some advice?! I had a Veinwave treatment last Friday (so I’m 6 days post today) and I’m a little concerned about the red marks I’ve been left with, it’s my first time dabbling into tweakments. I did my research and I know it can take 4-6 weeks for them to go, and my practitioner did tell me that too, but I’m slightly worried the marks will leave scars. My face is 90% recovered from how it looked when I first had it done. I’m back on my tretinoin now with azelaic acid.

Hiya, TTG editor Georgia here. Apologies for the late answer – hoping the marks have gone away now. If not, return to your practitioner and see what can be done about it.

Tweakments post-treatment for breast cancer – at 58, I’ve been lucky that, due to good genes and looking after my skin, I’ve only needed toxin and cheek fillers every 12-18 months. Now I’ve lost volume to my face, my jaw is sagging and I’ve developed heavy eye bags following chemotherapy. Should I be considering more radical steps e.g. a thread lift or Ultherapy? Can you also recommend a good rejuvenating facial? Many thanks.

Hiya, TTG editor Georgia here. First, make sure you have clearance from your oncologist for injectables and energy-based devices, and following that, ensure that the practitioner(s) you’re considering for treatment have your full, up-to-date medical history from the get-go. Providing you get the go-ahead, something like ultrasound could indeed be a good bet to tighten up your jawline – look into Sofwave as well as Ultherapy. The under-eye bags are tricker to treat because it depends what’s causing them – if it’s fluid retention, sagging skin or a result of the fat pads slipping down under the eyes. A practitioner experienced in treating the under-eye area will be able to properly assess yours and tell you what the best tweakment would be.

If you feel you’ve lost volume overall, have you heard about HArmonyCA? It’s a hybrid filler that both restores volume and builds collagen under the skin gradually over a longer period. We’re seeing some fantastic results with it so that might be worth looking into.

We’re a little iffy about thread lifts, but that’s not to say the right type for the right patient performed by the right practitioner can’t give brilliant results. It’s a fairly invasive procedure though, so my thinking (without being a medical professional) is that you may not be cleared for this following your treatment.

Facials – have a read of this to get an idea of what’s out there that we like. Specifically, the Byonik laser might be a good one for you because it’s very gentle but highly effective.

Best treatment for under eye dentation heading on edge of cheek bone and fine lines?

Hiya, TTG editor Georgia here. I’m not sure exactly what you mean by ‘dentation’ under the eyes. If you’re talking about a kind of hollowing then you may be a candidate for tear-trough filler, but this is a very intricate filler placement that certainly isn’t suitable for everyone, so use our Practitioner Finder to find someone experienced in treating the eye area and book in for a consultation. And wrinkle-relaxing injections will soften those fine lines at the corners of your eyes.

I have a very deep forehead wrinkle that I try to hide with my fringe. What is the best treatment for this, please?

I’d suggest you made an appointment with a great practitioner to get their view on what has caused the line, and what the best way to soften it might be. Most of the horizontal lines on our foreheads are from the way we raise our eyebrows, and the lines settle into place over the years. Because these lines are caused by muscle movement, wrinkle-relaxing injections of botulinum toxin A should help soften your line. For lines which are really deep, it may make sense to treat it with a soft kind of hydrating filler, but a skilful practitioner will know just what to do.


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