Have you ever noticed shop assistants and people walking down the street react differently if you wear smart clothes and groomed hair, compared to wearing tracksuit pants and greasy hair?

This is disappointing as I would prefer people see the “real me” rather than judge me by my appearance, but I have noticed that people do treat me better when I’m well groomed.

Your looks can get you places

Research confirms that attractive people are treated differently. From the courtroom to the workplace, good-looking people get advantages, whether it’s being paid more, or being more likely to be found innocent of a crime.
People with “plain looks” earn about 10% less than people who are average-looking, who in turn earn around 5% less than people who are good-looking.

Studies show even babies prefer to gaze at an attractive face.

What can you do?

There are many things you can do to improve your looks and your well-being? You can improve your appearance by dressing well, getting a good haircut, transforming your posture or learning the art of good make up.

These days, many people also choose to improve their faces with quick, simple cosmetic medicine treatments to give a better first impression.

Who gets Botox?

The people who seek me out are grounded and down to earth, but also aware that how they present themselves to the world can change how they feel, and how others treat them.

Are they vain? Not in my experience.

I find they want to think less about their face, not more.

One woman seeking lip line treatment told me “I’m so sick of painstakingly drawing on lip liner to stop my lipstick bleeding. I just want to slick on a bit of lip gloss and go!”

They are smart, successful people from all walks of life: whether that’s in accounting, grand-mothering, advertising, as a home-maker or a surgeon.

A colleague of mine who is a kind man, has an angular face and thick brows. His strong muscles give him a slight frown, even when he’s relaxed. He found people approached him differently after Botox.

“Before I had Botox in my frown, people used to look at me in a worried way. I think I scared them! After Botox, strangers looked me in the eye, and gave me a big smile.”
“I can always tell when my Botox is due because people back off again. They respond to my severe expression – but my face doesn’t match how I feel inside”

Your face may not reflect your state of mind

As you progress through life, your inner beauty and understanding of yourself grows.

You’re proud of the experience that comes with age. You might become a parent or move to a higher status job. But your outer image may not reflect how you feel.

Ageing can make you look tired, sad or angry, when in reality you feel energized and happy. These are exactly where cosmetic medicine treatments can help you to reflect what you are feeling inside.

Botox and dermal fillers are particularly good at altering the emotional signals your face conveys.

Yes, Botox can make you look less angry

Anger is communicated by frowning, pursing your lips and squinting your eyes. Try it yourself – do you feel angry?

These key signs of anger can be eased by injecting Botox into the frown muscles and along the brow. This relaxes frown lines and lifts your brows.

Lip lines, which can make you look sour and disapproving, can be reduced with tiny droplets of dermal filler like Juvederm Ultra or Volbella around your lips.

As a result, your face looks happier and more approachable.

Stop looking miserable

Sadness is communicated by “sad puppy” eyebrows that droop at the edges and a mouth that turns down at the corners, both of which can occur with ageing.

Using a thicker filler like Juvederm Voluma in the temples and outer cheek can lift this outer corner of your brow and combine nicely with Botox to lift your brow.

Filler can also lift the corners of your mouth, especially if I add a “Nefertiti Lift” using botulinum toxin to relax the muscles pulling the corner of your mouth down.

These simple treatments can make you appear more cheerful and positive.

Reducing signs of tiredness

It’s hard not to look exhausted with sagging cheeks and shadows underneath your eyes.

Placing a dermal filler like Juvederm or Restylane at key points around your face in an “8 point lift” can lift sagging, restore contour to your cheeks and reduce shadowing to make you look and feel refreshed.

After having treatment for sagging, patients often tell me “I look like I’ve had a good sleep or been on holiday.”

It’s not about looking different – it’s about staying the same

We want to go out into the world without having to spend time making ourselves look presentable every day. I say that’s a reasonable wish! Happily, I can help.

People who get Botox and fillers don’t want to look different, they want to look the best version of themselves and they want their outer image to reflect how they feel inside.

These days, with modern cosmetic treatments, that’s possible.

The post Is Getting Botox A Sign That You’re Vain? appeared first on Dr Sarah Hart.

However, you also want to make your own decisions about how your skin will look as you get older.

When it comes to cosmetic treatments, many of you will have seen poor results in the gossip magazines, and this has resulted in many people becoming nervous about ending up with sausage lips or a face that won’t move.

