Ozzie magazine explores non-surgical face lift options

Australia’s Dr Joseph Hkeik, resident expert on lifesyle site Resu, explains recent development in non-surgical aesthetics, including the “Liquid Facelift” which uses fillers similar to Sculptra in combination with botox. 

Let’s talk about all the non-surgical lifting and tightening options. Cosmetic companies attempt to address this with lots of formulations, co-enzyme Q10, Vitamin A, collagen. But what are some of the more serious and scientific things we can do to supplement topically.

Dr Joseph Hkeik, Rescu’s expert Cosmetic Physician fills us in, on the latest developments.

If we start with the injectables, you can do what we call a Liquid Facelift. Now a liquid facelift is when we use Botox and dermal fillers to lift and contour the face which is always customised to each individual.

We put a little bit of botox around the brow. This is your first point of lift. You can also put Botox in the frown muscle, crows feet and neck for a Nefertiti lift .

For lifting the cheek and the mid-face, I place some filler along the cheekbone. You start where the cheek prominence is and proceed to the mid face. If the cheeks are already looking good, I only support that area, not necessarily to change it, but to pull the skin up towards the ear.

The third point, we put volume below the lip. By getting rid of the marionette shadow, it gives the illusion that you’ve had a lift. By putting the extra volume in the corner of the mouth, below the lip, you’re lifting the corner of the lip.

As you’re addressing the whole face, not just a spot treatment, how long does that treatment take and is it uncomfortable?

The treatment takes less than an hour, so most of these treatments can be done within an hour. As a trainor, you are often given 45 minutes, so I’ve mastered the skills to do the procedure within 45 minutes,

Is there downtime afterwards?

There’s no down time normally because I’m doing cannula techniques. With cannula techniques you’re barely traumatising the skin. But on a rare occasion the patient may bruise but nothing a little makeup can’t cover.

Can you explain the cannula technique?

There are two techniques that a doctor can use to administer a product under the surface of your skin. One is with a sharp object, e.g. a needle, which you use to inject directly into the skin.

The cannula technique. It is a more advanced technique. , you can use a blunt, flexible, soft device, called the cannula. These are disposable items, they are harder to use, but once mastered they make the procedure so much safer and with almost no bruising.

Tiny amount of anesthetic is applied to the surface of the skin, we access the skin with a very tiny injection with a needle and then we introduce the device under the surface of your skin.

Does it allow you to put the product deeper?

Not just deeper, it also allows me to reach a further distance through the same entry point and therefore less injections are given.

Once I treated my sister with a liquid facelift from two injections, from the corner of her mouth. There was no needle mark on her face, so you can be creative. You’re sculpting, without leaving any mark behind.

What is the cost of something like this?

In most patients we’re required to do botox as well as filler. The botox could be anything between $400 and $750. The filler, 1-2mL is $785 $1570.

Right, so just over $2,000 to have everything and that would last how long?

The filler component would last anywhere between 1-2 years, and the botox will last 3 – 6 months.

So you would come back and just have the botox topped up?

Yes. And if needs be, if we haven’t done everything on the first visit, they can have the filler six months later with some botox, or we’d be doing their skin treatment plan.

Obviously working on your skin causes a bit of rejuvenation, so it’s going to cause a bit of a lift, especially with a deeper chemical peel, because you’re stimulating more collagenesis or collagen formation.

What about some of the ultrasound and laser treatments that are available, are they any good for lifting?

Definitely, ultherapy has been TGA approved for lifting. It’s the only device in Australia that is approved for lifting. Skin tightening can be achieved with things like Fraxel, Thermage, Pellevé, and Ultherapy.

Ultherapy is the only one approved for skin lifting, because it goes much deeper, it’s tightening at the same level as would a facelift, (i.e. where a surgeon tightens that layer).

This is the reach of the ultrasound, so it’s sound therapy, it’s not really laser. It does cause heat, because the ultrasound is focused.

As you heat the dermis , the old collagen contracts, but the heat itself stimulates the cells that make collagen. They become over productive and create an abundant amount of collagen in that zone, so skin tightens and lifts.

Unlike the liquid facelift, this takes some time why? And how long?

With Ultherapy, the patient will notice a little bit of tightness after the procedure, but that is just a tiny bit of swelling. It takes about 6 weeks before the patient notices anything, the results start becoming noticeable 6 weeks to 3 months after the treatment.

Collagen production is a very slow mechanism because we rely on the cell to produce it. By doing Ultherapy you’re not making new cells, you’re actually getting the existing cells to start to make collagen. We’re relying on the existing cells to produce collagen, it’s like a factory. Collagen production is very slow. You don’t lose collagen over night it takes months to lose, and months to build.

Can you take supplements to boost collagen, because a lot of people say the essence of the sea or bone broth or internal supplementation can also boost collagen production?

You know, I haven’t really seen any scientific proof of that. But I think the best way to promote collagen is to work on the cells. Promote a healthy lifestyle, diet and do exercise.

With exercise, providing you’re getting the circulation, to be pumping around your body, it’s going to wash up all the debris around where your cells were and going to supply more blood to the cells, so they’re more nutrient, so there could be a place for them (supplements).

Are there any other treatments that you would recommend for lifting?

Look there are other injectable products that you can use to cause a lift. There’s poly-L-lactic acid known as sculptra and RADIESSE

What sculptra is the same ingredient that exists in suture material injectable, and what it does is it encourages the body to make more collagen.

The other product is Radiesse, which is 25% filler, 75% collagen promoter and again, you’re using the same techniques as you would filler, but you’re trying to place it in a special area to promote collagen, so they both can really promote collagen.

Any laser treatment, chemical peel can promote collagen in the skin because of the heat effect within the skin. As acid penetrates deeper it’s going to stimulate the cells. With the laser, the heat component will stimulate collagen also.

You can also do needling. When you create inflammation within your skin, your body goes into repair mode. When your body is in repair mode, it makes collagen.

And light therapy?

Light therapy, the infrared light is also very beneficial because it goes deeper. It can go superficially so it’s good for the upper part of the surface, reducing pore size, breakouts and good for skin texture. But the deeper one is for healing and cell repair.

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