14 March 2016 March 2016 15 Expert guide: Aesthetics & Cosmetology 2016 The last 10 years has seen a huge increase in patients requesting facial rejuvenation. There are over 48,000 surgical procedures carried out annually in the UK, and this includes facelifts, eyelid surgery, and rhinoplasty (nose modify-ing) surgery. The range of treatments available to patients is bewildering, and the largest area of growth has been in the non-surgical aesthet-ic market. Complex facial surgical procedures still rate in the top 5 surgeries listed for men and women in the UK, but the non-surgical market has increased so that now it generates £ 3.6 billion a year.Patients are subject to constant battering from the press, TV and celebrities, and the offer of ‘quick fix’ surgery and treatments. These offers seem appealing and low risk, but often this is not the case. Patients are left dissatisfied and unhappy, and do not achieve the results they seek. The department of Health has commis-sioned several reports to attempt to regulate non-surgical treatments, and ensure that those who are offering these treatments are adequate-ly trained. This has not really had the effect that one might hope for, and the unwary pa-tient may still not achieve the results that they desire despite spending a considerable amount of money. Likewise, the Royal College of Sur-tion by the patient and the ability to consider the surgery I have discussed.It is not possible to design a universal facial re-juvenation process, but this needs to be highly individualised. It is important never to ‘sell’ an operation to a patient, and I think patients should be wary of this. My patients usually tell me that they want to look younger and not dif-ferent, and for me this means facial rejuvena-tion. Patients are often surprised that I use sur-gical and non-surgical treatments, and I think now that many of my colleagues would advo-cate this. Nonsurgical treatments that I routine-ly carry out include use of Botox and fillers. The only synthetic fillers I use are based on hy-aluronic acid, and are semi permanent. By this I mean that they will if used correctly produce subtle changes in the shape of lips, nasolabial geons of England, supported again by the de-partment of Health is going to introduce sur-gical standards for aesthetic surgery and this will provide a means of ensuring that your cho-sen surgeon is properly trained and has suffi-cient experience. When choosing a surgeon, you should ensure that they are a member of a professional organ-isation such as BAAPS (British Association of Aesthetic Plastic Surgeons) or BAPRAS (Brit-ish Association of Plastic, Reconstructive and Aesthetic Surgeons). Both of these organisa-tions seek to ensure that their members are well trained and operate to the highest clinical stan-dard.I always see my facial aesthetic patients at least twice. The first consultation is a ‘getting to know you’ experience for us both, and the goal of this should be an understanding of what the patient wants to achieve. It also allows me to as the sur-geon to examine them fully, and discuss how we may address their concerns. I encourage pa-tients to bring photographs with them, and this can provide vital information and be very help-ful in planning treatment, surgical and non-surgical. There is usually a ‘cooling off’ period between the appointments, and time for reflec-groves and cheeks, but their effects last for 6 months of so, and after this time will need to be repeated. Likewise Botulinum toxin, which has been used routinely in facial aesthetic treat-ments for 15 years only has a temporary effect, and may last for between 4 to 6 months. These products offer very different things. Bo-tox is used to soften creases or wrinkles in the skin, and is very effective around the eyes and forehead. It will, if used correctly still allow for movement of the eyebrows and forehead, but will give a softer appearance. Hyaluronic acid based fillers can treat deeper lines, particularly around the mouth, can fill out deflated lips, and fill out the cheeks. Again I always feel it is best to start subtly, and then add more if necessary. This may mean several visits, but I find my pa-tients are happier, and I can achieve the results that they are seeking.Simon Eccles www.simoneccles.co.uk simonecclespa@theconsultingsuite.co.uk +44 (0) 20 7927 6518 Decision Making In Facial Rejuvenation By Simon Eccles UK