If you choose to have treatment, many of you would prefer not to advertise the fact. You are happy for people to notice you look better, but you don’t want anyone to suspect you’ve had anything done.

The goal is to look like you have had a good holiday, not like a totally different person.

You want results, you want it to be convenient, and you want to look natural.

New Zealand is a harsh environment for skin

Recent studies by Australian dermatologist Dr Greg Goodman show that wrinkles and sagging can appear 20 years earlier in women living in the Southern hemisphere, compared to our sisters in the Northern hemisphere. Our exceptionally strong UV levels and outdoor lifestyle are likely to blame. This sun damage accelerates signs of ageing like wrinkles, rough, dull skin, brown spots, red veins and sagging.

What options do you have to correct ageing changes?

These days, there are powerful, effective treatments that can noticeably improve your skin, with easy 30 to 60-minute appointments that have minimal down time.

These are my top five treatments for Kiwi women.

1. Medical-grade skincare

I believe every Kiwi over 30 should be on a retinoid. Retinoids are derived from Vitamin A and truly make your skin cells behave as if they are younger.

Retinoids boost collagen levels, reduce brown pigment and give a dewy glow. They are the only skincare ingredient that can actually reverse signs of sun damage seen under the microscope and treating sun damage is crucial for New Zealanders.

If you have tried using retinoids and developed red, flaky skin, that’s a sign you need your skin barrier restored first. Vitamin B and hyaluranon gently replenish your barrier and can be life-changing ingredients for people with sensitive skin. Once the skin barrier is repaired, we can gradually add high concentrations of active ingredients including retinoids, vitamins and growth factors.

I’m not surprised to see many women are sceptical (and quite rightly) about skin cream claims. I’ve seen advertisements falsely claiming how creams will reduce sagging. This isn’t possible, as sagging is due to shrinkage of muscle, fat and bone deep under the skin, where creams can’t reach.

We Kiwis don’t like false promises.

Realistically, what medical-grade skincare can do is give your skin a dewy glow, a smoother feel and fade brown pigment. You need a high concentration of active ingredients for this to happen, and it takes at least six months.

Doctor-only creams have a greater chance of success, as they have a higher concentration of active ingredients than creams sold at a pharmacy or beauty counter.

2. Resurfacing for skin colour and texture

Resurfacing treatments can improve your skin colour and texture more than skin creams. They reduce brown age spots, red veins, acne scarring and signs of sun damage, to give you a healthier, fresher look.

I find many New Zealanders need to progress to this step because of the effects of sun exposure over many years.

There are many options such as peels, IPL, micro-needling, PRP (Platelet Rich Plasma), and fractional and ablative lasers.

Resurfacing procedures create tiny, precisely controlled damage to your skin, re-awakening your collagen producing systems. This leads to higher collagen levels in your skin, which is very beneficial for Kiwis, as sun exposure reduces our collagen.

Some of my patients have regular treatments before ageing changes are severe, to “bank” collagen in their skin, like saving for a rainy day.

Gentle treatments like peels give subtle, temporary results, while the strongest treatments like the ablative CO2 laser deliver dramatic, permanent changes.

The right resurfacing procedure for you depends on your goals and skin type and how much down time you can afford.

3. Injectable moisturisers for hydration

Tiny droplets of hyaluranon can be injected into the top layer of your skin with a gun, increasing hydration and cell density and boosting collagen production.

Available in Europe and South Korea for years, these treatments are now available in New Zealand,  and proving particularly valuable to improve the texture of sun damaged skin. They may provide temporary extra protection from UV damage.

My patients report their skin feels smoother and firmer after these intense nourishing treatments.

4. Dermal fillers for sagging and contour

Fillers like Juvederm and Restylane change the shape and contour of your face and, apart from surgery, are the best way to reduce sag and a tired appearance.

When you reach your 40s, ageing changes to facial fat and bone can cause saggy jowls, a down-turned mouth and tired shadows under our eyes. Placing small amounts of filler at key points, especially in unexpected places like in front of the ears, supports the areas losing volume. This gives your face a happier, fresher look without the “I’ve had my cheeks plumped” image. This is very important to New Zealand women, as looking natural is a very high priority for us.

Of the many skills my job requires, using filler is the one I have spent the most time perfecting. There is a strong artistic aspect, rather like sculpting, which takes time to finesse and accomplish.

