“Nobody wants to be told they’re old,” I later instructed him after we had passed an elderly woman sitting on a bench and he had cheerfully declared “She’s very old, Mummy!” loud enough for her to hear and for me to be mortified. I should add here that, in his eyes, teenagers were basically middle-aged. And to him, “old” wasn’t pejorative; his comment was an emotionally neutral observation. “Why is it bad to be old?” he asked me with the innocence of the very young. This was, now that I think of it, an excellent question. I answered clumsily, inadequately, coming up with something surely developmentally inappropriate about the march of time, the confrontation with death, etc., careful to spare him a discussion about our ageist culture that is bent on shaming us all for having birthdays after the age of 35.

I thought of all this when I recently watched 57-year-old actress, filmmaker and author Justine Bateman talk about her aging face on 60 Minutes Australia. The television segment was ostensibly a celebration of the current “Age of aging,” hailing 50-plus celebrities Michelle Yeoh, Jamie Lee Curtis, Paulina Porizkova and Bateman as its pinups.

 

 

 

 

 

 

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In the interview, Bateman recalled how, sometime in her early 40s, she googled herself and an autocomplete popped up: “Justine Bateman looks old.” She channelled the experience into her forthcoming book Face: One Square Foot of Skin, which takes aim at our dysfunctional, self-punishing relationship with aging, squaring off against a culture that frames getting older in a narrative of loss, as something that requires intervention and correction.

“I was taken aback to find that quite a few people had taken to Internet chat sites to passionately complain that ‘Justine Bateman looks horrible now,’” Bateman writes in her book. Its cover shows a pair of hands drawing lines under and around her eyes; on Instagram, she went further, posting a close-up of her face superimposed with a map of a plastic surgeon’s extensive suggestions, with the hashtag #TheresNothingWrongWithYourFace.

 

 

 

 

 

 

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This has proved to be an inflammatory stance. When I mentioned to my husband that I was writing about Bateman, he said: “Yeah, I saw a headline about her. Was there a scandal?” “The scandal,” I heard myself reply as if I was relaying the punchline in a New Yorker cartoon, “is that she has not had plastic surgery.” If it might once have passed as news that a celebrity went under the knife, it now passes as scandal if they don’t.

Part of the collective uproar over the natural state of Bateman’s appearance is that she doesn’t look young. More provocative, though, is that she isn’t trying to look young. “I just don’t give a shit,” she said about people’s reaction to her looks. “I think I look rad…I think my face represents who I am. I like it, and so that’s basically the end of the road.” Her comfort with her own appearance is in itself a middle finger to a youth-fetishizing culture, a refusal to submit to the rules of the game.

I will now age myself and admit that I grew up with Bateman as Mallory on Family Ties. Watching the Keatons muse over life’s disenchantments over pints of Häagen-Dazs at their round kitchen table was as tangled up with my childhood as Alex P. Keaton was in the coiled cord of the set’s wall-mounted telephone.

I’ll also admit that when I saw Bateman in the aforementioned 60 Minutes clip, I was stunned that she did not look like the fresh-faced, teenaged Mallory I remembered. I was then promptly stunned at my own idiocy—I mean, the woman is 57, not 16. But I was no more alarmed than I am when I behold my own face in the mirror and am reminded that I’m not 25. This, I think, is the point: Bateman’s un-Botoxed visage throws up a magnifying mirror to our own aging selves—and nothing is as unacceptable to us than our own weathered, wrinkled, sagging faces.

“For those in the spotlight, a panic can develop to surgically alter the aging face in an attempt to escape this ‘older, terrible face’ criticism,” writes Bateman in Face. “For those out of the spotlight, there can be a bit of horror in watching those who were once lauded as some of the ‘most beautiful people’ among us, publicly ripped to shreds when their faces age.”

It wasn’t always like this. In the old days, celebrities were allowed to age, both publicly and privately. Without access to injectables, or sunscreen, Audrey Hepburn, Elizabeth Taylor, Katherine Hepburn and Mae West all began to look older as early as their late 20s and early 30s, and while they may have lost the power they had in their full bloom of youth, the public didn’t hate them for it. But we have become so accustomed to seeing lifted, frozen, lasered and filled faces on our big and small screens that animate features and wrinkled skin now seems shocking.

Continuing on her book promotion way, Bateman took her unfrozen crow’s feet and uninjected lips to the morning talk-show couches. Host after manicured host leaned in sympathetically, furrowing their brows (well, some more than others) and commended Bateman for her bravery. And this is valid praise, because today, letting yourself age naturally is a radical act of courage. “I am brave in a lot of ways. But not in that way,” Jane Fonda (Jane Fonda!) told the Telegraph in 2015. Fonda has been open both about having plastic surgery on her jowls, eyelids and under her eyes, and about her fear of letting herself be seen to age naturally.

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In a culture obsessed with self-optimization, a refusal to partake in exhaustive, exhausting and expensive appearance labour is viewed as an act of self-abandonment, self-betrayal even. Somewhere along the way, we drank the Kool-Aid (or injected the botulinum toxin, as it were) and bought into the fantasy that aging is within our control, that the difference between looking fresh-faced and as well-used—and useless—as a crumpled Kleenex is a plastic surgeon on speed dial. Changelessness became the goal. It makes me think of a quote from Anaïs Nin: “Life is a process of becoming, a combination of states we have to go through. Where people fail is that they wish to elect a state and remain in it.” But let’s face it, that story is getting old.

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No sooner did one learn of the existence of “hip dips” did one also learn that they were undesirable. No good, not cute. Instead, what was desirable was a smooth, swaying curve seamlessly connecting the waist to the knee—in other words, the Kardashian hourglass.

Cosmetic surgeons began posting patient photos on social media, extolling the virtues of fillers and fat transfers to “correct” this apparent anatomical shortcoming. Fitness influencers promoted workout plans targeting the region, something many experts deemed a waste of time as “violin hips,” as they’re sometimes nicknamed, are mainly caused by the shape of one’s pelvis, something no amount of exercise can modify.

Well, we’re calling it: Buccal fat is the new hip dip. A region of the human physique few of us ever gave much thought to until, somehow, it permeated the zeitgeist and became yet another thing to feel self-conscious about.

“It seems to be one of the hot trends on social media now,” says Dr. Sherrell J. Aston, a world-renowned Manhattan plastic surgeon. Indeed it does. On TikTok, videos pertaining to buccal fat have amassed over 255 million views. 

If you’re unfamiliar with the term, “buccal,” pronounced “buckle,” comes from the Latin word bucca, meaning cheek. So “buccal fat” refers to the fat pad—our face comprises several, which help give it its shape—wedged between the cheekbone and jawbone.

“There are some people in whom it’s large from birth,” says Dr. Steven A. Hanna, a Canadian plastic surgeon who works with Aston and is currently completing a fellowship in New York City. “They have very round faces and look like cherubs.” Those are the people he and Aston consider prime candidates for buccal fat excision, a procedure during which excess fat is removed to narrow the face.

 

 

 

 

 

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As far as cosmetic surgeries go, this is one that’s considered relatively minor. It takes less than half an hour to perform and the sutures are hidden inside the mouth so there aren’t any bandages or external scars, only a bit of swelling for a few days. 

“Recovery was super easy,” says Patricia Gloria, a dog groomer out of Upland, California, who got the procedure done in December. “Maybe a little pain the day after, but I took some Tylenol and was completely fine. I felt back to normal after a week.” 

The 33-year-old had always had “chubby cheeks,” she says, but in recent years, she’d noticed they’d begun drooping, which made her insecure about her appearance, especially in photos. She saw a buccal fat removal before-and-after on Instagram and was stunned by the results. “I had no idea this surgery existed,” she says. She went in for a consultation and was scheduled to go under the knife a month later. “I couldn’t wait. I wanted to feel confident again and be able to take pictures with family and friends.”

As soon as she looked in the mirror after the surgery, she was elated. “I could immediately see a difference,” she says. “It’s only been two months, but I’m really pleased with the results so far.” 

She’s in good company. In Hollywood, pretty much anyone who’s anyone these days is rumoured to have gotten buccal fat removal. It’s as though it’s become part of the “welcome to fame” package, as commonplace as nose jobs and veneers. Bella Hadid is said to have had it, as is Zoë Kravitz and Lea Michele and Anya Taylor-Joy and Eiza Gonzalez. Two years ago, Chrissy Teigen posted a video to her Instagram Stories in which she pointed to her newly chiseled cheeks and shared she’d done “that buccal fat removal thing.” (Other celebs haven’t been so forthcoming.)

 

 

 

 

 

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The result is a parade of perfectly sculpted faces splashed over social media and red carpets. No wonder more and more people are walking into cosmetic surgeons’ offices asking to have it done. 

Aston says he’s definitely noticed increased interest around the procedure, though that doesn’t mean he’s been performing it any more than usual. “I’ve sent many young people away saying, ‘You’ll like it now, but you won’t like it as you get older.’” 

Because here’s what you need to know: As we age, the fat in our face naturally shrinks, causing us to look more gaunt. “Think about it: How do people in nursing homes look?” asks Aston. “They’re hollower in their cheeks.” So while some people, like Gloria, might benefit from the procedure, those who don’t resemble baby angels in a Renaissance painting run the risk of looking older as a result, especially in the long run. “There is evidence that the buccal fat pad is structural,” says Hanna, meaning it plays a role in holding up the face. Taking it out could thus lead to more sagging over time.

And there’s a kicker: You can’t undo it. “If someone takes that fat out when they’re 25—particularly some of the models who are having it done; they’re pretty thin to begin with—they may feel like they’ve got great cheek contour now, but the problem is, unlike some of the things we do, it’s not a procedure you can reverse,” says Aston. “You can’t fill that buccal space out with fillers very well. You can’t fill it out with fat graphs.” 

Even Sarah Balladares, a physician assistant and aesthetic injector in Louisiana who got buccal fat removal two years ago, admits “there’s a strong possibility that some people [who get it done] will look older long term.” That said, she doesn’t regret the procedure in the slightest and recommends it to patients when appropriate. “I get to look in the mirror every day and feel confident in my decision to have had the surgery,” she says. For her, it all comes down to finding a good doctor and making sure the procedure is truly right for you.

Seeking out an experienced surgeon is essential for another reason: “If you don’t do it correctly, you can have significant issues,” says Aston. There’s a facial nerve branch that runs through the area and if that nerve is damaged during the procedure, there’s a risk of hindering motor function in the face. A 2018 study found there was a “26.3 per chance of injury to the buccal branch of the facial nerve during total removal of the buccal fat pad simply based on anatomical variation.” 

All to say, while it may be a quick surgery with minimal downtime, buccal fat removal isn’t as straight-forward as it can seem on the outside. “It’s a trendy procedure and there are some people who will just do it,” says Aston. “A 20-year-old lady shows up in somebody’s office and says, ‘I want to take these out,’ and there are some people who say, ‘Yeah, sure.’ But I think it’s a good procedure for a limited number of people. Otherwise, you can make a 25-year-old look 45 with a 15-minute procedure.”

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There’s a Miuccia Prada quote that has always resonated with me that goes something like, “She’s the girl who spends so much time on her outfit that she forgets to do her hair.” Sounds about right. I’m also a hypochondriac who only fully accepted the presence of needles into my life at the ripe old age of 37 (many a blood test has ended in me passed out cold). 

All this to say, the fact that I became obsessed with injectables this year is kind of shocking to me. But something happens when a pandemic robs you of your stress-free mid-30s (okay, I don’t think that exists for anyone, but still)… it starts to show. Namely, in hollow, darkened crevices below my eyes that could only be temporarily remedied with copious layers of concealer and foundation. And laugh lines, which I’m convinced are so pleasantly named as to detract from the shock you feel when they first reveal themselves–they were suddenly there too. 

And while these small changes in my face were likely imperceptible to others, they made me feel uncomfortable in my own skin. Like it wasn’t really me on the other side of that selfie camera. Dermal filler–which I’d previously brushed off as something I wouldn’t consider for fear of it making me look unnatural–became very appealing. And the fact that my high school bestie was getting married on the Amalfi Coast on Labour Day weekend seemed like the perfect opportunity to explore. 

So, in late July, I headed to D Luxe Lab in Toronto’s Yorkville neighbourhood for a consultation with Dr. Basil Hassouneh, a surgeon who specializes in nasal and facial plastic surgery. I took baby steps, visiting the clinic with a friend who was getting Botox at the same time. (He was completely relaxed as copious needles punctured his skin.)

“If you support your face early on, you don’t get to the point where you need a facelift.”

I told Basil about my areas of concern, half expecting him to tear my whole visage apart. He didn’t. He told me to continue with those baby steps, only adding a small amount of hyaluronic acid filler under my eyes at first to ease into it. With a minimal amount of filler, I could fill the hollowness below my eyes, but also lift my cheeks slightly so that there was less sagging on my laugh lines–a loss of collagen, which comes with age, was responsible for both.

“I evaluate every person individually,” he told me. “I never want to go to a place where things look in disharmony.” Basically, I was quite far away from the overdone look I was afraid of–it was a matter of maintenance. “If you support your face early on, you don’t get to the point where you need a facelift,” Basil told me. 

I was sold on the treatment pretty quickly, and while it was certainly an investment (having filler injected by a doctor will set you back upwards of $1,200 depending on the area and amount used), the effects are immediate and last up to a year, sometimes even longer. 

I came back for my procedure a week later feeling calm, despite my midnight Google spiral the night before (I’ll spare you the details on the extremely rare side effect casually referred to as ’tissue death!!!’). After numbing cream was applied, Basil began injecting small amounts of hyaluronic acid under my eyes.

I’d like to think it’s scary for anyone to have a needle so close to your eyes, but the next thing I knew, I was starting to spin. We took a break, I talked myself off the hypochondriac ledge I’m so familiar with, focusing on the sunny Positano moments in my near future as two syringes were emptied into my under eye and cheeks. I left the clinic feeling like I’d been through war, and yet completely victorious over my inner doctor Google. 

“Aging is a process and permanency isn’t necessarily attractive.”

For a few days following the treatment, I was minimally swollen and bruised (as to be expected), something I remedied with ice packs and cold compresses. A few weeks later, it was like nothing had ever happened, only I looked like I’d been sleeping incredibly well. Funnily enough, no one noticed, which suited me just fine. Once the effects of my first round wear off, I’ll likely repeat the procedure. I don’t think I’ll ever go wild though. As Basil puts it, “aging is a process and permanency isn’t necessarily attractive.” I want to look like me… just more rested and less post-pandemic-y, you know?

A beginner’s price guide

Filler can be injected by nurses, medical aesthetician and doctors, with doctors having the highest rate associated. For more complicated areas like the under eye, it’s recommended to go with a doctor. In each instance, make sure you are comfortable with your practitioner and their previous experience. 

Lip filler

Thanks in part to the Kardashians, lip fillers are amongst the most common facial augmentations performed today. Rates vary between $500 and $800.

