How to Avoid Looking Fake When Choosing An Aesthetic Treatment

More and more people are opting for aesthetic treatments, but what are the most popular natural looking treatments available?

Gone are the days of looking fake and overdone, says Dr Natasha Chapman, a GP specialising in aesthetic treatments at Laserderm. The trend in aesthetics these days is a very natural look. Women (and men) want to look good for their age, and they want it to look as if they haven’t had anything done. The greatest growth in aesthetic treatments has been in patients looking for non-surgical skin tightening. “It seems more and more patients are shunning plastic surgery, and even those who are prepared to go under the knife are trying to delay it for as long as possible. Treatments such as Ulthera nonsurgical skin tightening have seen a huge increase in popularity in recent years. The fact that a treatment can be done in your lunch-hour with no downtime, and that effects develop gradually and are natural looking, means that it has universal appeal to both men and women, in all population groups. Everyone wants to look as if they have just been on holiday – rested and rejuvenated,” Chapman says.

Dr Natasha Chapman

Similarly, treatments such as Fraxel laser, which remove sun damage, even out pigmentation, tighten pores, and reduce fine lines and wrinkles, are growing in popularity across the board.

“The trend is to have a great-looking skin that requires very little make-up. We are finding that women of all ages are looking for skin-rejuvenating treatments – everyone dreams of the soft, unblemished and smooth skin of their youth. More and more men are also becoming aware of these treatments, and ask for them specifically.”

More people are also becoming aware of the preventive benefits of using Botox and fillers at an earlier age, and Chapman says they are finding younger patients asking for these. “The biggest growth in this area has been in our black clientele.”

Dr Sly Nedic adds that, in her practice, she is seeing an increase in 3D face reshaping (3D Liquid Face Lift) for both white and black skins. This targets aging areas and delivers beautification of the face by putting the face in a golden ratio (divine proportions).

Dr Sly Nedic

“Every patient, regardless of ethnicity, wants to be the best version of themselves,” she says.

Dr Maureen Allem notes that general rejuvenation treatments that treat skin sagging, skin tone and skin texture are all on the rise: peels, Laser Genesis, threads, Titania, Exilis, Titan and, of course, Botox and fillers. From Dr Robert Gobac’s perspective, the most popular treatments on the increase in the white and black population are anti-aging treatments, and treatments for the problems associated with aging. “Due to an increased life span, we are becoming more and more aware of the aging signs, especially visible ones (skin), and need to work against them. Our lifestyle is the result of better nutrition, increased health-hazards awareness and improved fitness, and therefore we are becoming aware and disturbed by the visible signs of aging that we feel unfairly match all other aspects of our daily lives. It is no longer an issue of population group, but rather generations, regardless of ethnicity.”

Dr Maureen Allem

Trends on the Down:

Nedic is seeing a decline in isolated procedures, such as neuromodulator (Botox) only, or fillers for nasolabial lines only. “Patients are more educated about how global makeovers can slow down aging and beautify the face at the same time, so they seek procedures for a complete makeover. ” Chapman has noticed a definite decrease in the number of patients asking for a forehead that doesn’t move. Most people are looking for a reduction in wrinkles, but a bit of movement, ie a natural look. “Many of my patients are opting not to treat crow’s feet, or to reduce them rather than remove them, as these are the ‘smile lines’ that give character to a face. More and more, we are finding patients requesting ‘soften’, rather than ‘remove’.” Allem explains that patients are time challenged. In her clinics they have noticed a decrease in the number of deep peels with lots of downtime. According to Gobac, topical, old-fashioned treatments such as “skin-whitening”, abrasive and invasive peels are on the decrease all over the world. This is the result of heightened general awareness, education and available information. “Marketing machinery of the giant corporates is getting replaced by new, modern, fresh and freely available information, allowing genuine brands, treatments and therapists to replace the ‘dinosaurs’ of our traditional skincare industry.”

Is It True That “Black Doesn’t Crack”?

We asked the experts about the most common aging concerns for black and/ or Asian and brown skin.

Dr David Presbury, a specialist dermatologist from Laserderm says most of the general problems of aging do not seem to be a huge problem in the black patients.

Dr Presbury

”In my practice, it is surprising how few black or Asian patients consider coming for Botulinum toxin (Botox) and fillers, yet we see them all the time for pigmentation problems and scars. Pigmentation has many causes and it is a major problem for dark-skinned individuals, particularly in our sunny climate. We can usually help it in all skin types.” There is absolutely no “one size fits all” solution, he adds.

For example, it may be easier to diminish hyper-pigmentation following a burn than when it is due to melasma. Chapman concurs: “Without a doubt, the most common presenting complaint in older patients with darker skins is the increase in pigmentation, rather than wrinkles. Typically, areas that are more exposed to the sun, such as cheeks, noses and foreheads, become darker as we age. The resulting unevenness in pigmentation is usually what causes a patient to seek treatment. Unlike fairer skins, this pigmentation tends to occur in patches rather than discreet sun spots.”

Enlarged pores are also of concern to black skins, comments Tatiana Shuvalova of Ericson Laboratoire in South Africa. Large pores absorb more moisture, so oilier skin (more prominent in black or darker skin tones) is naturally protected skin and therefore does not age as quickly (lighter tones are more concerned about aging signs such as wrinkles).

Some of the most prominent differences are that black skin has greater trans epidermal water loss than white skin, explains Gobac. This also applies for Asian skin.

Black skin has a lower pH than white skin, which, in turn, should have a better defence mechanism against opportunistic infections from the skin surface. “Unfortunately, the rate of spontaneous desquamation (cell shedding) is higher in black skin than white or Asian, and this will cause easier blockage of sebaceous gland ducts and the formation of acne.”

Inflammatory acne is more common in black and Asian skin, and therefore will have severe repercussions for the formation of the hyper-pigmentation marks that are left after acne healing. Those marks will remain for long periods of time and will often be a bigger concern for the affected person than acne itself.

Increased granules in mast cells (cells in skin that are acting as inflammation regulators, for defence purposes) in black skin will make it more reactive to inflammation and infection, and could even be the reason why black skin has a greater tendency for keloid scarring, he adds. “However, with perfectly designed products, attention should not be wasted on studying and analysing ethnic differences; it should rather be spent on analysing the individual skin of each person, based on their own specific needs and problems, regardless of the skin ethnicity. This is the secret of good skincare,” Gobac says.