5. Botox for wrinkles

There is nothing like a bit of Botox as the ideal wrinkle buster. After more than 20 years of use, it remains unparalleled for improving frown lines, forehead lines and crow’s feet. Used “off-label” it can also lift the corners of the mouth, tighten the jawline, or smooth the chin.

But many people dislike the lack of movement resulting from a strong treatment.

I agree – I prefer to “baby-tox”, scattering tiny doses over the face and neck, gently persuading muscles to subtly release their grip. This eases negative expressions while retaining your face’s natural warmth and animation. You can still lift your brows to say a silent Kiwi hello.

Facial balance is important

Ensuring your facial features are harmonious is crucial to keeping you looking natural.

Improving one feature of the face too much, while neglecting others, means our primitive brain can perceive a face as “wrong”.

When I give you a treatment, I am constantly checking that the improvements I make harmonise with the rest of your face. I might leave some lines on your face to ensure you look recognisably better, but still completely natural.

The slow approach

Most Kiwis prefer it when I deliver treatments over a period of months or years. You get better results with fewer side effects, and it is easier on the budget.

What’s more, a gradual improvement is less obvious to friends and family. That’s important, as although we’re getting more relaxed about revealing we’ve actually had treatment, most New Zealanders still prefer to be discreet.

Many of my long-term patients magically look the same at 50 as they did at 40, thanks to regular, subtle adjustments, rather than major facial-lift surgery.

Finally – please wear your sunscreen

The number one way to prevent yourself from needing my services too early is to protect yourself from the sun.

You know how to do it:

• wear a hat and sunglasses
• get into the habit of wearing a zinc-based sunscreen like Dermquest every day on your face
• slop on a thicker sunscreen like Invisible Zinc everywhere if you’re outdoors
• and get under shade whenever you can

If you would like to talk to me about which of these treatments might suit your skin, please make an appointment for a consultation here.  

The post My top five treatments for New Zealand women’s skin appeared first on Dr Sarah Hart.

“When are you doing treatment?” Mum asked.

“We’ve just finished” I replied.

“But…she looks normal!” Mum exclaimed in astonishment.

“Yes! That’s my signature!” I explained. “If you put the right amount of dermal filler in the right place, it looks beautifully natural.”

Mum was relieved to hear it. She couldn’t understand why people would want to look overdone and unnatural.

The rise of the overdone look with dermal filler

Sadly, I’m not surprised Mum had misconceptions about dermal fillers. I am seeing more obvious results on the street or in magazines these days.

‘Married at First Sight Australia’ features Tracey from Perth, who now looks extremely unusual compared to before she had filler. These are the worst dermal filler results I’ve seen in a long time.

I’m so disappointed – this is not what I want my profession to bring to the world. The overdone look spoils natural beauty, just as heavy makeup does, and it doesn’t have to be that way.

The key to a good filler or Botox treatment is that it should be undetectable. Just as with subtle makeup, the best work is invisible.

Done well, dermal filler can be absolutely amazing. It can make you look less tired, less sad, less saggy and more attractive. It can reshape your lips and restore hollows under your eyes.

But some practitioners don’t – or can’t – keep their patients looking natural. How can you access the amazing benefits of dermal filler without risk of looking like Tracey?

Your injector is key

Mostly, your result is about the skills of your injector.

Treating with filler is like sculpting with clay and it requires artistry to get the contours right. I’ve found artistic judgement can’t be taught – you either have a good eye, or you don’t.

Injectors without artistry struggle to see the face as a whole. Instead, they focus on eliminating wrinkles, usually at the expense of facial shape and harmony and this where the problems start. They don’t seem to know when to stop.

They fill lip lines until your upper lip bulges into a ‘monkey muzzle’.

They eradicate the nasolabial fold between your nose and mouth giving you a weirdly flat face.

They do the same “cookie cutter” lip on every face shape and size.

An untrained observer might not identify exactly what’s wrong, but your face doesn’t appear harmonious, especially when you’re making expressions.

How can you make sure this doesn’t happen to you?

Find an injector with artistry

Finding an injector with a good artistic eye is similar to finding a good hairdresser. Word of mouth is very important, so if any your friends have been open about having filler themselves and they look great, ask them for their recommendation.

Have a look at your injector’s own face. It will be a good clue as to whether they prefer a natural look or an overdone look. If they look freaky themselves, I suggest you keep searching.

