July 13, 2023

ageing aesthetic treatments

Did you know that some aesthetic treatments can accidentally make your patients look older? Sometimes, you can perform a good treatment, with a good result, but by doing so in isolation on the face, it has a knock-on effect that achieves exactly what you do not want to do – it makes your patient look older.

For example, if you treat the cheeks and not the temples, the relative difference in volume between the cheeks and the temples can make the individual look older, although her cheeks look better!

In this blog, Dr Tim Pearce raises awareness of some of the areas where you should take extra care when delivering aesthetic treatments that you hope will make your patients look younger and fresher. You can catch up with Dr Tim’s preceding blog on aesthetic treatments that will make your patients look younger.

Do you feel anxious about causing complications? Many clinicians feel so overwhelmed with the thought of causing a vascular occlusion that it stops them growing their aesthetics business. Dr Tim is currently hosting a webinar series to help you overcome your fear of complications so that you can uplevel your knowledge, and increase your CPD-certified learning to build a successful aesthetics business. Sign up here >>

Does buccal fat removal make you look older?

As aesthetic clinicians, Dr Tim notes that we are aiming for a sweet spot when treating patients where you have volume and definition at just the right balance.

Aesthetics Mastery Show Dangers of Non-Reversible FillersCreating patients who are over defined is one of the key pitfalls in aesthetic medicine, he warns. This happens a lot with new injectors who learn to treat the cheeks, for example, and jump at the opportunity to do so when a patient requests this treatment. However, if performed, for example on a 48-year-old patient with a BMI of 19, the result will be skeletal and they will look older – yes, they required treatment to the cheeks, but not in isolation, it is likely they also needed treatment to the temple and sub zygoma.

With the recent trend for buccal fat removal, the clue is in the name and basically involves removing fat in the cheeks. If done correctly, this can achieve beauty. However, as the patient gets older, they will lose that fat naturally, and in this case whatever fat is remaining, thus they could end up looking gaunter as they age.

If you take a patient who is currently 25 years old and seeks removal of a large buccal fat pad that makes them appear rounded in the face, you can likely create a phase that spans from post buccal fat removal surgery until around the age of 35 where they will look great. However, once they reach 40, they will suddenly miss the fat that was removed. This is the primary problem with this type of procedure in the long term.

As aesthetic clinicians, we are aiming for that sweet spot, and this procedure may look good for several years but then the pendulum swings in the other direction and the sweet spot is gone.

What is driving men and women to get buccal fat pad removal?

Known for being a founding member of the boy band, One Direction, singer Liam Payne is rumoured to have recently had a buccal fat pad removal procedure. Yet to reach 30, many have commentated that the procedure has made him look much older and questioned his motivation.

Dr Tim notes that in his before photographs he appears more like a young boy, perfect for a pop band idol and to appeal to younger girls, but this look is not appealing to women who seek a more chiselled and masculine appearance. The key again is balance, the alleged after pictures show him with an unhealthier look, with over definition and volume loss that gives the appearance of someone who is either underweight or older.

But it is not just men, many female celebrities are also linked to this procedure. Known for appearing in Glee, American stage and TV actress Lea Michele is alleged to have had buccal fat removal. Her once baby-faced appearance changed to a more defined look which commentators noted made her look older than her mid-30s.

blowfish filler trout pout lipsDr Tim notes that the female cases highlighted seem to be pursuing an adolescent look, almost that of an adolescent boy. There is a very skinny phase that young women go through, and he has heard this attributed to, and influenced by, fashion designers, who tend to be gay men and favour this look in their models. This concept of very slim women, including in the face, is not the typical first preference of most heterosexual men, but it has become the fashion.

The most confusing aspect of aesthetics is what is objective beauty and what is fashion, proposes Dr Tim. He believes that with the rise in apparent proponents of buccal fat removal, we are detecting a trend or a fashion that within certain circles is valued but is probably not valued in the mainstream. There is obviously beauty involved in seeing cheekbones and jawlines, but this is shifting beyond beauty and into an edgy, fashionable appearance, influenced by celebrities.

Can too much volume make you look older?

