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Aesthetic Medicine…

Submitted by on Sunday, 20 January 2008No Comment
Aesthetic Medicine…

As Dr Clark steadily withdrew the syringe from the girl’s philtrum, (groove between nose and upper lip), her mouth eerily changed shape in front of our eyes. Along with six aspirant ‘aesthetic’ doctors, I was attending a demonstration lesson in aesthetic medicine at the Sandton Aesthetic Institute. I queasily watched as Dr. Clark injected into the physiognomy (face) of a young female patient. The product being injected, Restylane, a gel containing Hyaluronic acid, is known as a ‘filler’. When injected into tissue it takes up space. It is hygroscopic and absorbs water around it and does not become solid in the body.

During the demonstration – which involved numerous shallow injections under local anaesthetic, the patient was constantly told to check progress in a hand-held mirror, and asked how she wished her lips to look. “This bigger..? Smaller..? Do you want a dimple..? More to the side..? Fuller ..? More kissable..?” etc.

Looking increasingly apprehensive, the patient laughed nervously and hesitantly specified between injections that she didn’t, “… want to end up pouting and looking lustful”.

“You won’t,” Dr Clark reassured her.

At the beginning of the exercise, she had possessed a very ordinary mouth; but just under an hour later, after dozens of small injections, she could undoubtedly look forward to a lip-smacking future.

Aesthetic medicine covers a range of beauty and anti-ageing treatments such as laser hair removal, cellulite reduction and skin rejuvenation, but without invasive surgery, and thus no recovery downtime. Changes made are not permanent and last from six to ten months. An advantage of which is that if you hate the result, it is reversible. You just let it grow out. A disadvantage is if you love the changes, you are condemned to bi-annual ‘top-ups’.

So how do aesthetic medicine and cosmetic surgery relate to each other? In many respects they are complementary. There are procedures that aesthetic medicine simply doesn’t do, or emulate; like most reconstructive surgery on noses (rhinoplasty), on eyes (blepharoplasty), on chins (mentoplasty) and on terminal defects; as well as facelifts (see later), breast reductions or enlargements; but there are areas which overlap, the most obvious being the administration of Botox.

I asked Dr Clark why someone wanting Botox treatment, would go to him instead of going to a plastic surgeon. “I have actually specialised in injecting Botox, whereas for most of them it is an ‘add on’. Also I have been trained by plastic surgeons, locally and internationally (University of Sweden). Such is the extent of my specialisation I am now an ‘accredited’ national trainer and ironically have taught Botox techniques to plastic surgeons.”

A major concern of his is that persons who have no medical training might be injecting the human body. “With the boom in medical aesthetics so new in South Africa, the line between conventional ‘beauty salons’ and medical aesthetics practitioners, remains blurred. But this is a branch of professional medicine that applies highly sophisticated technology and in-depth medical knowledge to the business of beauty.”

Treatments involving the injection of Botox and fillers require knowledge of human anatomy and the complex muscles of the face. While the results of such procedures can be extraordinary, in the wrong hands the risks are considerable. The stories of people undergoing Botox treatment and ending up looking like wide-eyed bats are legion.

“Is aesthetic medicine not just a softer more lucrative option than running a normal general practice?” I asked him.

“No.” He said. “To set up a proper aesthetic practice needs an enormous investment of capital, especially if you are buying a proper range of quality equipment. For example just one of my lasers cost R1.5 million. As to the lucrative nature – as a rule aesthetic medicine is cheaper than plastic surgery. But you wouldn’t want cut-price heart surgery so equally it would be silly to look for the cheapest aesthetic or cosmetic surgery procedures.”

I asked to Dr Richard Stott, Plastic & Reconstructive Surgeon and Clinical Head of the Wits University Donald Gordon Centre, his opinion of aesthetic medicine. “They are on an awkward interface between beauticians work and cosmetic surgery. But there is a huge demand from the public world wide and in my opinion plastic surgeons don’t want to do that kind of work. So somebody has to do it. Obviously who ever does it should be highly qualified and I think there is a huge need for training and regulation, to avoid the public being hurt. But I wouldn’t like to be in aesthetic medicine as the level of outcome wouldn’t satisfy me most of the time. Without surgery for instance, they can’t do a proper facelift which is probably the most anti-ageing procedure there is.”

It appears then that the choice between undergoing cosmetic surgery or opting for a non-invasive aesthetic procedure, depends on a combination of the desire for permanency, the cost and to some extent the level of faith in the practitioner and his qualifications to carry out the procedure.

I think I just might start saving for a lip job.

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