During a consultation, ask to see before and after photos of patients your practitioner has genuinely treated themselves, or check their website or Instagram for evidence. It’s wise to remember that natural results can look understated in a photo, so if a photo looks overdone, the result will look even more obvious in real life.

Careful attention to detail is paramount

Beauty is measured in millimetres. When your injector is treating your face, they should be taking time and care, as keeping you looking normal requires careful attention to detail. I like to see injectors study their work closely and tweak it until they are completely satisfied.

During treatment, your injector should observe your face from all angles, and touch and pinch your face to feel the shape of structures underneath. They should ask you to smile, frown and kiss before they inject filler. This helps them to find the exact right location to place filler.

Training and experience definitely counts

Learning how to inject filler is difficult and presents another challenge for injectors.

It’s not possible to become a skilled injector after a two-month course. It takes years to build up the full range of techniques, and good training is hard to find in New Zealand. I had to go global to find the right mentors, such as Brazilian plastic surgeon Mr Mauricio De Maio, Australian plastic surgeons Mr Steven Liew and Mr Peter Callan, and Australian dermatologist Dr Greg Goodman.

Ask your injector who they trained with, how many days of training they’ve had, and how many filler treatments they have performed. The more you do, the better you get.

Keeping up to date is essential. Every year, I update my skills by attending international conferences.

Injecting techniques have completely changed in the last five years. We now treat “indirectly”, placing filler distant from the area needing improvement, so your face looks normal when you smile and laugh. The best injectors move with the times.

Look for a doctor with the NZSCM Diploma in Cosmetic Medicine. This two year diploma is the highest available standard of filler training for doctors in NZ and is only available to doctors with at least 10 years of medical training.

You have a part to play too

Some patients end up over-treated because they ask for more and their injector obliges. Bear in mind, the best injectors will say no when needed. If your injector says no, listen to them – they have your best interests at heart.

An area might look like it needs more in your mirror, but we can observe from an angle you can’t see and know it will give an unnatural contour.

Never fear – dissolver is here

If the worst happens and you think you’re looking weird, all is not lost. If the filler is made from hyaluranon, it can be quickly dissolved away.

I have taken many upset patients treated at other clinics back to normal with dissolver, then started all over again. My less-is-more approach means people come to me because I refuse to make them look weird.

The rewards from dermal filler can be amazing

With a 2,000% increase from 2003 to 2016, fillers now sit second in popularity after botulinum toxin injection, surpassing laser hair removal, chemical peels and microdermabrasion.

With its ability to shape the face, reduce wrinkles and improve the condition of the skin, versatile dermal filler can do things no other treatment can. It smoothes; it nourishes; it gives contour and projection.

Nothing else can shape your lips or reduce lip lines as well as filler does.

The lack of downtime and ease of a simple 60-minute appointment mean it fits into our lives and is the ultimate secret weapon for looking good.

Filler can be amazing – once you find the right injector.

If you want to find out more about how I can help you to find the right look for you, please contact me here.

The post Discover the secret to a natural look with dermal filler appeared first on Dr Sarah Hart.

Often, we notice wrinkles first, like crow’s feet and forehead lines. They add character and can be attractive. Our skin texture becomes rougher, no longer reflecting light with a smooth sheen.

Bigger, structural changes come next – saggy cheeks, jowls, a down-turned mouth. These changes make us look sad and tired and are harder to accept.

You might be surprised to know that dermal fillers can help all of these changes.

How can dermal fillers help with the ageing process?

Dermal fillers are gels that are injected into the skin and they have two main actions. Firstly, they can physically lift the skin. Thinner gels lift fine lines and thicker gels are placed deeper to support the face and reduce sagging.

Secondly, they provide hydration and nourish the skin to make more collagen. Together, these benefits make dermal fillers a very powerful tool in the fight against ageing skin.

What are dermal fillers made from?

The most popular, versatile group of dermal fillers are made from hyaluranon, which is naturally present in our own skin, joints and eyes. I’ll explain more about hyaluranon later.

Hyaluranon dermal fillers like Juvederm, Restylane and Belotero have the highest level of safety because they are quickly reversible with a dissolving enzyme called hyaluronidase. Dermal fillers made from other substances are less widely used, and there is no quick way to reverse them.

Semi-permanent fillers include Radiesse and Sculptra. Radiesse is made from calcium hydroxyapatite, found in sea coral. Sculptra is made from poly-l-lactic acid, the same substance that dissolvable sutures are made from. Radiesse and Sculptra take months to years to disappear. They can’t be reversed.