Cheek filler

Hyaluronic acid is used both to plump and lift cheeks so as to lessen frown lines. Expect to spend between $600 and $900

Under eye filler

The under eye is one of the most complicated areas for injections, so it requires an advanced practitioner with years of experience. Prices range between $1,200 and $1,500.

Liquid rhinoplasty

Hyaluronic acid is used to mimic the effects of a nose job through less invasive means. A doctor is recommended for this procedure as it can presents substantial risks. It will set you back between $900 and $1,600.

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Then, the whole southern hemisphere of my visage was a sort of anatomical Switzerland—a corporal province of restful indifference. I felt great, almost morally superior, about not feeling bad about it. Ephron was 65 when the piece was published, and I concluded (the smugness of youth!) that by middle age I would surely have gained enough wisdom, sagesse and appreciation for the precious fragility of time to spend it worrying about neck wrinkles, dermal sag and the fragility of the jawline.

I now long to be as young as that first time I felt old. “According to my dermatologist, the neck starts to go at 43 and that’s that,” wrote Ephron. I can confirm that this prediction proved uncannily correct—by your early-to-mid 40s everything does seem to, well, go south. So, too, have my delusions of reaching a stage of mellow and worldly self-acceptance. I am mature enough to notice a certain descent in the lower face and neck region, but not mature enough to dismiss my concerns about it. I have also developed enough vanity (and vulnerability) to care, and enough intellectual vanity to hate myself for caring.

I am mature enough to notice a certain descent in the lower face and neck region, but not mature enough to dismiss my concerns about it.

“In your early to mid-40s, you are experiencing a fluctuation in estrogen and progesterone levels. You’re not all of a sudden growing more skin; you’re experiencing a loss of bone density, an involution of your bones, your facial skeleton is shrinking, so everything on it looks saggier,” explains sought-after New York–based plastic surgeon Dr. Lara Devgan. I feel my mood beginning to sag as she speaks. “Imagine you have a beautiful couture coat, and it’s on a hanger and then the hanger shrinks—the coat is going to start looking less and less structured,” she says. This loss of structure causes a bottom-heavy pile-up of flesh—a blousing, creping, pleating, wobbling. (There is a wretched poetry to the language used to communicate the maturation of the lower face, all designed, it seems, to send you directly to the syringe—or the psychiatrist.)

But if what is causing these changes is as old as time, our obsession with the area is newly intense. Patients in their 30s and even 20s are now hastening to book appointments to see what can be done. “The ‘snatched’ jawline—a tight, swept-back jawline—is very popular. It’s all over TikTok,” says Toronto dermatologist Dr. Julia Carroll of Compass Dermatology. This look is sought after by what she calls a “beautification group” of Kardashian-influenced patients who have exactly no signs of aging.

Interestingly, she points to a psychological undercurrent to this aesthetic trend. “Think about the language: strong jawline vs. weak chin. There’s judgement in those words. A jawline invokes ideas of power and confidence,” says Carroll. “All Marvel superheroes have strong, chiselled jawlines.” Meanwhile, villains like The Joker have lax jowls, the melting ambiguity of their jawline conflated with moral collapse.

There should be a new diagnostic term for the micro-trauma that occurs when you behold the southern hemisphere of your face by grace of a Face Time video you didn’t know was on.

While judgment, Hollywood beauty standards and the ruthless march of time are nothing new, the ubiquitousness of our own image is. “That’s another thing about being a certain age that I’ve noticed: I try as much as possible not to look in the mirror,” wrote Ephron, “If I pass a mirror, I avert my eyes. If I must look into it, I begin by squinting, so that if anything really bad is looking back at me, I am already halfway to closing my eyes to ward off the sight.” But today, we are in the constant punishing company of our own reflections. In the age of video calls and selfies, we can’t avert our eyes. It has occurred to me more than once that there should be a new diagnostic term for the micro-trauma that occurs when you behold the southern hemisphere of your face by grace of a FaceTime video you didn’t know was on—one that your newly blousing jowl might have reached down and turned on for you.

“It’s 100 per cent Zoom,” says Carroll, accounting for the rising popularity of lower-face treatments. “We’re used to seeing ourselves straight-on in the mirror, but with Zoom, you catch yourself in a lag or you see yourself in a three-quarter view, and…” Carroll and I were not on Zoom for this exchange, but I must have let out a heavy sigh at this point. “I’m not depressing you, am I?” she asked. “There are just so many things to worry about,” I say, weary at the thought of all of this imminent descent. “Yes, but there’s also so much you can do now, it’s great!” she replies with pragmatic cheer, as someone who clearly traffics in uplift (of sagging skin and moods). A perfect storm of technology and neuroses has led us here—we have the technology to witness and study our own aging faces and now we have the technology to intervene as well. “We’ve conquered the upper face with Botox and filler, but now tightening the lower face is more achievable,” she says.

The face’s southern border seems to be to cosmetic professionals what the Gold Coast was to the American Cowboy—a landscape of possibility. “The lower third of the face is the final frontier,” says Devgan. Among the skin-tightening possibilities she lists are Botox applied to the mandibular border or underneath the jawline. This causes the muscle to contract and makes the lower face look more defined. She also recommends the (very judicious!) use of injectable filler, placed in the cheekbone and jawline area to fill the bone structure and rebuild the loss of skeleton.

The lower third of the face is the final frontier.

While some dermatologists are reluctant to use filler in the lower face, as it can add weight and, well, gravity to the situation, Devgan says it’s all about the artful precision of its placement. “You can use the same syringe of filler and the same volume and make it look totally different with different people. It’s extremely practitioner dependent. It totally depends on who is on the other side of the syringe,” says Devgan. “It’s called dermal filler, but I almost never use it in the dermis,” she continues. “I almost always am using filler on the periosteum [the layer of tissue enveloping the bone]. And that’s how you make somebody look more structured. If you place filler superficially it can look bulkier, but if you place it deep, it can make a face look paradoxically slimmer even though you’re adding volume. It’s all about going deep in the tissue plane.”

Carroll shares a similar filler philosophy. “I hate the word ‘filler’—most of the time, I’m not filling. To treat the lower face, I start at the top and work my way down. It’s about lifting from the temples, the cheeks and behind the ears, behind the jawline. I’m strengthening a ligament, I’m lifting. It’s all in the artist’s hands.” Should you prefer a needle-less procedure, Carroll also recommends Ulthera, a device that dispatches ultrasound energy to the skin to induce collagen production and firm the skin. “When you look at celebrities that look good, who look like they are paused in time, they’re probably doing Ulthera regularly,” she says.

Keen on pressing pause, I decide to visit Toronto’s Clarity Medspa for an Ulthera treatment. Registered nurse and medical aesthetic trainer Chantal Ward begins by appraising my jawline and taking a variety of photos, the sort that could serve as blackmail. She is direct but never shaming—a fine balance. I had been warned that the treatment could be wincingly painful, but under Ward’s deft hand the treatment is less unpleasant than a dentist’s appointment. In a few months, she tells me, I’ll look rested and fresh. I feel freshened just at the prospect, and I leave her office hoping my collagen will be as boosted as my spirits.

Devgan is more circumspect about heat and energy-based modalities like Ulthera and Thermage, which are intended to tighten the tissues. “The results are clinically insignificant,” she says. As a cosmetic surgeon, she is able to offer more significant results—at a more significant cost, of course. “In New York City, a lot of patients are moving toward face lifts in their 40s,” she says. “They lift the tissues, re-drape the skin, de-bulk the heaviness of the lower face, and de-fat some of the excessive jowls,” she says, describing skin as a kind of carnal upholstery that occasionally needs to be renewed.

I feel my hope, if not my jawline, swiftly snatched. I don’t have the time, or the income, to throw at this particular neurosis. Major intervention is not in my future. Short of taking to the operating table, Devgan recommends minimally invasive suture-suspension lifting, sometimes called a thread lift, in which sutures are placed in the deep plane of the face to reposition sagging tissues. “It gives you a beautiful result. But it’s a luxury intervention—it doesn’t last,” she says. “Nothing is as durable as surgery.” Except for despair.

The lower face treatments

Ulthera

This treatment uses focused ultrasound, or heat energy, to induce collagen production and lift the skin. It takes up to an hour, and there’s no downtime. Lower face and neck treatment costs from $1,200 to $3,500 depending on the area being treated, and results from a single treatment last at least a year.

Suture suspension lift

Here, custom-moulded polymer sutures are “threaded” below the skin to reposition facial tissues, meaning it can lift what sags. Downtime is minimal, and results last about a year. Prices start around $7,000.

Filler

Filler can be used to add structure to the jawline and lift a descending lower face when applied at strategic points by a talented and judicious practitioner. There may be some bruising for a few days, and results last a year or more. A syringe of filler costs around $800, but the amount and application vary widely by patient.

Face lift/neck lift

A surgical procedure that resuspends the muscular substructure of the face for long-lasting lifting. It typically involves anaesthesia, up to three weeks of downtime and small scars that are usually hidden in discreet areas. A full face lift can cost upwards from $19,000 depending on the surgeon; a mini lift or neck lift that addresses more minor sagging of the lower face may start around $12,000.

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“I’m totally fixated on the bags under my eyes. I always look tired, even if I’m not. I’ve spent a fortune on concealers, but there’s no covering them up anymore. Surgery feels too radical for me, but is there anything else that will help? I don’t really understand how fillers work. Could they work for this?”—Johanna, Toronto

First, it must be said that we are all looking more closely at ourselves than anyone else is, Johanna. But then, for me, this is the point of aesthetic procedures: we do them for ourselves.

I will hand the mic straight to dermatologist Dr. Julia Carroll, of Toronto’s Compass Dermatology clinic, where she does all manner of cosmetic treatments. I love her work: it is subtle and she can really read and work with facial structure. With the non-invasive procedures she does, you don’t get the big “reveal” of plastic surgery, instead you get a slow and steady improvement, until you (blessedly) can’t remember what you were so fixated on before. “There is a reason we take before and after photos,” she says. “Some of the treatments we do take weeks or months to show results. You get used to the changes over time.”

I couldn’t take you in with me, Johanna, so I had Carroll look at my face as a proxy. I’m a few years older, but the under-eye area only really started to bother me recently. “Every face, and every solution is different,” was the first thing out of Carroll’s mouth when I asked her your question. “Treatment is always customized.”

Before we dive into the nitty gritty of what can be done, Carroll explains her approach to assessing a patient’s concerns. “So people come in and ask about bags under their eyes. You observe volume loss or discolouration or thinning skin. Bags under the eyes is the diagnosis,” she says. “But what is the cause? You have to take two steps back; you can’t just treat features in isolation. That’s when people start to look odd.”

“You can’t just treat features in isolation. That’s when people start to look odd.”

If someone goes to their doctor to complain about dizziness, she offers as an example, the doctor doesn’t just give them dizziness pills. She has to figure out why they are dizzy. “It is the same with aesthetic medicine,” Carroll says.

Who is a good candidate for under-eye filler? “Not you,” she tells me. “You need to have a defined volume loss under the eye, with good skin integrity.” Here she shows me the “snap test,” which shows how well the skin bounces back. She is avoiding the word “crepey,” but I see a little creeping crepe under my own eyes.

A good candidate with “classic tear trough volume loss” would receive a “traditional filler of hyaluronic acid gel.” That would be approximately $800. Docs use very little filler these days—Carroll describes a syringe as containing “a fifth of a teaspoon, or one-tenth of a packet of ketchup from McDonald’s.”

In the early days of fillers—the technology goes back to the ’80s, but only went into widespread aesthetics use in the past two decades—“doctors went high volume, filling the face up like a balloon,” Carroll says. This did not look great, and some of my own fear of fillers dates back to the early 2000s and what happened to various celebrities’ faces; you know the ones.

Treatments must also be holistic. Carroll says judicious amounts of filler in what she calls “secret lifting points” on the face will give lift invisibly, and support the undereye treatment. “We’ve evolved a lot. You need to do a bit of natural filling and lifting on the side: temples, cheeks, in front of the ears. This will help improve the lower face, too. If you still have gravity pulling things down, you have an uphill battle.” In other words: if you just focus on the one thing, that is when fillers can make you look weird.

Her rough rule is one dose of filler per decade, plus an extra if you smoke or have sun damage. Remember that one syringe of filler costs about $800. That means that to do a really great job on your undereye bags in a holistic way, you may spend another couple of thousand on fillers and a little Botox here and there. Ladies and gentlemen, I’ve seen the results and it is well worth it, if you can swing the price tag.

But what about my eye bags, which are not good candidates for filler? Carroll says she would do a combination of Ulthera and PRP. Ulthera is a technology that has been around for a while; it is micro-focused ultrasound, designed to tighten skin. It hurts (though there are various pain relief options), and it takes time to show results, but those results last for a long time. Under-eye treatment is about $1,500.

PRP (which stands for platelet-rich plasma treatments) we have spoken about often in Ask the Kit. In this case, Carroll says she would do two under-eye treatments, eight weeks apart, so two times $800. “I would put in PRP via a cannula, like a filler; and I would also flood the zone with microneedling just below the skin surface.” PRP helps thicken the skin and improve skin tone. It is your own blood spun to remove cells, leaving just the plasma and platelets. “If you injure yourself, the first thing that shows up is platelets that tell your body what to make more of,” she says to explain how it works. In this case, that would be collagen, which help restores the elasticity that was lacking in the “snap” test.

There are lots of other tools in the medical aesthetics toolbox, says Carroll, including Sylfirm, a new RF microneedling tool (she calls it a next-generation Morpheus, for those fluent in radio-frequency aesthetics machines). Lasers can also help with discolouration. “Again, the treatment has to be customized. We have so many options now, but everything isn’t right for everyone.”

We switch over to eye creams. I’m always hoping my problems can be solved with the right jar. “They do help,” she says. “Especially the med-spa options. But please, can you mention how important it is to use sunscreen? It really is the most important anti-aging tool there is.”

Carroll points out two eye serums that she particularly likes; she also shows me before and after photos of herself she took while experimenting with these specific potions during the pandemic. I can see the improvement right there on the doc’s face. One is Neocutis Lumiere Illuminating Eye Cream, which has caffeine to stimulate circulation and ease dark circles. The other is Alastin Restorative Eye Treatment, which takes down puffiness and makes the area look dewier after regular usage. I tried these, and over time—which I normally don’t give to products, because there are so many to try—I, too, am pleased with the results. Sticking with something really does pay off. So does modern aesthetic medicine: it is an investment, to be sure, and the results are subtle. But to me, that is a great thing. No one really wants to look different: we just want to look a little bit fresher, and do a bit better on our snap tests!

Shop the Advice

Specialty eye care does not come cheap! But a little goes a long way

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This eye cream is available at physicians’ offices, and comes tested and recommended by Dr. Carroll.

At a more accessible price point, this drugstore favourite contains gold-standard retinol to firm and refresh under-eyes.

