Twenty years ago, a cosmetically altered nose or artificially enhanced breasts would have meant hours on the operating table knocked out under general anaesthetic and eight weeks of bed rest. Anyone who dared to venture into the day light would be instantly identifiable by the bandages bundled around their wounds, stared and scoffed at by passers by.
Fast forward to today, and the scene is almost unrecognisable. Plumped up lips and puffed up cheeks are commonplace, namely thanks to celebrities like Kylie Jenner speaking openly about their enhancements, and society is slowly opening up to the idea of people having treatments to alter their appearance. But as opposed to a record high of surgical procedures, the number of people going under the knife is plummeting.
According to research conducted by the British Association of Aesthetic Plastic Surgeons (BAAPS), the number of cosmetic surgical procedures hit a record high in 2015, only to drop more than 40% in the following year. BAAPS President and consultant plastic surgeon Simon Withey believes the figures represent a positive change indicative of people being more thoughtful about the serious risks associates with surgical procedures; “patients seem to be getting the message that cosmetic surgery is not a ‘quick fix’ but a serious commitment and are as a result, carefully evaluating risks as well as benefits surgery may offer. If it means people are taking their time to be truly sure a procedure is the right investment for them, then this can only be a good thing.”
While there’s little doubt that surgery is on the decline, many cite the advancement of less invasive alternatives.
According to consultant plastic surgeon and former BAAPS President Rajiv Grover, the public are “by and large opting for less costly non-surgical procedures such as chemical peels and microdermabrasion, rather than committing to more permanent changes.” Indeed, over 28,000 treatments of the kind are performed in the UK every year.
Dr Tijon Esho, renowned cosmetics doctor, agrees. “What we’re able to achieve with non-surgical procedures rivals results that previously could only be achieved through arduous surgical procedures,” he says. “When you take into account that the results of non-surgical procedures are immediate, there’s nearly no downtime required and they are far more affordable, it’s not hard to understand the change. People today don’t have time to take six weeks off work.” As well as the financial and physical advantages of a less invasive procedure, Dr Esho also notes that the most recent non-surgical innovations are reversible, giving patients a greater feeling of control.
The advancements can be attributed in part to the increasing expertise of doctors, who have learned from their predecessors and are able to implement a more sophisticated approach to aesthetic medicine. Take Botox or Botulinum toxin, a neurotoxic protein that temporarily paralyses muscles when injected. It used to be associated with a frozen look but recent developments in application has opened up a world of possibilities; “All the muscles and structures of the face are linked, so you have to consider how they move together in order to create a natural look,” says Dr Michael Prager, cosmetic doctor. “The aim is to subtly lift key points using small amounts of Botox to create a fresher appearance.”
Dr Esho notes that Botox has further cosmetic abilities above and beyond treating wrinkles. “Botox can be used to raise the eyebrow, the lip and the tip of the nose. It is also used for the treatment of a gummy smile and to slim the jawline by treating masseter hypertrophy [a condition where the jawline muscles are enlarged],” he explains. “It’s similar with filler. It used to be a case of, you see a line so you fill a line. Now, we have a much better understanding of facial anatomy and muscle interaction, we can use filler in one area to lift another area.”
As well as the techniques used, the products themselves have come a long way. “Old fillers were a lot harder and they certainly didn’t mimic natural tissue,” explains Dr Esho. He’s right – many of the older fillers were made of silicone and as well as being incredibly firm, were permanent. “The fillers available now are much more malleable and mimic natural tissue. Plus, they are a lot safer, and last around six to eight months before the results completely wear off.”
While it all sounds like the industry is going in the right direction, there is still a long way to go. Non-surgical procedures are relatively unregulated and although Botox is classed as a medical product requiring a qualified doctor to prescribe and administer it, fillers are not. In fact, fillers can be bought online and administered by absolutely anyone, all totally legally so the onus lies entirely with the consumer. If you are considering any type of surgical or non-surgical cosmetic treatment, it’s of paramount importance to research your practitioner, ask to see credentials and take time to consider your options. Doctor’s orders.