There are also permanent fillers which last forever, such as Acquamid and silicon. I have seen significant problems with permanent fillers and I advise my patients never to use them. (link to blog Never Have Permanent Filler)

I only use fillers made from hyaluranon.

What is Hyaluranon?

Hyaluranon is a carbohydrate and is an amazing clear, jelly-like substance found in our skin, joints and eyes. Our own hyaluranon surrounds our skin cells, supporting and nourishing them. It helps cells to make collagen and communicate with each other.

We are born with high levels of hyaluranon and our levels drop drastically as we age.

Insert image of graph

Hyaluranon has an incredible ability to trap water molecules, holding up to 1,000 times its own weight in water. It is now added to many moisturisers where it can provide hydration without oiliness.

Hyaluranon for dermal fillers is made by bacteria in a laboratory and is identical to our own natural hyaluranon.

The scientist who first isolated it from a cow’s eye used it as an egg-white substitute in commercial cooking. It never took off as an egg substitute, perhaps because it absorbed too much water.

What happens as we age?

The changes we see in our ageing faces are not just the result of changes in the skin itself.

Our facial bones also change, just as our spines shrink and curve with age. Our cheekbones and jawbones get smaller and the bones behind our nose move backwards. The fat under our skin decreases, especially in the cheeks and around the eyes.

Like a tablecloth on a shrinking table, this loss of underlying support makes our faces look saggy. Our nose droops down and we get jowls and hollows under our eyes.

Filler can contour your cheeks to treat sagging

The good news is that dermal fillers can be used to counteract the loss of fat and bone that occurs with ageing.

Firm, thick dermal fillers can be injected under the skin to replace the lost volume, increasing the support underneath.

Restoring your cheeks with filler can reduce sagginess in your face, smooth under your eyes and firm your jawline.

Filler can reduce signs of tiredness and sadness

As ageing reduces the fat around your eyes, they start to look tired, no matter how much sleep you have. Hollows under the eyes are called tear troughs. Treating the cheek, temple, outer corner of eye and tear trough with filler can reduce these dark shadows and make you look less tired.

Ageing can also cause your mouth to turn down at the corners, making you look miserable and grumpy. Supporting the mouth with filler can correct this and make you look happier.

Filler can restore your lips and reduce lip lines

The mid-thickness dermal fillers in the Juvederm, Belotero and Restylane ranges can create soft, smooth lips.

My personal favourite is Juvederm Ultra, as it has an excellent balance of softness and structure. Kylie Jenner has confirmed Juvederm Ultra injections are responsible for her enhanced lips, although she has had more injected than most Kiwis would want!

You can have more or less depending on your preference – it’s up to you and the skill of your injector.

If you wish to be subtle, the softest lip fillers like Juvederm Volift and Juvederm Volbella give a “lip gloss effect” without increasing size.

Insert image with tagline ‘lip gloss effect with Volift’

Filler can treat fine lines

The softest hyaluranon gels are injected into fine wrinkles to reduce the line, increase collagen production and build resistance to creasing. Where the skin is too thin for this, we find that restoring facial contour by injecting thicker fillers deeper under the skin can stretch the wrinkles, improving them.

A good example is improving crow’s feet by enhancing cheekbone contour with a thicker filler like Juvederm Voluma.

The thinnest fillers act like injectable moisturisers

The thinnest fillers of all can be injected in tiny droplets into the very top layer of the skin with a gun. This hydrates the tissues and increases cell density, leaving the skin feeling smoother and more radiant. It acts like a moisturiser that doesn’t disappear.

Dermal fillers are very versatile

Hyaluranon dermal fillers like Juvederm and Restylane are one of the most versatile tools in the fight against ageing skin today. Whether used deep to lift sagging, or at the surface to improve skin density and hydration, they can significantly improve your face and skin.

Link to blog: The Secret to a Natural Look with Dermal Fillers

If you would like to find out more about dermal fillers please contact me to arrange a consultation.

I would love to hear from you and see how I can help you regain a youthful, natural appearance.

The post Could dermal fillers be your solution to looking younger? appeared first on Dr Sarah Hart.

Are you a busy person who wants to look your best, but don’t have time to scour the web for skin and beauty information?

Do you want trustworthy advice about which aesthetic procedures really work?

Would you like to keep updated with the newest skin treatments?

If that sounds like you, then welcome to my blog.