Another Carroll favourite, here a combination of peptides helps to smooth fine lines and take down puffiness.

Vitamin C and ferulic acid go to work in a refreshing gel formula to brighten and depuff the eye area.

This article contains affiliate links, which means The Kit may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by advertising. By clicking on an affiliate link, you accept that third-party cookies will be set. More information.

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The permanent makeup renaissance that began with the eyebrow micro-blading boom has migrated to our mouths, and now lip blushing—which is basically a lip tattoo—hashtags are invading our feeds with an endless scroll of perfectly rosebud-y, pink-ified pouts.

In addition to juicing up the shade of your lips, a lip blush tattoo can add more definition to your Cupid’s bow and give the illusion of slightly fuller lips. Some pretty interesting upsides, especially as we age and our lips start to lose their shape and volume. While I had tiny bits of lip filler many moons ago and loved the results, that only lasted for about eight months. Lip blushing can last three to five years, so obviously I had to try it. For science! 

Thankfully the harsh permanent makeup of the ’90s and early aughts that left women looking like a deranged Auntie Mame and sometimes faded to an awkward blue hue has morphed into a kinder, gentler form as the techniques, machines and even the ink that’s used have evolved over the past 20 years. While you still can get darker permanent makeup on your lips—often called a “lipstick effect” technique—lip blushing, which gives you a wash of colour akin to your favourite tinted lip balm, looks a lot more natural. 

“It’s more modern,” says Veronica Tran, who does lip blushing at the Markham outpost of her Pretty in the City studios. “It’s softer and more diffused, and the colour isn’t as saturated.” 

 

 

 

 

 

 

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But like any tattoo, lip blushing isn’t risk-free. Because anybody can get “certified” to do lip blushing in as little as two days—there’s no industry standard—you can easily end up with someone whose facilities aren’t up to code or who just doesn’t have a steady hand putting a semi-permanent tattoo ON YOUR FACE. Infection from poorly sanitized tools or premises is the biggest risk, so make sure wherever you’re going has passed a public health inspection (in Toronto, tattoo services are certified by the BodySafe program). You’ll also want to seriously vet the artist you’re booking through word-of-mouth, reading online reviews and trawling through their websites and Instagram feed to see their work.  And if the price seems too good to be true, it probably is. Lip blushing generally costs between $500-$800 (Tran charges $525 for the initial visit and $60 for a “perfection” touch-up two months later). 

A cosmetic tattoo can trigger cold sores, so before your appointment Mama Tran makes all her clients start a course of anti-viral meds. She even makes you bring the bottle to prove you’ve been a good girl (I was!). Tran draws the outline of my New Lips in lip liner, which, other than a pointier Cupid’s Bow, isn’t radically different than my usual lip shape. You can’t scribble too far outside the lines of your vermilion border (i.e., where the lips turn into skin) because not only would you look like a toddler who stole her mom’s lipstick, but the colour would also fade unevenly. 

After Tran applies topical lidocaine, we talk about colour. I want something as rosy as possible, but Tran advises me to go easy the first time, telling me I can always boost it at my follow-up appointment. 

Now it’s party time!

Lip blushing uses tiny, mechanized needles to layer pigment. Tran does the outline with a single needle but then switches to something that’s (somewhat alarmingly) called the “Magnum,” a larger head with multiple needles in it that she shades back and forth over my lips, to fill in the colour. “Think of it like a dot matrix printer,” she explains. 

It doesn’t exactly tickle, but it’s not the worst. It feels like someone is scribbling on my lips for two hours with a particularly scratchy pen. Immediately afterwards, my lips look amazing—super pink and juicy thanks to the swelling, but Tran has already warned me that once the scab falls off in about five days it will take about four to six weeks for the colour to “bloom,” and that it will be at least 30 to 50 per cent lighter than this rosebud lip scab of my dreams (a phrase I’d never anticipated writing). 

@fyttttttttt Would yal try? 💋 #lipblush ♬ Love Tonight – David Guetta Remix – Shouse

Like any tattoo, a lip blush is basically an open wound, so I have to apply a clear ointment all day long to make sure my lips stay moisturized until the scab falls off. Rule number 1? No picking! If you scrape or pull the scab off, the colour might not take and you risk damaging the skin on your lips.  

I wait like an 11-year-old girl hoping for boobs for my colour to “bloom” (Will it be today? How about today?). After about a month my lips definitely have more definition—like I’m wearing a very light lip liner—but there isn’t a big change in the colour. But then I get my second treatment. 

Thanks to various stages of COVID lockdown, I can’t get back in until almost 6 months later. But when the colour “blooms” this time, it’s definitely noticeable. I wake up looking like I have the chicest little lipstick stain left over from a big night out, or like I’ve been eating popsicles in my sleep. I love it.

Now who wants a kiss? 

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The post I Tried Lip Blushing, a.k.a. Permanent Lip Makeup appeared first on The Kit.

A social media outcry ensued. Hadid’s Dutch-born mother, Yolanda Hadid, was accused of stage-managing her daughter’s plastic surgery, and of encouraging her to conform to white, Eurocentric beauty standards.

It must be said that Bella Hadid wears her current nose—petite and refined, if a little…surgical—with the same arresting self-possession she wears everything else. And it’s a little difficult to generate sympathy for a preternaturally spectacular and successful supermodel lamenting a loss of imperfection, longing for a flaw. But what’s really at issue here is the question of whether a 14-year-old is too young to outsource physical insecurities to a surgeon’s blade, parental permission notwithstanding. If your nasal bones have not reached maturity by 14, neither has your pre-frontal cortex—one’s adolescent judgment may well be more objectionable than the proboscis in question.

In fact, there isn’t a firm consensus on when a nose is ready to be operated upon. Some doctors venture it’s at 16, some say it’s 18, some say it’s 25. In Australia, for example, there is a federal law banning people under the age of 18 from getting cosmetic surgery. But, in Canada and the U.S. there’s no legislation around this subject, no hard and fast chronological cut-off.

“I don’t worry so much about the physiological age of the patient—I base my decision on the patient’s psychological maturity.”

“Timing remains a contentious issue,” says Toronto-based rhinoplasty surgeon Dr. Oakley Smith, known among cosmetic surgeons as “the nose guy,” when I ask him if there’s a wrong age to get a nose job. “But I don’t worry so much about the physiological age of the patient—I base my decision on the patient’s psychological maturity. The actual change in the nose is important but mostly insofar as it influences the person’s psychology and self-perception. Rhinoplasty is a psychological operation. That’s why cosmetic surgeons are known as psychiatrists with a scalpel.”

Dr. Smith tends not to see patients under the age of 16. Before then, he believes, patients (we could also call them children) are too likely to internalize their parents’ opinion as their own. Although Dr. Smith is unfamiliar with Hadid’s nasal history, upon hearing the tale, he ventures that what she may be regretting is not the plastic surgery itself, but the nose she ended up with. The era of the ski-jump nose is going the way of the skinny jean: People are no longer solely in the market for the northern European “baby button” nose that’s slightly turned up at the tip, with a delicate dorsal scoop. “Patients want a natural look and they want to maintain their identity connected to their heritage, but at the same time, they want a good-looking nose,” says Smith. “Oftentimes those two desires are in conflict.”

 

 

 

 

 

 

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Just as the soi-disant “natural nose” is in vogue (so long as it’s “good-looking”), so too is expressing regret. Author Daniel Pink’s latest book, The Power of Regret, champions the value of regret, celebrating it as a healthy part of the human condition. “No regrets” is a wrongheaded credo better left to hashtags, sociopaths and uninspired tattoo artists. (The book shares the classic anecdote of a man who regrets getting a No Regrets tattoo.)

The upheaval of the past two years has exhorted us all to reframe our perspectives on everything—our work, our time, our decisions, our noses, etc. It exposed our silver-lining dependency, inciting us to trade the tyranny of optimism for the tyranny of regret, which is at least more honest. Although I suspect that this new celebration of regret may just be another way of framing the half-empty glass as half full. Edith Piaf’s warhorse, “Non, Je Ne Regrette Rien,” always struck me as unbelievable (like, really, rien?), and also as profoundly un-French. My mother is French and I can assure you that I was raised on regret. To me, the feeling has long been as central and prominent as the nose on my face.

I admire strong noses on other women—Anjelica Huston; French actress Camille Cottin of Call My Agent—in the same way that I think puff sleeves and mustard yellow look fabulous on people who aren’t me.

I’ll admit that I’ve long regretted the prominence of my own nose. As the bromide goes, we are more likely to regret the things we didn’t do than the things we did. And I have often regretted not getting a nose job when I was younger. (I’ve also regretted wasting energy on this particularly frivolous regret, and the time I’ve wasted nasal-gazing in general.)

Fashion editor and icon Diana Vreelend famously said, “If you have a long nose, hold it up and make it your trademark.” I love this point of view, and I regret that I’ve never developed the confidence to adopt it myself. I admire strong noses on other women—Anjelica Huston; French actress Camille Cottin of Call My Agent—in the same way that I think puff sleeves and mustard yellow look fabulous on people who aren’t me. The strength of Huston and Cottin’s noses implies a vive la résistance refusal to submit to aesthetic convention, giving them a certain hauteur and sex appeal. Their attractiveness also comes by dint of their own self-acceptance, from the peace treaty they must have made with themselves somewhere along the way.

 

 

 

 

 

 

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A post shared by Anjelica Huston Archives (@anjelicahustonarchives)

It makes me think of a quote I once read by psychologist Carl Rogers: “The curious paradox is that when I learn to accept myself just as I am, change happens.” Maybe when I learn to accept my nose, I’ll finally get a new one.

“You’ll work out a peace treaty with your nose,” Smith assures me. “If you don’t, you’ll be the exception, not the rule.” By his calculations, I have aged out of ideal nose job candidacy. “Rhinoplasty is a young person’s operation,” he says. “Twenty-five is the choice age.” He attributes this to social biology. “When you’re in your reproductive years, you’re out there looking for a partner. You want to look good, you want to procreate. In your 40s and 50s and 60s, you just no longer care. There’s no longer a genetic imperative.”

But I don’t think we do stop caring. A friend of mine who is equally dissatisfied with her nose recently said to me wistfully, “I’ve dreamed of getting a nose job,” as if she were talking about going on safari in Botswana. She added, “but I’m in my forties now. It’s too late. It might be my deathbed regret.”

The younger me imagined that what we lose with age (youth, collagen, possibilities, etc.), we gain in wisdom and perspective. I regret to inform her that the calculus isn’t so neat. As far as I can tell, we don’t magically ascend to peaceful, wise-woman-on-the-mount status in midlife; hard-won sagesse doesn’t suddenly replace superficiality. Age merely shifts the needle (forgive the pun) so that rejuvenation surgeries like face and breast lifts, designed to make us look like we used to, become more socially acceptable than wanting to alter how we’ve always looked.

Vanity and its close friend self-criticism aren’t reserved for the young. Our issues with ourselves change, but they don’t evaporate. Dr. Smith tells me about his oldest rhinoplasty patient, who was 84 at the time. “She said to me, ‘Look, now I’ve got the money and I’ve got the time, I want to do this!’ So, she did. She was very happy.” No regrets.

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The post Is There a Wrong Age to Get a Nose Job? appeared first on The Kit.

After two kids, I don’t love my breasts anymore. I just don’t feel like “me.” I was reading about yet another celebrity having her boobs “done,” and it made me wonder—is surgery really an option for a normal (non-celebrity, non-socialite) person? How long is the recovery? Will it look natural? Do I need a breast implants or just a lift? —Sagging in Sudbury

Great question! When it comes to breast surgeries, I know to hand the mic to Toronto cosmetic surgeon Dr. Jacqueline Rose Makerewich. She is great at breaking down not just the nitty gritty details of cosmetic surgery (she posts surgical journeys on Instagram at @realdrrose) but the emotions behind it, informed by her feminist philosophy.

“To me, body positivity is achieving harmony and a positive relationship between your body and your mind,” Makerewich says. “I firmly believe that people have a right to their own bodies and should be able to love themselves in whatever way they personally deem best.” For some, that means accepting our bodies as we age and not trying to change them. For others, it means making peace with lingering stigma around cosmetic procedures. “I hope that the movement will continue to grow and will one day embrace surgical scars as an acceptable and shameless body attribute, too.”

In answer to your question about whether “normal” people seek surgery, Makerewich describes her patient range: “My patients range in age from teens to 70s! My patients are pilots, exotic dancers, lawyers, women in the military.”

The initial consult is where Makerewich probes for what a person really wants from surgery, and why. “Surgery is life changing, there are risks, and recovery is a commitment,” she says. “Being emotionally fit for surgery is just as important as being a healthy candidate physically.”

Restoration of confidence is something many of her patients cite, but she needs to make sure they understand it isn’t a quick fix for all that ails them. “Cosmetic surgery may have the effect of improving confidence, but you shouldn’t pursue cosmetic surgery to give you confidence or to restore confidence—that has to come from within.” Red flags include people who want surgery to please, or find, a lover.

A better reason to pursue breast surgery is wanting to restore your breasts to their pre-childbirth shape. Many moms “feel fit and healthy and their deflated and loose breast tissue doesn’t feel harmonious with the rest of their body,” Makerewich says. A patient with realistic expectations for surgery will have a good understanding of their body and will be able to describe in detail the specific change they would like to make.

So here are the hardcore details. First, the breast lift. “The general idea with a lift is to remove skin and reshape breast tissue to create a perky breast and correct droop,” says Makerewich. There are two common scar patterns for this: A vertical lift creates a lollipop scar, where the incisions travel around the areola and in a vertical line down to the bottom of the breast. With an anchor scar, there is an additional scar in the breast fold, which allows for more skin removal and a “powerful” lift.

There are more technical enhancements possible from there, including liposuction and a reinforcing “internal bra” or suturing. But to achieve a lift, note that the nipple always has to be moved. “A breast lift alone is best for patients who want a natural teardrop-shaped breast and would be happy with a breast that looks perkier and slightly smaller.”

If you are looking for any lifting effect, know that implants alone will lift the breasts very minimally. Rather, they are used to add volume. Breast implants vary by fill material, profile and volume. The two options for fill material are silicone and saline (salt water). There are many different shapes available, ranging from low profile (more natural-looking) to extra-high profile (a round-looking breast with more projection and upper pole fullness).

In terms of cost, this is an investment for sure: A breast lift typically ranges from $9,000 to $12,000. Implants add extra expense. The addition of lateral chest wall liposuction for contouring can also increase surgical time and therefore cost.

There is a time investment to surgery, too: Major recovery occurs during the first week. Most patients can return to sedentary work or activities after one to two weeks, and to exercise and heavy lifting after six weeks.        

That’s for physical recovery. But the emotional side of healing is a particular research interest of Makerewich’s. “Immediately after surgery, patients feel excitement and relief,” she says. “They are in survival mode, managing pain, surgical dressings and garments, the awkwardness of not showering. Between three weeks and four months is when patients struggle the most emotionally.” That can include sadness, worry and anxiety. “There is a shift in sense of self and self-image, where the mind is trying to accept and love the new body, but in the early post-op months the results have not settled yet.” Swelling distorts shape, scars are fresh and obvious, and implants take months to settle. “By six months, most women love the results.”