A few years ago, Love Island star and social media influencer Molly-Mae Hague had several extreme aesthetic treatments including procedures to her cheeks, jawline, and lips as her celebrity status put her in the limelight. This appeared to give her an overfilled look and aged her much beyond her twenty years. She went on to have all the hyaluronic acid dermal filler dissolved and has become an advocate for the more natural look. Molly-Mae now claims she looks five years younger after getting her fillers dissolved, but why did these treatments make her look far older than her real age?

Dr Tim explains that Molly-Mae’s natural face is quite interesting. She has relatively petite proportions with no big features, just gentle contours between the cheek and jawline and her lips. However, the treatments that she had did not sit in proportion to her face.

He explains that aesthetic clinicians cannot treat patients like they are playing with a Mr Potato Head – they cannot simply take body parts and stick them on and expect it to work. This appears to have been the short-sighted approach used by those treating Molly-Mae at the time.

It is very easy to get drawn into carrying out procedures in isolation –

“I will have my cheeks done, I will have my jawline done, and now I will have my lips done”.

Sadly, none of it takes into context the overall picture of the face. You may look at the chin or jawline from one side, by itself, and it looks great, but in difference angles it can create an abnormal look if the whole face is not considered.

Dr Tim thinks this happens to a lot of well-intentioned injectors who learn a procedure to treat a specific area; it can look great in isolation but does not fit in with the underlying proportions of the face, creating volume loss in other areas. In the example of Molly-Mae, he points out that her temples appeared empty because her cheeks had been bulked out with filler, along with her jawline. This created a sense of volume loss underneath the cheek and volume loss above the cheek after the addition of too much volume in the other places.

Does having Botox too young make you look older?

Often popularised by reality television shows like The Only Way is Essex, we have seen a rise in younger and younger people having botulinum toxin or Botox treatments, often favouring a completely frozen look.

A youthful face is naturally dampened by fat, there is a little bit of movement, but the eyebrow positions and the way the cheek moves on smiling has a natural Botox-like effect because there is a dampening of the muscles by the presence of fat. Therefore, if you choose to treat a younger patient with botulinum toxin, you usually require lower doses. If you treat with normal dosing to achieve a more frozen look, it has been proven that muscle atrophy creates volume loss which can make you look older. This is not permanent, however, and is easy to cure by leaving sensible spaces between repeat treatments.

Dr Tim’s take-home message is that if you are constantly thinking about treating your patients along bony contours – chins, jawlines, cheeks – and you never consider the in-betweens – underneath the cheekbone, in the temple, in the forehead – you will naturally create an over defined, cachexic look which is more skeletal in appearance. You should be constantly maintaining a delicate balance between definition and volume when treating your patients.

Dr Tim loves to hear from his followers, so why not drop him a comment or question on social media if you have anything to say about treatments that can have the opposite effect to making your patients look younger and fresher; you can find Dr Tim Pearce on Instagram.

Aesthetics Mastery Show

Treatments that make patients look older – what to do instead

In this episode, Dr Tim discusses the treatments that are aging patients and what you can do instead to meet their needs for definition without compromising their youth. Watch the full Aesthetics Mastery Show here.

The video has been watched thousands of times already and has stimulated debate from viewers, including patients as well as practitioners. Feedback on the youtube page includes:

@sarahmunsey4907 said:

“I think the goal of individuals seeking buccal fat removal is to look older. But it takes some serious education and preparation on the providers end to ensure they can still look young/refreshed/healthy.”

@TexasLady added::

“I agree he looked so much better before. I don’t think this procedure helps anyone. They will hate when they are older.”

Read more comments and join in the debate on our YouTube channel.

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Dermal Filler eLearning Courses

If you want to increase your knowledge about safe and effective dermal filler injectable treatments, Dr Tim Pearce offers a series of fabulous courses. The foundation level is a popular starting point, with many delegates continuing to complications courses focused around safety, including how to minimise the risk and how to handle things if the worst occurs:

Both give CPD and certificates on completion and are highly rated by our delegates.

In addition, browse our FREE downloadable resources.

Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

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