Many of us are confused about what really works and need help to sort the wheat from the chaff. Beauty marketing claims can be misleading. I can’t tell you how many times I’ve looked at advertisements for ‘miracle’ moisturisers and thought, “That’s simply not true!”

In my blog, I’ll reveal why some treatments work, but others never will. You will get candid advice about the best aesthetic treatments, products and procedures.

As one of New Zealand’s most experienced cosmetic doctors, I’ll combine my own observations from treating my patients with insights from global experts and the latest scientific studies to give you credible, understandable information on the latest skin treatments available.

My career as an international trainer in cosmetic medicine gives me access to the world’s top experts and conferences. I go behind the scenes, visiting the laboratories where products are made and talking directly to researchers. I find out the truth behind the claims, then share it with you.

You’ll pick up lots of tips, like how to select the best practitioners, avoid side effects, and chose the right treatment for your skin.

I look forward to becoming your trusted resource for cosmetic health and wellness.

Welcome and enjoy the read.

The post Welcome to my blog – keep up to date with Sarah on the latest skin treatments available appeared first on Dr Sarah Hart.

Which treatments will we all be having in ten years time?

High-tech at home devices

Just as computers have gone from room-size giants to small portable devices, large, powerful machines like IPL and LED light therapy are now available as mini-versions for home use.

Once restricted to the clinic, home IPL is touted for hair removal and LED therapy for skin rejuvenation.

While regulations understandably limit their strength and effectiveness compared to in-clinic treatments, it’s a convenient option.

As with home haircuts and dye jobs, I expect we’ll see some disasters, but despite the risks, I predict this trend will grow.

Skin burns, discolouration and scarring are all possible with IPL when used wrongly, but an “at home” solution will be too tempting for many to resist trying.

Tattoo removal lasers

The new generation of “Pico” lasers, which fire 1,000 times faster than the current generation of “nano” lasers, are particularly well suited to removing tattoos quickly with fewer side-effects.

With the massive growth in popularity of tattooing, I believe there will be more people wanting to adjust or remove their tattoos over the next decade. I expect the price of the currently very expensive Pico lasers to drop, as all new technologies become less expensive over time.

As a result, I predict we’ll see more tattoo removal services using Pico lasers over the next ten years.

Hyaluranon dermal fillers

With a 2,000% increase from 2003 to 2016, I predict hyaluranon dermal fillers will continue to grow.

Fillers now sit second in popularity after botulinum toxin injections, surpassing laser hair removal, chemical peels and microdermabrasion.

Hyaluranon improves skin hydration and collagen production as well as lifting wrinkles, plumping lips, and contouring cheeks. Where once there were just two hyaluranon options, a huge range of varying thickness are now available, making it a very versatile treatment.

In the right hands and using the latest injection techniques, hyaluranon fillers can now reduce sagging jowls, correct an undersized chin, restore sunken temples and reduce hollowing around the eyes. This wide range of use, coupled with the lack of downtime and ease of a simple 60-minute appointment, mean that fillers will continue to be a standout growth area in cosmetic medicine.

Hyaluranon fillers have the highest level of safety of all fillers, as they can be quickly dissolved with a doctor-prescribed enzyme.  Although the vast majority of treatments go well, there are some rare risks including scarring and blindness, especially in high risk areas like the nose.

Filler should only be administered by a nurse or doctor in a medical clinic. Nurses need rapid, easy access to doctor backup to ensure your safety in the event of a side effect. Ideally, nurses should be working right alongside a cosmetic doctor in the clinic.

The artistry of your injector is also important, as creating new contours for the face requires an eye for proportion to ensure you look natural, just like sculpting.

Ask to see genuine “before and after” pictures by your injector to check their aesthetic matches yours.

Injectable moisturisers

Using a multi-needle gun to inject tiny droplets of nourishing substances into the top layer of the skin has been popular in Europe for years. Known to Europeans as mesotherapy, this treatment can improve hydration and and density of the skin by injecting a powerfully moisturising substance called hyaluranon.

Hyaluranon attracts a remarkable number of water molecules. It is used in dermal fillers, and in moisturisers where it provides hydration without oiliness.

Treatment has few side effects, little down time and is remarkably comfortable.

In New Zealand, popularity is growing quickly due to its success improving the appearance of our sun-damaged skin. Research shows improvements in skin hydration, cell density and collagen production. Patients report their skin feeling smoother and firmer.