Dr. Makerewich prescribes a supportive bra to maintain the perkiness from breast surgery long-term. “I am a strong advocate of wearing a supportive bra day and night,” she says, “This helps transfer the weight of the breast and implant to the bra and not to the skin, preventing breast drooping over time.”

How big are women choosing to go? “Often I find that women are looking for a natural enhancement that complements and balances their figure. They want to feel feminine but not fake,” she says. There is still an appetite for serious cleavage, but that’s not the only option. “Women looking for a more noticeable enhancement tend to be less shy about sharing their results on social media—this can create a false perception that breast implants have to be large and noticeable.”

We are saturated with images of “ideal” breasts in the media and on social media, which can distort reality for even the most educated consumer. “I deal with reversing unrealistic expectations created by photoshopped images frequently during the surgical education process,” says Makerewich, “but the effect is so much broader than that and really has global, ageless and genderless reach.”

On that note, transgender affirmation surgery is an active part of Makerewich’s practice. Cisgender men are also clients. “Surgery for men [to remove] breast tissue is often performed through very small discreet incisions around the areola,” she explains. “Surgery for excess chest skin after weight loss, creating the look of a deflated breast, is a different operation where excess skin is removed, and masculine chest contour is restored. Incisions are hidden around the areola and in the shadow of the pec muscle. Both of these surgeries can be quite life-changing.”

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Before then, practitioners like herself had but two options when a patient came in seeking to, say, soften their naso-labial folds (those lines connecting the nose and mouth): animal-based collagen injections or a full-on facelift. The issue with the former was that because the collagen wasn’t human, there was an increased risk of reaction. “And then, to say to someone who was 35 or 40, ‘If you really want to get rid of that fold, you need a facelift,’ just wasn’t appropriate for such a young patient,” says Kellett.

Restylane changed that. Launched in Europe in 1996, the product consisted of hyaluronic acid, a substance naturally occurring in the body, which greatly reduced the risk of adverse effects. It was designed to be administered under the skin for aesthetic purposes—add volume here, smooth out a crease there—and became the first injectable of its kind approved by the FDA. It would go on to transform the face of cosmetic dermatology—not to mention the face of legions around the world: over 50 million treatments and counting.

“You’d hand them the mirror and you’d see right in front of you how happy they were”

The results were astonishing. Patients could appear refreshed in a single session without having to endure the risk of surgery or the associated cost or downtime. “It was fantastic,” says Kellett. “You’d hand them the mirror and you’d see right in front of you how happy they were.”

In those early days of fillers, the dermatologist says she mostly treated mature patients looking to restore the facial volume they’d once had. See, as we age, the fat pads in our face begin to shrink and shift downward, which can lead to more sunken eyes, thinner lips and sagging along the jawline. Fillers could counteract the phenomenon. 

But over the years, their use expanded beyond solely correcting signs of time. For many, it became not about looking younger but rather pursuing a certain look. “Now you have young patients whose lip size and volume are normal, but from a purely aesthetic point of view, they just want more,” says Kellett. “That’s quite common now for Millennials.”

The rise of this trend is often pinned on reality-TV-star-turned-makeup-mogul Kylie Jenner. In 2015, some clinics even reported a 70 per cent increase in enquiries for lip fillers after the then 17-year-old confessed to plumping her pout.

That’s around the time Shelby Hall first got her lips done. Until Jenner’s much publicized enhancement, she hadn’t even been aware that “fillers were a thing,” she says. “There wasn’t anything wrong with my lips per se, but I was like, ‘What’s the harm in a little extra volume?’” 

Enamoured with the results, Hall began a regimen of twice-yearly top-ups, eventually getting injections in her cheeks, chin and jawline, too. The thing was, though, that the filler wasn’t completely disappearing after six months, contrary to what she’d been told, so every new treatment added more volume to her face, further transforming her appearance. “Over a span of four years or so, I found myself with all this filler, and I was like, ’I’m not really looking like myself anymore.’” 

So she made the decision to have it all dissolved with an enzyme called hyaluronidase, which can be injected to break down hyaluronic acid. Actor Courteney Cox famously discussed doing away with her fillers in the same way after finding she “looked really strange.” “I feel better because I look like myself,” she told New Beauty magazine at the time. 

Hall felt the same. “I just loved seeing myself again,” she says, though she notes that the over-plumping did cause some premature wrinkling on her lips. You’d probably assume she never touched fillers again, but, actually, quite the contrary. Hall became an injector herself. 

She is the founder of Skinfidelity Medical Spa in Mississauga and now uses her social media platforms to share her story and educate followers on the do’s and don’ts of cosmetic procedures. A video she recently posted about her experience with “filler dysmorphia” has racked up nearly 530,000 views on TikTok. “I think people are seeing so much overdone, over-the-top work that they’re scared of not looking like themselves or looking weird,” she says of her content’s popularity. “Everybody’s kind of shifting at the same time.”

@skinfidelity WAIT FOR IT ⚠️ 0/10 ☠️ #lipfiller #chinfiller #jawline #cheekfiller #pillowface #abcdefu #lips #foryourpage ♬ abcdefu – GAYLE

Indeed, we seem to be witnessing a collective move away from what’s been termed the “Uncanny Valley,” a phrase coined by a Japanese robotics professor who found that highly realistic humanoid robots provoked a sense of unease or even revulsion in people. “I think sometimes you can see this feeling of the Uncanny Valley with people who have had too much facial filler or too much plastic surgery,” says Dr. Lara Devgan. “The ideas of what is beautiful are changing and a more realistic, ‘less done’ looking end-point is the future.” 

 

 

 

 

 

 

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A post shared by Dr. Lara Devgan, MD, MPH, FACS (@laradevganmd)

Devgan, one of the most sought-after plastic surgeons in the U.S., is famous for her signature “facial optimization” technique. It consists of “many tiny, millimetre-level” tweaks all over the face, all while maintaining people’s “facial identity.” In before-and-after photos, her patients appear more rested, radiant, but you can’t quite put your finger on what’s changed. 

The approach appears to be a growing trend when it comes to fillers. Kellett remarks that, nowadays, patients are wanting to be more judicious with them. It’s not that they’re using less overall, but rather “instead of a lot of filler in one place, it’s smaller amounts in different places.”

Examples of popular areas to fill include: the temples, which can hollow out over time; tear troughs, a.k.a. that dip under your eyes that can cast a shadow and make you look tired; the cheekbones, for example, to help correct naso-labial folds caused by dropping cheeks; the chin to make it project more or elongate the face in an effort to balance out the facial profile; the jawline and even the nose, in what’s been dubbed a “liquid nose job.”

 

 

 

 

 

 

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A post shared by Dr. Lara Devgan, MD, MPH, FACS (@laradevganmd)

The results can be absolutely jaw-dropping, but the procedures don’t come without serious potential side-effects. The nose, for example, is considered especially high-risk due to its limited blood supply. A vessel inadvertently blocked by filler could lead to vision loss or tissue necrosis. “You could easily lose the tip of your nose,” says Hall, who recently stopped offering the treatment at her clinic. “Liquid rhinoplasties kept me up at night so I decided it’s not something I’m going to do anymore.”

As Hall points out, it’s easy to find someone who’ll say ‘yes’ to all the alterations you want to make, but what you really want is someone you can trust to say ‘no.’ Someone who’ll be able to look at your face as a whole and advise you on the best options for you. “There isn’t one look that’s beautiful,” says Kellett. “You have to look at that patient and do what’s best for them—not what’s trendy for a certain cohort of people.”

That means looking for a practitioner who 1) is experienced and can safely administer the treatment (Hall notes that in some provinces, all it takes for a nurse or dentist to become a licensed injector is a two-day course), and 2) shares your aesthetic preferences. Look at their Instagram if they have one—do you like the way their patients look? Look at the staff working in their clinic—they’re likely getting procedures done by their boss.

At the end of the day, cosmetic dermatology is a matter of personal taste. “Just because you see something that you don’t like, it doesn’t mean that the whole genre is to blame,” says Devgan. “It’s like seeing a painting you don’t like and deciding you don’t like paint!” With any procedure, there are many possible outcomes, including ones that are understated, elegant and refined, she ensures. “Beauty is not only in the eye of the beholder, but also in the hand of the needle holder.”

More on Cosmetic Procedures

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The post The New Ways of Using Filler appeared first on The Kit.

“I keep developing more and more of these little milia and/or closed comedones. Why?? And they stay forever and there seems to be nothing I can do about them. I use both retinol and glycolic acid to try to peel them away. I keep meaning to make an appointment to find out because I suspect a derm is my only option for treatment, possibly by extraction. I don’t use rich creams, just CeraVe. They’re on my cheeks, forehead and between my brows. Help!” —Dena, Etobicoke 

Hello, Dena! I’m taking your question here on a pause from perusing my own pores with a magnifying mirror. Don’t try this at home, kids, it can lead you down into a deep funk. In fact, mostly I’m grateful my up-close vision is no longer as sharp as it once was: Because what you can’t see won’t hurt you! 

I’m intrigued by your question, Dena, because I realized I hadn’t a clue what milia actually are (though it turns out I have some, too), and I only barely had the gist of what a comedone is. So I turned this question over in its entirety to Dr. Julia Carroll, of Toronto’s Compass Dermatology. (Note to you all at home: At the doc’s request, I gathered a photo from our reader so we could have a starting point for this conversation; Carroll added the proviso that this was not a diagnosis, as she would need to see Dena in the flesh for that, but that a pic would give us a starting point for general pore education purposes.) 

So, let’s start with Carroll’s definitions of various skin conditions. She suspects Dena has milia, possibly comedones and potentially something called seborrheic hyperplasia.  

So let’s break all this down. Closed comedones are what we colloquially refer to as whiteheads. “Basically, when you have acne, if it starts off as a pore that doesn’t have skin covering it and is open to the air, the sebum oxidizes and turns black, which equals a blackhead.” But if it is clogged and the sebum is not open to the air, then it is a whitehead, or a closed comedone. You can generally squeeze these, but restrain yourself, says Carroll, because squeezing any kind of zit can lead to scarring. 

Milia, she says, are “tiny, hard, white balls under the skin. They are small epidermal cysts, and they are very common. You often see them in babies, but you can get them at any age.” These come up randomly, she says, or can be the result of injury. “Milia do come and go away sometimes on their own,” but if you want to be sure to banish them they require extraction, as they are deeper than you think under the skin. A more serious type of extraction, which sometimes involves an incision, cannot be done by an esthetician, as they are not allowed to pierce the dermal layer. In a dermatologist’s office, says Carroll, one to three milia extractions would be about $100; a lot of them in an area would be about $250. She adds, “These are really fun for the dermatologist to remove.” Definitely do not try this at home, as an incision is required and thus scarring is highly likely done with anything but a sterilized instrument and professional skills.  

Another thing that can look similar is something called seborrheic hyperplasia. “These are essentially enlarged oil glands, yellow papules on forehead or cheek. They’re pumped-up oil glands, swollen like they have been working out. They appear as raised bumps.” Seborrheic hyperplasia tends to occur more with age, and there may be a genetic component. There are a number of approaches to minimize the look of these raised bumps: cauterization and fractionated lasers are effective, she says. Sometimes, a dermatologist may prescribe an oral medication, or topical retinoids. “Unfortunately,” she adds, “they often recur,” because of the genetic factor. 

Topical retinoids may also help with milia and comedones. Prescription strength is obviously higher than over-the-counter, but Carroll says OTC products (see below for her recos) can also be useful in prevention and treatment. Chemical exfoliants, as you indicate you already use, Dena, can be effective, in glycolic acid and salicylic acid formulations. 

The doctor also says you are onto something, Dena, when you talk about not using too rich or thick a cream. “These can clog pores,” says Carroll, and contribute to the formation of the little white dots you describe. “If you use a cream moisturizer, switch to a lotion. And perhaps oil-based cleansers and rich moisturizers aren’t for you.” 

In general, says Carroll, she is not a fan of “overkill” skincare rituals that use a dozen steps. “There is only so much moisture your skin can absorb,” she says, “plus layering multiple products can be irritating to the skin.” She subscribes to a simple acronym: KISS, for “keep it simple, sweetie.” 

Music to my lazy ears. I have tried those 10-step skin rituals, I’ve tried snail slime (it’s totally a thing) and seaweed and bee pollen among all manner of exotic elixirs and unguents; I happily mix expensive products and cheap products; but in the end, the regimens that work best (for me) are the dead-simple ones. Hiding my reading glasses and magnifying mirrors helps, too. I highly recommend that for greater self-care and a positive skin attitude. 

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We asked Dr. Julia Carroll to give us a few over-the-counter product recommendations that might help minimize milia and closed comedones. But as always, take the time and make the effort to go see a medical doctor to get their personalized, authoritative advice on all your skin issues. 

 

 

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This is Carroll’s recommendation for an over-the-counter glycolic option to exfoliate for improved texture and tone of the skin. 

 

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Another Carroll pick: This is a splurge, but this Vitamin C serum is great for both anti-aging and acne issues. A blend of antioxidants for protection against environmental damage, this serum reduces oiliness, minimizes pores, refines skin texture and improves radiance. Use it in the morning, after cleansing, before your sunscreen layer. 

 

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Carroll also likes this brand, new to Canada. There is a .25 formulation if you want to start more slowly onto retinols. You use a retinol at nighttime; this one can be used every night. Antioxidants and anti-irritants will help calm sensitive skin and help smooth skin. Retinol gives you big bang for your skincare buck.

 

 

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You are onto something with this choice, Dena: dermatologists everywhere love this moisturizer. Hypoallergenic, non-comedogenic (doesn’t clog pores or cause acne), this lotion is a lighter option than the cream formula, plus it has SPF built in.

 

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Another reasonably priced option found on many doctors’ favourite product lists: this soap-free, pH balanced paraben- and sulfate-free cleanser that can be used daily without drying out skin or clogging pores.

 

This article contains affiliate links, which means The Kit may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by advertising. By clicking on an affiliate link, you accept that third-party cookies will be set. More information.

 

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The post Help, I Have All These Little White Bumps on My Face appeared first on The Kit.

“Can you do please a piece on crepey arms for older women? Is there anything I can do about it?”  —BB, from Toronto

Arms in general are such a touchy subject for most women, BB. Unless you have the smokin’ guns of Michelle Obama, most of us can find some kind of fault with our arms. How old are we when we start to hide them from sight with sleeves and sweaters, even in the steamiest part of summer? Maybe you are convinced yours are too unshapely, flabby or flappy. Maybe that crepey grandma skin is creeping up on you.