I predict these treatments will become widely known and accepted for all age groups.

Non-surgical fat removal

Yes – removing fat without liposuction is now possible.

We have learned that fat cells can be permanently destroyed by heating, freezing or dissolving injections, and technologies have developed to a point where they are safer and more effective.

Freezing and dissolving appear to be the most reliable methods. The original fat freezing technology, Coolsculpt, was developed after researchers observed that children who frequently sucked ice blocks often lost cheek fat where they’d rested the ice.

Coolsculpt truly works, so cheaper copies of this technology have appeared, with different names and variable effectiveness.

It’s crucial your operator is well trained. If fat freezing devices are used incorrectly, dents and irregularities where the fat has been wrongly removed can occur.

A new product from the makers of Botox is Belkyra, a fat-dissolving injectable treatment that can melt away your double chin without surgery.

Belkyra is made from deoxycholic acid, a substance naturally present in your digestive system that breaks down fat. Called Kybella overseas, Belkyra was launched in New Zealand in February.

I’ve had the opportunity to treat patients prior to launch and can confirm that, like the fat freezing, these injections really do work.

Belkyra is a well-researched product and studies are already underway on use in other body areas, starting with the fat that hangs over your bra strap.

There are very few people without unwanted fat somewhere on their body, so I believe body contouring without surgery has exceptional growth potential.

Genital rejuvenation

It makes us snigger, but paying attention to your naughty bits is a trend that’s not going away.  We got used to enhancing our breasts, then buttocks – moving on to the genitals is inevitable.

The fashion for removing pubic hair has revealed that, like our faces, the appearance of our genitals changes with age.

New treatments now offer a solution to restore appearance, although they have not been studied with the same rigour as facial treatments.

Lasers can heat genital tissue to tighten it and injections of platelet rich plasma or dermal filler can restore plumpness. Patients have also reported improvements in continence and sexual function.

However, as yet there is very limited evidence for safety and effectiveness. This lack of good research is my main reservation.

I’d like to see larger, placebo-controlled studies that monitor the effects of these treatments over time to assess safety in these delicate tissues.

Although I don’t personally offer these treatments, as I don’t believe they’ve been studied enough yet, I predict that genital rejuvenation will become more discussed, acceptable and popular in coming years.

More botulinum toxins

Botulinum injections are a safe, highly effective solution for wrinkles like frown lines and crow’s feet, and statistics show it’s the most common cosmetic medicine treatment sought by patients.

Botox is the most popular and well researched botulinum toxin brand available, and remains dominant worldwide.

Other similar botulinum options such as Dysport and Xeomin have been available for a number of years, and are reputable products with slightly different lasting and spreading qualities.

Over the next 10-20 years, I expect more botulinum toxins to appear. The question is, will there be any improvements?

An exciting advance is being reported in the United States, as two clinical trials have just shown a new botulinum toxin called RT002 can last for 6 months, rather than the usual 3-4 months that other toxins currently offer.

I’d like to see “real life’ use that confirms it really does last longer before I get too excited. We may also have to wait a number of years before it is released in New Zealand. Nevertheless, I expect botulinum injections to continue to grow and a greater variety of botulinum toxins to be developed over coming years.

Tighter regulations and a more educated public

Recently, I was reading questions in an Australian on-line forum for people considering plastic surgery.

“My surgeon has advised I need a more expensive implant – do you think it’s necessary, or is he upselling?” asked one member.

Whilst it saddens me that she has to ask this question, I think consumers are becoming aware they need to be careful.

The high demand for cosmetic procedures has attracted unscrupulous operators without appropriate training. Thankfully in New Zealand, regulations are tighter, although this does not remove the need for caution when choosing a practitioner.

NZSCM, the NZ Society of Cosmetic Medicine, trains and regulates cosmetic doctors in New Zealand and acts to protect the public from “cowboys” who put patients at risk. NZSCM has recently successfully lobbied for firmer regulations for dermal fillers. NZSCM will continue to lobby about safety in coming years, and I expect to see ongoing tightening of regulations to protect the public.

In the meantime, I encourage people considering treatment to do their research online; ask your practitioner about their training and experience, and ask friends if they can make any recommendations.

Check your doctor is NZSCM qualified or has a specialist qualification such as dermatologist or plastic surgeon.

I expect that in future, the public will be choosier about who they go to, as they realise the importance of proper training and supervision for these procedures.

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