Let me say right off the top that I really believe you look great the way you are, that everyone does in fact. None of us is the sum of our imagined flaws. But knowledge is power, and we are here to give you the lay of the land and fill you in on what the options are—what the upsides and downsides are, and what it all costs—in the brave new world of skincare, where new techniques, technology and treatments appear all the time.

BB, you are not alone in lamenting your skin laxity. I reached out to Toronto superstar plastic surgeon Dr. Tom Bell (once named one of the world’s best by W Magazine), the medical director at SpaMedica Plastic Surgery on Avenue Road to get the low down on the latest surgical and nonsurgical options for tightening skin on crepey arms. He says it is a “very, very common” concern.

“The skin throughout the body is very different. The skin on the face, neck, eyelids, arms, back and legs would all look different on the same person,” he says, adding that “sun is a big culprit” in laxity. “Non-sun exposed areas tend to do better. But over time, we lose elasticity everywhere; collagen breaks down and the strength of the skin is not what it was.”

Thanks for that reality check, doc. Facial skin, he says, can do better, which is why sometimes women look younger in their face than they do on their arms (or hands, an age giveaway we see on the well-preserved faces and bodies of some celebs). “Throw hormonal changes into the mix, inherited factors, sun exposure and external environment, overall health,” says Bell, and there are a lot of things at play in why some people have more issue with crepey skin than others as they age. Weight loss is a big one: “When you lose weight,” he says, “you lose tone. It is like a balloon, when you let out the air: When you lose weight, the skin never snaps back completely.”

One of the “holy grails of plastic surgery,” he says, “is how to tighten skin without removing it.” He has another graphic-but-helpful analogy for what happens to skin over time. “Skin is like an elastic band. When you are younger, you stretch it out and it bounces back. When you are older, after you let go of the stretch, the loop loses tone, like it has been stretched around a stack of magazines for a number of years.”

Okay we get the effects of time and gravity: So what can be done? The good news is that over the past 15 years or so, there have been some serious innovations in the area of body skin tightening. The less good news is that it works most dramatically on people who are fit and have only a modest amount of laxity (a.k.a. crepeyness). You will get some improvement at any age, he says, but you have to adjust your expectations accordingly.

First there is BodyTite (from about $3,500 per treatment of both arms, sometimes done in a series, as prescribed after consultation with a plastic surgeon). This is where a surgeon uses a tiny liposuction cannula that heats up under the surface of the skin with directional radio frequency. “It is kind of like Saran Wrap,” says Bell. “You heat up the skin”—carefully, with calibrated temperature controls—”and it tightens up.”

Then there is Morpheus, which is a microneedling process and the same price range as BodyTite, also sometimes offered in a series of treatments. “Think of it like aerating a lawn,” says Bell. “A radio-frequency current comes through the microneedles at different levels of penetration and shrinks the skin between the needles.”

Both of these techniques with new technology will yield about 30 to 40 per cent improvement, says Bell. Both of them have little “downtime” or pain, though some numbing is used, and laughing gas can be used for BodyTite. The latter can also be done as part of a larger surgical procedure.

For more advanced crepeyness, the big gun option is surgical: Arm surgery in which skin is permanently removed to tighten the overall appearance of the rest of the skin is called brachioplasty (priced from about $4,000 to $10,000 by surgeons across the country) and is increasingly popular. Unfortunately, this will leave a scar of varying lengths, depending on the individual situation, but it can either be tucked mostly into an armpit in the best-case scenario, or running the length of the arm, usually on the inside, toward the back. (By combining BodyTite and Morpheus with a surgical armlift a shorter scar located in the armpit is often possible.) A long scar is often what stops people from pursuing the surgical option, though it is plenty popular (and is a true life-changer for people who have lost a lot of weight, especially through things such as gastric bypass surgery). “The bigger the problem,” says Bell of cases of extreme excess skin, “the less the scar is of concern to the patient.” Brachioplasty typically takes about an hour and a half under anaesthetic.

If these more extreme (and pricey) measures aren’t for you, Bell says that topical solutions can make a small but appreciable difference. SpaMedica Cosmetic Surgery offers a customizable skin program with medical grade active ingredients available without a prescription (though there is a consult for customization). Called Universkin, the serum starts at $199, and can be used on face and targeted areas of the body. “Note that more aggressive retinols are less tolerated on the arms than the face,” says Bell, reminding us as above about how the skin is thicker on our faces. “On arms it could cause a rash.”

As for over-the-counter options? No one can—or should—promise to make crepey skin disappear with OTC products. But keeping hydrated, staying firmly and fiercely protected from the sun, these things will make you feel better and prevent further damage. Hydrated skin will always look more glowing, healthy and appealing.

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Short of high-tech interventions and/or surgery, skin tightening for crepey arms is a tough problem to solve. But dependable hydrating products will keep your skin looking and feeling its best and brightest. Never underestimate the transformative power of well-cared-for skin to boost feelings of body positivity.

Featuring jojoba seed extract for firming and toning; turmeric root extract for brightening and evening skin tone and shea, murumuru and capuacu butters for hydration. Free of parabens.

Hydrolyzed rice protein helps skin feel firmer, reinflating and supporting skin structure for the appearance of smoother, tighter skin. Good for upper arms, abdomen, buttocks, thighs and knees! Paraben- and fragrance-free.

This cream with a great name is for improving the appearance of damaged skin and strengthening the skin barrier to protect it from future damage.

A natural exfoliant (lactic acid) to hydrate and support the natural lipid barrier of the outer skin with a brightening effect. Plus probiotic extract for skin renewal and better skin texture.

Rich, thick, melts right into your skin. A real pleasure to use.

This article contains affiliate links, which means The Kit may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by advertising. By clicking on an affiliate link, you accept that third-party cookies will be set. More information.

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The post Is There Any Way to Get Rid of Crepey Arms? appeared first on The Kit.

“I have a secret, one that I haven’t shared with any of my girlfriends. In fact, I worry my husband is going to find out. I have a standing appointment for Botox a couple of times a year. I love how it makes me look and I look forward to it. Why do we freely talk about sex toys now, but still not Botox?”  —Signed, Smooth of Forehead

First of all, I believe that among people with the means to do so, more of them than you think are regularly indulging in a little subtle pick-me-up of Botox. This is just my hunch, and an eye trained by covering the goings on in the emerging injectables field. Plus, the fact that the global market for botulinum toxin used for cosmetic purposes is more than $6 billion. But you’re right, so few people talk about it openly that when someone does, it feels dangerous and exciting.

Attitudes around getting a little work done are in transition right now: On the one hand, we have J.Lo who has sworn up, down and sideways that olive oil (a key ingredient in her own skincare line, J.Lo Beauty, launched late last year) is the “natural” secret to her age-defying complexion. On the other, we have fashion designer Marc Jacobs this summer sharing daily updates on his face lift on Instagram, from day 1 swelling to his stints in a hyperbaric healing chamber, on through yellow bruising across his neck. It was graphic, and quite liberating.

Here is my own experience with Botox. I tried it in the early days of injectables, circa 2000, when I was editing a fashion magazine; it was part of the cushy accoutrements of the job title, along with thrice-weekly hair appointments and a ritzy wardrobe for galas and events. These may as well be the memories of someone else (or of an alien) at this point, as my life now takes place exclusively in jeans and sneakers with my hair lumped atop my head in a messy bun. But anyway, back in the day, when doctors were just calibrating dosing and techniques, Botox could have a heavy, frozen effect. This look did not inspire me, so I did not do anything else intrusive to my face for a good decade and a half.

Then I tried Botox again about a year ago, a conservative amount (because I wanted a natural look, and as above, because of the cost factor). Frankly, it was really great: The look was very subtle, my eyebrows slightly raised, the giant worry line between them soothed, eye crinkles softened. Twenty years later, doctors have amassed deft skills with needles; the art of Botox injection has come a long way, baby. The relative skill of a practitioner does matter: Do your research!

But the benefit was much more about how I felt. The act of self-care, especially after an expanse of pandemic neglect, gave me a palpable, lasting emotional lift. If I could afford it—or more accurately if I were to rearrange my budget priorities—I would definitely keep it up.

So why do people hide Botox still? Why did I hide it? Reflex, is my answer. I associated Botox with the whole plasticky exaggerated vibe of Real Housewives (great on my TV; jolting IRL). I also have a defiantly proud working-class streak, and it felt a little indulgent to broadcast widely.

The perfect person to get the medical and emotional perspectives is Dr. Leah Smith, the founder and medical director of My Beauty Doctor, a female-physician-led practice in Yorkville. A doc with a feminist stance on aesthetics after my own heart, Smith started doing Botox herself when she finished medical school, aged 25 or 26. “Medical school aged me,” she says, laughing. Clearly a hard worker, she spoke with me by phone at 8 a.m. on a Sunday morning. As a client, she found a lot of holes in the market and attitudes that frustrated her: “I wanted somewhere physician-led, inclusive and not stuffy, not rushed or pushy. But I especially did not want to be told I needed a whole new face! There is a really toxic part of the industry.”

Smith says Botox is a luxury item, and it should feel like one. “It should be about people doing something nice for themselves, to look relaxed and refreshed.” She is intent on countering “the culture of pointing out people’s flaws, and clinics that prey on insecurity.

The MBD motto is “beautiful before, beautiful after.” The offerings are simple: medical grade facials, lighter to more intense medical grade skincare products, micro-needling, Botox and some hyaluronic acid fillers. “We are a minimal aesthetics clinic,” she says, focused firmly on “understated” looks.

As to stigma, it is something Smith thinks a lot about. “Botox is going through its journey,” she says. “People are starting to talk about it on social media, moving toward being more authentic. Really, how is it different than covering up grey roots?”

She likens it to online dating and the changing attitudes toward that. “I met my ex-husband online, at a time when people weren’t really doing that openly,” she says. “I hid it, from a sense of shame I had failed to meet a partner organically.”

The openness that has transformed online dating, she says, is something she is starting to feel about Botox. “Our mission is to abolish Botox stigma.” Her clinic did a poll of its clients, and the top fear was of being judged by others for Botox use. “Another thing that disturbed me was that people were afraid they weren’t naturally pretty enough, or that not aging perfectly was somehow a failure.” Social media’s filtered ideals contribute to these misconceptions, she says, as celebrities pretend “they just woke up like that.”

Smith sees patients of a wide variety of ages, and about 20 per cent of MBD clientele is male, usually referred by the women in their lives. “At any age Botox can have an effect.” Preventative is a big push these days, she says. See, in younger people (30s and under) you see dynamic lines, ones only visible when the face is in motion. As we age, those lines stick around at rest. “It depends on your goals,” she says of how much Botox she uses on a client. The costs range from about $300 to $1,000 a session, and the recommended time between appointments is three to four months. So, it does add up.

Smith, who did her residency in family practice, is also trained for maternity care, and is on call once a week to deliver babies. She sees her various disciplines as complementary. “My passion in medicine is women’s health care,” she says. “I see self-care as an extension of that.” I have to say after speaking with her, I felt comfortable enough to talk here about the wee bit of botulinum I indulged in: It’s still a cost hurdle for me, but the emotional upside was quite uplifting, indeed. It’s worn off now, but I will not say never to going back for another round.

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In the spirit of self-care, here are some highly pleasurable facial devices and products. They may not be the instant fix that Botox is, but self-care is best served in multiple iterations

“One of our MBD cult faves is the ZO Growth Factor Serum because it’s lightweight, smells amazing and makes your skin feel silky smooth. It feels very luxurious to use at the end of the day as part of any medical grade skincare routine.”

 

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These are a super-fun way to give yourself a face massage. Keep them in fridge or freezer until ready to use; the cold helps with circulation and oxygenation, shrinks pores and the massage action helps product absorb better. Plus they are really fun to use, especially on these steamy summer nights.

 

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Another cooling product, this eye stick has aloe vera for an instant brightening effect, plus it feels really great to apply around the eye contour area: The product goes on with a refreshing finish.

 

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From Toronto skin guru Victoria Radford, these eye masks are infused with gold! Cooling, soothing, nourishing, the hyaluronic acid plumps skin and reduces appearance of fine lines. Use it before a big night out for a luxe boost.

 

This article contains affiliate links, which means The Kit may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by advertising. By clicking on an affiliate link, you accept that third-party cookies will be set. More information.

 

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The post Why Is There Still Shame Around Using Botox? appeared first on The Kit.

Before I was made aware of the existence of thread lifts, I was entirely oblivious to the fact that people could have actual threads under their skin, holding up their face, like a subcutaneous Geppetto working full-time. Now that I know it’s a thing, I feel like I’m seeing them everywhere. And by everywhere, I mean Instagram.

Celebrities like Bella Hadid, Kendall Jenner and Ariana Grande are all rumoured to have gotten thread lifts, with before and after shots revealing their eyes appear much more extended and upturned these days. It’s a look that’s been referred to as the “foxy eye” trend. 

 

Essentially, a thread lift consists of inserting a thread under the skin to pull up a given area of the face. The threads themselves are made of cone-shaped beads of lactic acid, which act like hooks that grab onto the fat under skin. They start breaking down after about three months, but their presence encourages collagen production, which can prolong the lifting effect for up to a year.

It’s a minimally invasive procedure done under local anesthetic. Swelling and bruising are quite rare and the only tell-tale sign is usually some dimpling of the skin at the insertion point, which can take about two to three weeks to subside. Prices range anywhere between $2,000 and $6,000 depending on the number of threads used.

 

In Canada, thread lifts were only approved last spring and so far, only one type, the Silhouette Instalift, has been cleared. “What most people will see online when they search thread lifts are the PDO threads,” says Toronto’s Dr. Neel Bector, who specializes in non-surgical aesthetic procedures. “Those are done mainly in the U.S.—Health Canada has not approved those threads.”

The type that can be performed in Canada is mainly indicated for the mid and lower face, namely lifting jowls and nasolabial folds (the results are admittedly jaw-dropping, or the opposite of that, really. You know what I mean). However, Bector, who trained in Europe to become one of a handful of Canadian experts on thread lifts, says Silhouette Instalift can be used off-label to perform eye and brow lifts.

Interestingly, Bector says the majority of patients who come in for this kind of eye procedure are between 25 and 35 years old. “I think it’s just something different that people have picked up on; they like the look and see some celebrities who get that done or who have that look naturally,” he posits. 

This is where things can get, shall we say, questionable, because the people who have this look naturally tend to not be of the same race as the people getting the procedure. “The foxy eye trend frustrates me to no end,” says my colleague Lara, who wrote a brilliant piece about the otherness that comes with being half-Chinese. “Just generally, Asian people have been so mercilessly mocked for their eyes that to see this beauty ‘trend’ come up feels kind of like a slap in the face.”

 

It feels especially problematic considering the current and very alarming surge of anti-Asian racism and hate crimes. Lara also points out that subtly pulling one’s eyes with one’s hands has become a popular pose among Instagrammers. (Another total “can’t unsee” moment. Now that you’ve read this, I guarantee you will notice it everywhere.) “It really bothers me because that gesture is so loaded,” says Lara.

On TikTok and Instagram, the hashtags #foxeyes and #foxyeye often accompany photos of dramatic eye makeup that seems to recreate the effect of a thread lift. I ask my lovely makeup artist pal Brittany Sinclair to dissect the look. “The key is they are pulling the liner and shadow outwards rather than upwards,” she explains. Most of the examples we find involve a long flick at the outer corner as well as liner extended into a point toward the nose at the inner corner. Neutral-toned shadow and gradient false lashes (meaning ones that get longer toward the end) are often added to mimic the shape of the liner.  

 

I ask Lara what she thinks of these kinds of makeup looks or just cat-eyes in general. “Honestly, I don’t know,” she tells me. “I think about that, too. I definitely use liquid liner to accentuate my Asian features and I’m proud to do so, but overall I really think makeup is different than a cosmetic procedure or physically pulling at your face. It’s definitely never bothered me to see anyone do a cat-eye.”

What she feels is bothersome, she explains, are words like “exotic” or people seeking a more “slanted” eye shape. “It’s complicated because, of course, I love seeing Asian beauty celebrated, but not in this way.”

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The post Unpacking the Problematic “Foxy Eye” Trend appeared first on The Kit.

“I fantasize—a lot—about liposuction. I have one friend who did it a few years ago, and I’m so envious of her flat stomach. Our kids are both 12 now, and my baby belly just isn’t going away. How much would lipo cost?” —Liza, North York

Dear Liza, you are not alone. Who hasn’t been awake at 4 a.m. (not pleased to meet you, COVID insomnia) and focused way too deeply on our perceived flaws? In my middle-of-the-night imagination, lipo is a magic wand of instant gratification.

In the cold light of day, I am of two distinct minds on the subject. On the one hand, I do, passionately, want to walk the talk of body positivity. I want to live in the belief of owning my body, and my face, as they are, being proud of the marks of age (and love for pasta) that make me who I am today and in the future. I desperately want the next generation of women to love themselves and feel good enough as they are, too.

And yet: I simultaneously believe that we each have the right to make our own decisions about our own bodies and what makes us feel good. Celebrities, those ultimate influencers, have brought the stigma of plastic surgery into the light. What was once shrouded in denials and oversized dark sunglasses and scarves tied round the chin (oh dear, I just conjured the image of Gisele Bündchen captured by paparazzi in a burka a few years ago outside a Paris surgeon’s office, though I suppose her millions rest on the premise she is naturally perfect). But other stars such as Chrissy Teigen, Cardi B, Jamie Lee Curtis, Jane Fonda, even Dwayne The Rock Johnson, have all copped to having had lipo. In the end, my primary mantra is: You do you. As for me, I clearly vacillate on this, so I can’t rule out ever getting a nip or a tuck.

But this is a subject for the professionals: I tapped Dr. Frank Lista, medical director and founder of the Plastic Surgery Clinic in Mississauga. With three decades of experience, Lista and his clinic of docs do the full gamut of cosmetic procedures, and are known especially for liposuction and tummy tucks post-baby, as well as skin reduction surgery after gastric bypass. “Liposuction is the one procedure that fascinates people more than anything,” he says. “The thought of making fat go away: Who doesn’t have a bulge?”

COVID has proven a magic waiting-room filler for plastic surgeons everywhere. The latest figures from the American Society of Plastic Surgeons date to 2018 (when US$16.8 billion was spent in the industry), so we rely on individual doctors for anecdotal evidence, but that is pouring in from the world over. Cosmetic surgeons are enjoying a “Zoom boom” for people looking for solutions to “lockdown face,”—flippant terms that seem to have originated in the voracious British tabloid press.

Body work is also on the upswing: COVID has us—on the whole flabbier, less fit and emotionally challenged from lockdown and loss—wanting to control and change anything we can about ourselves.

The result? “I’m busier than I ever dreamed,” says Lista. “I thought people were going to be afraid, or not have any money. It’s exactly the opposite,” he says, for many people, if they are lucky enough to have a job, they’ve saved on dinner out and travel.

 We also have plenty of time at home for the “down time,” as the cosmetic enhancement field refers to the recovery period. Plastic surgery involves medical compression garments and other manner of wound dressings and drains. Even non-invasive procedures like lasers and injectables take time to heal the redness and swelling.

So if you make it to the consultation room, what comes next? Lista says talking is the most important part of the process. “First of all, you have to be physically healthy to be a surgical candidate.” Then comes the psychological assessment, where the surgeon matches your expectations with the reality of what they can deliver. “We are operating on people to make them feel better,” he says. “But are they a person who is going to feel better? It is important to understand plastic surgery will not change your life; it won’t find you a spouse or get you a job.”

Lista says he turns away up to one-third of people who come to him for liposuction. “Many people are not candidates, or they need something different. You have to be at, or close to, the weight you want to be at. You can’t have a BMI over 30. Lipo is not a weight loss tool.”

That said, there are lots of people it works well for. He says the classic stomach area is popular, as well as hips, thighs and saddlebags (though it doesn’t fix cellulite). A new area of interest, Lista reports, is in back fat—you know the squishy bit that gets folded up around your bra.

It really doesn’t hurt, Lista says. “There is not a lot of cutting; it’s more like feeling bruised, like banging your leg against a table.” You do have to wear a compression garment for six weeks, though, and the final result is not complete until six to 12 months later. A couple of other provisos from the doc: Lipo is only permanent if your weight never changes. “One of the early theories of fat cells is that they never grow back. We learned that is not true. You do not have carte blanche to eat whatever you want, as you will gain weight all over if you do.”

What is the bottom line? For one area, i.e., tummy, he says his base price is about $9,000. The costs—for anaesthesia, operating room time, nursing, are fixed. For each region you add on it’s about $1,000. “So the ballpark for lipo,” says Lista, “is roughly $9,000 to $13,000, but everyone gets an individual, written quote.”

Lipo is neither a quick fix, nor a cheap one. It all comes back to those pesky expectations. Says Lista: “If you go to a spa, they heat up rocks and put seaweed on your body or dunk you in a mud bath, and you don’t expect much to happen. But if you go to a plastic surgeon,” he says, “people expect to look like Angelina Jolie when they are done.” But keep your magic-wand fantasies on the realistic side, and you can get good value for the time and money.

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While you’re considering your lipo options, focus on some indulgent treats to pamper your body

Celebrity makeup goddess Charlotte Tilbury gives us the same bag of tricks she uses to make supermodels limbs and torsos glow on runways and photoshoots. Zapped with hyaluronic acid for max hydration, rosehip oil, caffeine, aloe vera and vitamins C and E.

Ouai is the haircare line by Hollywood hair queen Jen Atkin, who counts Chrissy Teigen and the Hadid sisters among her clients and friends. The pill shape of these tabs is a fun play on a prescription for relaxation! Jasmine and rose moisturize, nourish and soothe. 

French clean-beauty line Caudalie is made from grape seed extracts, which have a natural bounty of antioxidants. Pairs well with the glass of wine beside your bath.

The luxury in this special formula is that you scoop it out as a cream, and it smoothes on as an oil. The result is smooth and greaseless, an effect heightened by the light lemon, rose and vetiver scent.

This blend of essential oils is super concentrated, so you need a scant capful to leave your skin soft and your body chilled out. This is what you want a chic spa to smell like: a touch of eucalyptus, a dash of fresh woodsy pine; it feels soothing for tired muscles, even if all you’ve done is type all day.

This article contains affiliate links, which means The Kit may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by advertising. By clicking on an affiliate link, you accept that third-party cookies will be set. More information. 

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The post I Think I Want Liposuction. How Much Does It Cost? appeared first on The Kit.

“I am interested in getting injectables and would like advice about how to find a good place to go. My face just looks tired all the time and I would like to do something about it.” —Patricia, Toronto

 Not to be glib, but I’d like to suggest “My face just looks tired all the time” as the working title for an oral history of the year we’ve had. It’s been an exhausting bile-inducing year to say the least. So since I know you’re a smart, sensible person, I’m going to assume that you have already given some consideration to the question that naturally arises before the question you just posed, which is: How tired are you, actually? Because yes, there is an amazingly comprehensive array of skincare science out there that can help refresh your appearance, but none of it replaces sleep or the daily machinations of caring for yourself in a basic and fundamental way. Layering treatments on top of stress and anxiety and nights spent staring at the ceiling isn’t going to give you the results you are after. I may not be about to count on much at this point, but I know that.

Now, if you’re feeling good—if you’re eating real food and resting and getting outside and breathing from your belly and doing some of the vitally important things we often forget to do—but the appearance of your skin is still bothering you, then, sure, you can chat with a qualified pro to see what your options are. I called Dr. William McGillivray who founded noted dermatology clinic and medispa Project Skin MD in Vancouver for some shortcuts to help you find the best practitioner.

“The most important thing to do is to see somebody who’s very qualified because injecting Botox or fillers is a medical procedure,” he says. That may sound obvious to some, but it doesn’t to those who have willingly gotten injections at, say, pool parties. (While the pandemic has ushered in loss and isolation, I can only hope that it has at least put an end to get-togethers during which otherwise smart people get drunk and dabble in medical injections.) “Botox and fillers should only be administered in a controlled environment that is well-lit, where the patient can be properly assessed, where there is time to get all their questions answered,” says McGillivray, outlining the absolute baseline concerns. Any provider should be licensed and registered with their provincial college of medicine, and that license should be posted on the wall for anybody to see. “Patients should always get proper consent forms—and providers should give patients full knowledge of the risks and benefits of the procedure based on their specific medical background and any issues they may have.” Basically, if it seems like it might be an inappropriate setting, it likely is. “A new patient of mine told me she got her lips injected in a nail salon once,” says McGillivray. “The most important question is: If a complication arises, are you somewhere that can deal with it?” (Ask these two key questions: Are there materials on hand to dissolve filler, if necessary, and is there a physician present or on call?)

So if we are building a house of credentials, all that would form the basement. Once those concerns are satisfied, we can move onto the proverbial main floor by asking questions about the level of experience and training your provider has gotten. How often, for instance, is the doc in question actually injecting Botox? “Some physicians may just dabble in it, so their daily experience is not much—and it’s important to note that Botox in particular has to be reconstituted, so you don’t want it sitting in the fridge for a long time before using it, since the potency degrades,” explains McGillivray. Non-permanent hyaluronic acid dermal fillers like Juvederm are gels that can be safely stored until their expiration date. (There are also, of course, other semi-permanent and permanent filler products on the market, but McGillivray doesn’t work with those because, as he says, “permanent products can have permanent problems sometimes.”)

Experience is particularly important because your injector must absolutely understand the anatomy of the face. “It’s crucially important for safety for both Botox and dermal fillers because there are vascular structures that must be avoided,” says McGillivray. “Only experienced injectors should be working in the area under the eye, for example, because there are some vessels there that have a retinal branch so there can be a very bad outcome, like blindness, if the person does not know where those vessels are.”

Asking lots of questions during an initial consultation will allow you to gauge the doctor’s approach, as well, since injecting is as much an art as a science. “It’s the opposite of sculpting because we add instead of take away.” But thinking of the face as a sculpture is a handy way to realize that no two can be approached in quite the same way: Male and female faces have different typical structures, as do different ethnicities. “If an injector is treating everyone the same, then eventually everybody starts to look the same.”

In fact, there are different kinds of fillers that you might want to use for different areas, he explains. While the basic purpose of filler is to replenish the volume in certain areas that’s lost as we age, there are myriad details. “We can use a tiny amount to hydrate and redefine the lip line, so you have a more defined line when you put on lipstick,” says McGillivray. “Or if we correct the loss of volume in the middle of the face, we can help the area under the eyes, the folds around the mouth and also the jawline—with just that one treatment.”

A little volume in the temples helps combat the look of tired eyes and lifts the brow. Jawlines can be redefined, while bumps on noses can be smoothed. (The simplest shortcut to getting a doc who has lots of product knowledge is this: “Look for a doctor who might be involved in research. We have a research department in our clinic, so we have a big knowledge base of what’s going on out there.” And lots of pros will list what research projects they are involved in on their websites.)

The result of most fillers can last anywhere from around four to 18 months depending on where in the face they are used. The cost also varies widely depending how how much you’re getting. Project Skin MD charges about $500 to hydrate the lip, while a comprehensive facial rejuvenation could be as much as $4,000. And again, common sense always applies: If it’s super cheap, question why.

Importantly, expect a trustworthy professional to ask some hard questions of you, too. “The ability to talk patients out of things that might not be appropriate is essential,” says McGillivray. “I don’t have many dysmorphic patients in my practice, but it’s inevitable that you get some, and it’s our job to recognize those people and help them—not to ignore them and certainly not to enable them.”

Here are some tips for pre- and post-care

Before:

• Avoid Aspirin, Advil and non-steroidal anti-inflammatory medications for up to a week before a procedure.
• Avoid alcohol for a week before injections, since it may result in more bruising, as well as a host of other common foods and supplements like green tea, ginkgo biloba and oral antioxidants.

After:

• Don’t exercise vigorously.
• Avoid liquid makeup for 24 hours.
• Expect to see the full results only after a week or two.

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These products can help care for your skin after injections

A cooling eye mask can help relieve pain and swelling after under-eye injections.

Arnica has been shown to reduce bruising and swelling when applied topically.

Stick to a gentle, fragrance-free moisturizer—no retinol or AHAs—while your skin is sensitive.

You can start using concealer after 24 hours, and DermaBlend is a good heavy-duty option for hiding bruises that is also suitable for use on sensitive skin.

Acetaminophen—not ibuprofen or aspirin—is recommended for post-injection pain.

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I am soon to be 67. My skin is in pretty good shape except for my neck. It has a crepe-like texture. Could you recommend a good neck cream so I can get rid of my neck wrinkles? —Isabelle

Years ago, I was chatting with a news anchor who told me that viewers often wrote in to the network simply to criticize her neck wrinkles. The letters were so common that she started to favour turtlenecks so she could deliver the current events of the day in peace. Her experience stoked my belief that, as a collective, we have a duty to focus our attention in the right place—say, the mess of modern global issues rather than the décolletage of the messenger. But I know that personal insecurities are hard to sidestep and, in fact, many of us are bothered by our necks in particular. (Nora Ephron even penned a book called I Feel Bad About My Neck.)

“As we mature, the neck is an area that starts to show our age more,” explains Dr. Channy Muhn, who co-founded rapidly-growing dermatology clinic Dermetics in Burlington, Ont., alongside Dr. Nathan Rosen. The two doctors say that it’s very common for their clients to wonder why neck skin has a different appearance than facial complexion. Rosen explains that the skin in that area is actually very different from the skin on your face: It’s thinner and more delicate. “It’s also very susceptible to being broken down by ultraviolet light and has fewer oil glands, which are what gives the skin its ability to recover from injury,” says Rosen. “And we also tend to do better at protecting and treating the face, while we often ignore the neck.”

Before you can start addressing the issue that’s bugging you, it’s important to understand any elements that might be exacerbating the issue. Genetics are, of course, a factor to consider (your mom or dad likely had similar skin texture) as is rapid weight loss or gain—but sun damage is often the main culprit for those of us who are bothered by the laxity of the skin on our neck and chest. “It’s a highly, highly exposed area that’s naturally poor at fighting off the effects of sun damage,” says Rosen. “A lot of the patients we see with this concern are people who have occupational or recreational sun exposure, like people who drive all the time with the windows open, or people who sail and spend a lot of time out on the water.”

So sunscreen should be the first product you heap into your cart. “Sunscreen is, of course, an important tool from a cancer-fighting point of view, but also from an anti-aging perspective since the sun is the single most important factor in aging skin—even more so than pollution, stress or nutrition,” adds Muhn. So load up on a product that offers solid protection from UVA rays and then make sure to carefully apply it on your neck and chest, because while your chin might shade the area at the top of your neck, the rest of that region is just out there baking.

Then make sure to be consistent with regular use of high-quality skincare. “Simply moisturizing the neck is a very important step that a lot of people miss. It prevents a lot of the water loss across the neck and makes the skin look better,” says Rosen. “And look for products with hyaluronic acid, which will temporarily offer moisture,” adds Muhn. “But remember that if you’re looking for a visible change in the neck, it’s not going to be fast.”

Scientific skincare trials typically last about 12 weeks, he explains, so you won’t see results overnight, even if you’re using expensive high-quality creams. And though you have to be patient, regular use of active ingredients should deliver a bump in skin quality. “We like products that include growth factors as an ‘active ingredient,’ because they penetrate the skin and sort of remind it how to act like it did when it was young,” says Rosen, referencing one of their go-to products called SkinMedica TNS Essential. “Vivier GrenzCine Neck is another product that uses a combination of antioxidant Vitamin C and polyamine to target the layer of skin between the epidermis and the dermis, which is very important to that crepe-y skin scenario because that’s where a lot of degeneration and damage occurs.”

These products are, without a doubt, very pricey—much more so than simple moisturizer and sunscreen, which should be the foundation of any preventative skincare routine—but that’s partly because the neck is a very difficult area for even doctors to treat. “There’s much more risk when it comes to using some of the same treatments that we would use on the face,” says Muhn. Dermatologists must proceed very gently and slowly because the skin is so sensitive and fragile, typically using small amounts of injectables and ultrasound devices to stimulate collagen instead of laser resurfacing, and results are harder to achieve. “We always encourage our patients to really take care of that area preventively because the reality is that the neck is still a challenge to treat,” explains Rosen. “Doctors like to tackle the face because we know we’re going to be able to generate more of a wow factor.”

Setting realistic expectations is vital, says Muhn. “Depending on the clinic, injectables like Juvederm cost from $600 to $2,000 per treatment and multiple treatments are required, so a neck treatment is not a small investment.” A neck lift, which is “major surgery,” rings in at closer to $12,000. Suddenly daily sunscreen application doesn’t seem like much of a hassle, right?

Send your pressing fashion and beauty questions to Kathryn at ask@thekit.ca

Shop the Advice

• 

  The Firming Cream

  Vivier Grenzcine Neck, $230, dermetics.ca

• 

  The Suncreen

  Coppertone Sunscreen Lotion SPF 50 Defend & Care, $11, amazon.ca

• 

  The Moisturizing Cream

  Consonant Skincare Ultra Moisturizing Organic Face Cream for Dry Skin, $40, consonantskincare.com 

• 

  The Anti-wrinkle Cream

  SkinCeuticals A.G.E Interrupter, $185, skinceuticals.ca

• 

  The Serum

  SkinMedica TNS Essential Serum, $300, beautysense.ca

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The post What Can I Do about My Neck Wrinkles? appeared first on The Kit.

I’ve always had a few moles on my body, but in my 40s they’ve proliferated on my torso to the point that, should I ever have the opportunity to remove my clothes in front of another human—that’s a different issue—I’d be super self-conscious. What should I do?  — Patricia, Toronto

There’s an expression that gets thrown around a lot about how, the older you get, the more comfortable in your skin you become. Unfortunately, I think that’s metaphorical. While it’s true that we tend to settle into ourselves as we mature, that we find our voices, and our confidence in our ability to use them grows, I don’t know too many people who get more comfortable in their actual, literal skin. Most people, in fact, look at their skin with increasing disdain as they move through their lives. To that point, I would almost guarantee that whomever you may one day remove your clothes in front of feels exactly that way about their surgery scars or love handles or weird patch of hair that didn’t use to be there…. You know, all the things that mark the human body, but that we don’t notice on others because their features are obscured by our absolute fixation on our own perceived flaws. I have a birthmark on the middle of my calf, for example. It looks like I was hit with a brown bingo stamper, and I hate it and I’ve almost had it removed many times. I mentioned my intention to cut it off to my husband not too long ago. He admitted that he’d never noticed it.

Take from that what you will, but know this: “People want their skin to be smooth—whether that means they are bothered by their brown spots or acne or moles—but how many people actually have smooth skin like that? I’d say that’s very, very rare,” explains Dr. Julia Carroll, director and founder of Compass Dermatology and professor at the University of Toronto Medical School. So I’m not telling you not to be bothered, I’m just begging you not to be straight-up mortified by your body because, well, that sucks, and life is hard enough.

In order to address your situation and gain some peace of mind, though, Carroll suggests starting by talking to your doctor about any issue you might be having with moles or your skin; and don’t worry, despite COVID-19 limitations, you can still see a doctor either virtually or in person depending on the need, so there is no reason to avoid seeking medical advice if you are having health concerns.

While you wait for your appointment, however, you might be interested to know that a condition called seborrheic keratosis is incredibly common and is defined by a proliferation of marks that kind of look like moles at first glance, but aren’t. These non-cancerous (read: totally harmless and purely cosmetic) skin growths tend to be genetic. “They almost feel stuck on skin,” says Carroll. “Sometimes they have a smooth pebbly surface, sometimes they have a rough dry surface. It’s very common to have one or two and then get sort of a shower of them over a short period of time; pregnancy can do that, but dermatologists typically call them ‘wisdom spots’ because they often come with age.” Some people, she explains, become peppered with hundreds.

Moles, on the other hand, don’t typically multiply at a great rate. “You get the odd mole here and there over your lifetime, but getting a lot as an adult would be strange,” says Carroll. If, however, you have a mole that is changing, you should book an appointment with your family doctor or dermatologist. The short list of concerns to keep an eye out for? Asymmetry, a border that becomes undefined, changing colour and increasing size. “I tell my patients to check their moles once a month. Moles on your body are like constellations in the sky; they look confusing at first, but you can easily pick out the Big Dipper after you get to know what it looks like—and so you can more easily spot if things might be changing.”

If, however, one might in fact be dealing with seborrheic keratosis (and Carroll estimates that some 80 per cent of her patients have some of these markings, often mistaken for moles, so odds are that whomever might take their shirt off in your company will likely have a few as well) there are a few options to minimize their appearance or remove them all together. Slathering on good body moisturizer is the easiest way to help the markings blend in—“especially in the winter when people complain that they get itchy and irritated and appear drier than the surrounding skin.”

If nixing them completely is a route that’s of interest, then the most common procedure is cryotherapy. “We basically spray them with liquid nitrogen, which, on average, gets rid of about 70 per cent. It feels very cool and then they get crusty and peel off over the course of a couple of weeks.” It’s possible that some may return or new markings may appear, so Dr. Carroll’s patients typically return once a year to have the procedure done. If a spot is particularly large or in a medically sensitive area, then a doctor might consider removing it by incision or with an ablative laser. But generally, after the marks are removed by cryotherapy, you simply dot on a little antibiotic ointment at first and then use sunscreen regularly to help preserve the results.

So while removing them isn’t complicated, coming to terms with them as they appear might be. “I think you look at these marks on your body and are reminded of something you used to see on your parents or grandparents, which links you to an aging adult,” says Carroll. “If you’re struggling with that, there are deeper reasons as to why these particular spots bother you.” I know that aging has its disagreeable angles, but please remember that there are so many adventures ahead—and it’d be a shame to let a few spots blur the view.

Shop the Advice

• 

  Smooth with lotion

  CeraVe Salicylic Acid Lotion for Rough & Bumpy Skin, $16, Walmart.ca

• 

  Smooth with lotion

  Eucerin Complete Repair Rich Lotion, $22, shoppersdrugmart.ca

• 

  Protect with Sunscreen

  Aveeno Zinc Oxide Mineral Sunscreen SPF 50 Active Naturals Body Sun Cream for Sensitive Skin, $14, amazon.ca

• 

  Protect with Sunscreen

  Sun Bum Mineral SPF 50 Moisturizing Sunscreen Lotion, $20, well.ca

• 

  Protect with Sunscreen

  Thinksport Safe Sunscreen SPF +50, $20, well.ca

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“What can I do about my acne scars? It seems like the older I get, the more I notice them!” —Shauna, Toronto

We’re always told that we’ll feel good in our skin when we’re older. It’s a message of empowerment that is frustratingly often delivered with a cold smile that translates the sentiment into something that feels more akin to “be grateful that, at your age, you no longer have to care anymore.”

Grappling with cystic acne (the type of blemishes that typically cause scarring) as a teen is often just one of the many sucky parts of that stressful stage of life, when trivial issues can take on the same importance as life-shattering events.

When we get older, however, I don’t think many of us are able to let go. Rather, we seem to refine our ability to focus on the parts of ourselves that cause us pain, waiting for the promised freedom from self-judgement to arrive before we feel used up and disposable. But that relief doesn’t come swinging into your life like Jennifer Lopez on a stripper pole. (Yes, she’s 50; no, it’s not normal to look that way; yes, we’ll all be okay.) Rather, you have to work for the confidence, much like J.Lo no doubt worked to refine those swizzle-stick moves.

A positive attitude can be tough, though, when you look at the situation reductively: It’s not that your acne scars get worse after 40, it’s that the overall condition of your skin does. Dr. Lisa Kellett, who runs the well-respected DLK on Avenue dermatology clinic in Toronto, hears that complaint from many of her patients. “You’re losing structure and collagen in your skin, so the scars appear more distinct.” Collagen, like youth, is also wasted on the young. “People can be quite self-conscious—especially, for example, in an elevator, where light comes down from above and makes scarring more obvious,” Kellett adds.

But the situation is not actually dire and should not cause you grief, so let’s take a step back and gain some perspective. “The issue is that acne scars are poorly understood—and you have to understand something before you treat it,” she explains. “Acne scars are actually caused by inflammation, unlike a traumatic scar from a cut, so underneath the skin there are fibrous adhesions pulling the scar down, which is why you see divots and pits.”

Because acne scars tend to be so “bound down,” as Kellett describes, it’s difficult to treat them at home with over-the-counter creams and harder still to cover them up with makeup, as you likely have learned. (Avoid makeup with glitter, by the way, which can highlight texture like scarring; I don’t think adults should often wear glittery makeup anyway, so it’s not a huge loss.)

“The best thing to do at home is to prevent the acne so you’re not causing any additional scars,” says Kellett, because you can’t treat the damage caused by blemishes until you get them under control. Also, I know we’ve all heard this a zillion times, but I’ll add in another refrain one more time for the cheap seats in the back: Do not pick! Like, not at all! It will not feel satisfying even though our lizard brains tell us it might.

“In general, I tell my acne clients to use an exfoliating cleanser, a topical benzoyl peroxide, no creams, no lotions, no oils, no liquid foundations—all of which can contribute to acne,” says Kellett. “Use gel-based moisturizers and sunscreens that are alcohol-based, as well, since you don’t want to use anything that will make you break out. You can also use topical vitamin A such as topical 1% retinol, which you can get over-the-counter because it’s good for acne as well as wrinkles.”

So that’s your homework, if you still have active acne. But if that’s in the past for you, there are certainly in-office treatments that can improve the look of your bothersome scars. Though it’s unreasonable to assume deep pits will be erased, Kellett says her patients are normally happy with the results.

One of the newest treatment options available is laser-resurfacing, which “burns the surface of the skin and also goes underneath to help improve collagen regeneration.” Micro-needling—which, let’s just say it, needs a cuter and cuddlier name—is well suited to ice-pick scars because the doctor can use a small needle to stimulate the collagen in a very precise way. 

Kellett often opts for the subcision technique, however, when dealing with scars, in which she uses a fine needle to cut the fibrous adhesions that are pulling down on the skin and causing the puckering. “You can actually feel them as you break through them,” she explains. The benefit is that the results are permanent. “There are always possible side effects,” says Kellett, since it’s considered to be a very mini surgical procedure, and they include scarring, infection, pigment change and bruising. “But they are rare.” Injectable filler such as Restylane Skinboosters dispersed in tiny droplets across the scarred area afterwards can further improve the texture of the skin.

So if cutting the ties that bind down a few of your little scars will help you to also release some of the burden you’ve been carrying with you, then talk to an experienced doctor and see if it’s right for you. Whatever you decide, it’s time to feel good in your skin—and not because you’re too old to care, but because you’re too young to miss out on any of life’s pleasures.

Shop the Advice

• 

  The Daily Treatment

  Clear daily skin clearing treatment with 5% benzoyl peroxide, $27, paulaschoice.com

• 

  The Sunscreen

  SkinCeuticals sheer SPF 50 sunscreen, $48, skinceuticals.ca

• 

  The Exfoliating Cleanser

  SkinMedica AHA BHA exfoliating cleanser, $50, beautysense.ca

• 

  The Serum

  Biopelle retriderm serum with 1% retinol, $102, eskincarestore.com

• 

  The Moisturizer

  Juice Beauty oil-free moisturizer, $39, sephora.ca

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“I am contemplating tattoos for my disappearing eyebrows. Any advice? I am retired and ordinary looking.” —Gail, Hamilton, Ont.

I am not someone who gives much consideration to mantras. I have never read The Secret. I don’t have a book of inspirational quotes on my bedside table. The closest I ever came to buying in to that vein of affirmation was when I was regularly attending a yoga class taught by a woman who was certainly one of the most charming creatures I have ever encountered. We’d all line up eagerly on our mats, waiting for her to pause at our side to correct a posture, because when she did, she’d always whisper something like, “What can you achieve? You are astounding.” It sounds so cheesy in retrospect, but every time, I suddenly felt as tall as a skyscraper. Then, after class, the feeling would fade. One day she moved to Australia and we all slunk around the yoga studio like lost puppies. My friend got one of her oft-repeated uplifting sayings tattooed on his arm: That was the extent of her power.

All this to say, while I may not often go in on affirmations, I believe in the power of language. So don’t describe yourself as ordinary, please. I’m sure you contain multitudes. You deserve to acknowledge and celebrate the parts of yourself that are glorious. You deserve to spend your days—yay retirement!—reaching for the sun.

That’s the advice you didn’t ask for—but to garner the advice you did request, I called up Veronica Tran, a seasoned pro and founder of Pretty in the City Brow and Lash Bar in Toronto. “About 25 years ago, when I was 18 and very impulsive, I got my eyebrows tattooed—and it was really bad,” says Tran with a sad laugh. “There was no laser tattoo removal at that time, so for about 10 years, I saw a lot of permanent makeup artists who tried to help me remove them, and in speaking to them, I realized it was my future. So since 2005, I’ve been working to help people get a natural result they’ll be happy with.”

Microblading is one of the methods that has taken off in North America since Tran suffered at the hands of an overzealous tattooist. (It’s been big in Asia for about 20 years, though.) “It’s a form of eyebrow tattoo that uses a manual tool that looks like a blade but is made up of several needles, and that the artist uses to draw strokes into the skin with pigment to mimic hair and blend in with your existing eyebrow,” she explains.

But even though it’s wildly popular, it’s not well suited to everyone. “It’s good for someone who has some hair but wants to fill in gaps and create fullness,” says Tran. “It’s not for someone who doesn’t have any hair—because it won’t look natural—or who has really oily skin because the strokes will blur out.”

The ideal candidate has normal-to-dry skin, so being in your retirement years helps on that front, since skin tends to get drier as we age; in that case, the effect could last as long as two years.

There’s another method that is rapidly overtaking microblading, however, known as the “ombré powder brow.” (A very silly name, but for a very good technique, Tran assures me.) “The finished look simulates brow makeup, but can look very natural—more so than microblading at times—and it’s great for oily skin, too.” This process is achieved using a permanent makeup device (a fancy moniker for a piece of tattoo equipment) that uses a single needle “almost like a paintbrush to mist color into the skin, building sheer layers, to give the brows shape and dimension.” The ideal, says Tran, is to recreate the look of children’s brows, which are full, but lighter at the inner corner, and therefore relatively natural looking. (It’s also a little less painful than microblading, although aestheticians should be using an anesthetic either way.)

Whatever process you’re considering, know that the bill is steep: Tran, who says her services ring in around “the middle of the road,” charges $685 for the treatment and follow-up appointment. Some newbie artists might charge $400, while others net more than $1,000. “Remember: It’s your face, so be cautious of anyone charging $199,” says Tran. I’d add that salons having e-blast sales to drum up business should probably not be your first call, either.

“Of course, check qualifications and how long someone has been doing it. They have to be inspected and certified to be doing this service legally—not doing a mobile operation or doing it at a party,” cautions Tran. “Also, it’s really important to see what someone’s work looks like when it’s healed, rather than fresh, because that’s when you can truly tell if the work looks natural.”

You should also make sure you’re on the same page as any potential aesthetician, since you’ll have to live with it for at least a calendar year. “Everyone has their own style, so make sure you like that look,” says Tran. “To make sure someone has realistic expectations, I always ask for three pictures: one with no makeup, one that shows how they apply their makeup day-to-day, so I can tell how they see themselves, and one inspiration picture that shows the look they’re going for.” She then works to create a look that blends reality with possibility. So, no matter who you’re talking to about a service, bring three pictures—or better yet, send them in advance when you book your appointment.

The aftercare for permanent makeup is relatively simple: Keep it clean, avoid strenuous exercise and sweating for about two weeks, avoid the sun, don’t use skincare on the area until it’s healed and expect the colour to start off really dark, and then peel slightly as it settles into the final shade.

If getting your eyebrows touched up will help you feel wonderful—and the price tag doesn’t rattle you—then go ahead and book a session with an experienced artist. Otherwise, feel free to snag a simple shaping appointment at your local brow bar and ask for makeup tips while you’re there. Either way, know this: You are not ordinary. None of us are.

Shop the Advice

• 

  To Easily Shape

  These products can help you create fuller brows on the daily.
  
  Benefit eyebrow pencil in neutral medium brown, $32, benefitcosmetics.com

• 

  To Keep Them Looking Healthy

  RevitaBrow eyebrow conditioner, $82, nordstrom.com

• 

  To Add Thickness

  Milk Kush fiber brow gel, $26, sephora.com

• 

  To Lift and Fill

  Lise Watier eyebrow duo, $34, shoppersdrugmart.ca

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  To Fill in Spots

  Anastasia Beverly Hills Brow Wiz in taupe, $28, sephora.com

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The post What Can I Do about My Sparse Eyebrows? appeared first on The Kit.

“I have always had puffy eyes (as opposed to dark circles). My grandma had me put tea bags on them, but nothing ever really helped. I just wear glasses now, to sort of hide behind. What should I do?”— Jamie, Toronto

This is the time of year when most of us are left feeling a little puffy. I was lucky enough to bookend an all-you-can-eat beach vacation with family dinners and a couple of boozy nights with friends, so while my eyes aren’t the only things feeling a little swollen, they are certainly the most noticeable. The old trope holds up: The eyes are the windows to the soul, and they often tell the world if your lifestyle has slipped out of alignment.

Why is that? “Well, the eye area is as delicate as very fine tissue paper, so anything you’re experiencing is going to be exacerbated around the eyes,” says Stephanie Gee, one of the founders of Gee Beauty, a painfully chic destination for curated beauty finds and treatments in Toronto and Miami.

What are the common culprits that could make you swell like a balloon at a parade? Stress, lack of sleep, loading up on salty foods, allergens, dehydration, sinus congestion, hereditary predispositions and on and on. These can lead to inflammation in the tissue around your eyes and/or a buildup of fluid that pools instead of being sent on its merry way. It’s an extensive web of irritants to parse—especially when you’re already tired and bloated. But the big picture is this: “The overarching challenge is that there’s a lack of circulation,” says Gee. “So while you might not be able to fix every issue, especially hereditary ones, you can definitely improve the look and reduce the intensity.” That knowledge alone is soothing.

Your first step should be to try to get your blood moving and your fluids draining, says Gee. “Massage is going to be very helpful for that area,” she says. “Work on patting the area gently with the fingertips, doing a light flutter motion or a circular motion around the eyes to give yourself a bit of a massage.” Tools—like the Instagram-famous jade rollers—can be helpful and super stimulating, while remaining gentle on the delicate skin. Gee’s go-to is the Gua Sha, which, for the uninitiated, essentially resembles a bowl scraper used by bakers. “It helps to flush out excess water and inflammation, if you use a gentle amount of pressure and work it in an upwards and outwards motion,” says Gee. In a pinch, you can also apply a cold compress to the area, which could temporarily ease some swelling—the reason spa-goers apply cool cucumbers.

Though your grandmother suggested tea bags as a treatment, there are a lot more targeted products on the shelf these days. “I often wear patches under my eyes as I get ready for work or an event,” says Gee. These handy mini-masks deliver potent skincare right where you need it most and can act as a kick in the pants to your regular routine. Her favourite ones are clear, so you can slap them on while on a flight or under sunglasses while walking the dog. (Sometimes multi-tasking is good; sometimes it means you’re half-reading an email while drinking tepid coffee and misspelling your kid’s name on a form.) 

When it comes to your daily regimen, there are a few guidelines to keep in mind. First and foremost, make sure your products are gentle, fragrance-free and ophthalmologist-approved. Puffy eyes can be a symptom of a sensitivity to an irritating product, after all. Also, if you wear makeup, you must pledge to take it off every night before bed—another common cause of unhappy eyes.

Then, opt for high-quality eye serums over creams, suggests Gee. They tend to have more active ingredients—the heavy-hitters that can tackle pesky issues—rather than eye creams, which are geared more toward simple moisture. Finish things off with a sunscreen specially formulated for use around sensitive eyes, says Gee, since these formulas are non-migrating and won’t run into your eyes. (SkinCeuticals makes her Holy Grail SPF eye product.)

Oxygen-based and radio-frequency treatments can also help de-puff your eyes, if you’re up for splurging on a spa day. “Oxygen can help with circulation and the overall hydration of the skin, and radio frequency is a heat-based treatment that helps to work on that circulation and promotes natural collagen,” says Gee.

Lastly, make sure your lifestyle is in check: drinking enough water helps flush out your system, but adding a little lemon to your water will boost the anti-inflammatory effects, says Gee—as will working up a sweat. “Any activity, from walking to strength training, will help increase circulation and get rid of water retention.”

It may seem a bit blink-inducing to hear that the solution to puffy eyes can be found on a Zumba sign-up sheet—not this year, Satan!—but that might be over-simplifying a tad. In reality, the best thing you can do for your eyes, and yourself, is to be realistic and reliable. “There is no doubt that every little thing helps,” says Gee, “but only when you’re consistent.”

Shop the advice

• 

  Eye De-puffers

  Joanna Vargas Bright Eye Firming Mask, $60, joannavargas.com 

• 

  Eye De-puffers

  Dr. Sebagh Supreme Eye Serum, $195, geebeauty.ca 

• 

  Eye De-puffers

  Bioderma Sensibio H2O Micelle Solution, $20, shoppersdrugmart.ca 

• 

  Eye De-puffers

  SkinCeuticals Physical Eye UV Defense SPF 50, $39, skinceuticals.ca 

• 

  Eye De-puffers

  Gee Beauty Dual Action Makeup Remover, $25, geebeauty.ca 

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The post How Do I Fix My Puffy Eyes? appeared first on The Kit.

Over the past years, lines on my forehead have taken up residence, and I think they make me look old and frowny. I’m only 34! Frankly, I don’t feel old or grumpy on the inside, so I don’t want to look that way on the outside. I suspect that my friends have also started using Botox injections, but they’re cagey about it. I want in! How should I start? —Leanne, Toronto

It’s interesting that you’re asking how to start Botox injections and not why one should kick off an anti-wrinkle regime. That alone illustrates how commonplace injectables have become in the beauty regimens of women, and increasingly, men.

I have certainly seen the shift in attitude: Years ago, when I chatted with models and actresses on set at fashion shoots, they’d demurely insist that they’d never “had any work done.” Recently, however, a fellow mom casually mentioned her Botox regimen while we watched our kids play in the local park.

That, coupled with the fact that neighbourhood Botox parties are actually a reality, proves that social stigmas are evaporating more quickly than the ozone layer, but these types of procedures still deserve research and consideration before, quite literally, plunging in.

I called Dina Martins, a medical aesthetician who has been in the biz for 25 years and who is now the general manager of The Clinica, a recently opened beauty clinic in Toronto that caters to people looking for effective and efficient ways to “refresh” their appearance.

“People are a lot more comfortable talking about it, which I think is great because it leads to more conversation about proper safety,” says Martins. If Botox is done correctly, she says, the side effects are relatively minimal, and you can maintain a natural look, sidestepping the frozen look that happens when it’s overdone.

Now, just to clear up a fundamental point: We use the name Botox freely, but it’s in fact just the most widely recognized brand name of a category of neurotoxins that are designed to paralyse muscles and ease wrinkles. There are now other neurotoxins, namely Dysport and Xeomin, that have been approved by Health Canada and the FDA for aesthetic use.

Neurotoxins are used to soften the look of wrinkles created when you make facial expressions. For instance, as we age, eyes tend to start crinkling up in the corners when we laugh at the latest episode of comedian Gad Emaleh’s show Huge in France, which is now streaming on Netflix and is absolutely worth watching. (Botox isn’t, however, appropriate to address the wrinkles that etch your face when it’s static and still—or the loss of volume under your eyes or cheeks. That’s a job for fillers, and a topic for another day.)

“When you’re considering Botox injections, the most important thing to be aware of is the kind of injectable you’re going to be getting,” explains Martins. “There are places that offer amazing bargain deals, and that’s very enticing, but you need to question whether or not the dilution of the neurotoxin is correct because otherwise it might not be effective.”

The best way to vet a potential clinic is to get a “crucial” consultation and ask a lot of questions, Martins explains. You should not be dictating where injections go. You can point out the wrinkles that bug you, but you should not be directing the placement of any subsequent treatment because there is a great deal of information an injector should be putting to task to make that determination. Someone who isn’t well versed, for example, could easily hit the wrong muscle when injecting above your brow and create a downward turn instead of the lift you were looking for. 

“It’s very important that the injector—whether it be an experienced cosmetic nurse or an actual doctor—feels for your natural muscle movement first by getting you to make different, weird facial expressions,” says Martins. “It sounds silly, but that’s important to show how strong the facial muscles are and will give an indication of what kind of dosage is required and in what particular areas. If they aren’t asking you to make facial movements and aren’t taking your picture first, those are red flags. You need a thorough consultation beforehand, rather than have someone move directly to injecting.”

During the consultation, you can talk through your budget as well. I can’t give you a real guideline for what the final bill might be, since the tally depends entirely on how much product is used, but your doctor should be able to give you a “proper and firm quote” after they examine you and before you see any needles. “And if you decide that something doesn’t feel right, it’s okay not to have injections that day and think on it,” assures Martins. “You don’t need to have a consultation and the treatment the same day if you’re not ready for it.”

First-time patients might also experience what Martins cutely refers to as the “Botox buzz.”

Once you’ve decided to go ahead with a neurotoxin treatment, you need to pick the right time and prep for the procedure. Martins suggests booking your appointment at least two weeks before any big events, since it can take that long for the full effect to kick in—and that allows a comfortable buffer period for any incidental bruising to subside. (Botox injections can nick a blood vessel and cause some temporary pooling.)

Also, read up on which medications and supplements might negatively affect your treatment. Some medications, for example, lead to blood thinning; and you should shelve your antioxidants like ginseng, Vitamin A and E for at least four days before your appointment, she says.

The actual injection shouldn’t be excruciating. “Patients need to understand that in order for it to work, it needs to be injected into the muscle, so you will feel a pinch,” says Martins. “But it’s not painful like a flu shot. Most people compare it to acupuncture.”

First-time patients might also experience what Martins cutely refers to as the “Botox buzz”: a feeling of heaviness, dizziness or headache that typically goes away in a day or so.

With that in mind—and remembering that you can’t apply makeup onto the injection site directly after, in order to prevent infection—you might not want to make your first appointment during a busy day. (Even though Martins says many of The Clinica’s clients of all ages swing by during their lunch hour.) Last, if you love the results of your initial dose, you can expect to return every four to six months for a top-up.

So while an initial foray into Botox might seem exciting, just promise you’ll give it the same thought you’d give to any other less sexy medical procedure.

Shop These Gentle Post-Botox Products

• 

  The Concealer

  Charlotte Tilbury Magic Away Liquid Concealer, $38, charlottetilbury.com

• 

  The SPF

  Green Beaver Face Cream SPF 25, $21, well.ca

• 

  The Cream

  Kiehl’s Ultra Facial Cream, $65 (125 mL), kiehls.ca

• 

  The Light Therapy

  Red Light Man Red-Infrared Combo Mini, $135, redlightman.com

• 

  The Cleanser

  Lano Face Base Gelcream Glycerin Cleanser, $30, sephora.ca

The post How Do I Start Using Botox? appeared first on The Kit.