I have just watched a television programme on BBC1 called ‘The Truth about Cosmetic Procedures’ in which a young girl paid £575 for a liquid nose job. To you or me she looked perfectly fine with a nose that was neither too long, short, fat or thin. But her nose had a tiny bump in it that cast a small shadow on one side, so the doctor wielding his syringe convinced her that an injection to iron out the bump was the very thing to make her look better in photos. Ten minutes of slight discomfort, job done and she’s £575 poorer, he’s £575 richer and everyone is happy!

Or, as I would argue, maybe everyone is just a bit more paranoid about the tiniest facial imperfection and therefore even more desperate for the latest quick fix for every perceived defect, especially any sign whatsoever of ageing!

I usually avoid programmes like this because they make me cross (as you may have already sensed!) but I was interested in this one because it was headed up by Dr. Michael Mosely and his approach tends to be scientific, objective and evidence based. My interest was therefore piqued and I decided to watch to see his conclusions about facial treatments and the truth or otherwise of their claims. The programme set out to answer three questions:

  1. Do invasive cosmetic procedures make you look younger and more attractive?

  2. Do they impact physical health?

  3. Do they impact mental health?

The programme investigated four of the most common cosmetic procedures to determine whether they actually worked as promised and whether they were safe.

1. Dermal Fillers

These are seen as everyday, harmless and practically every young person interviewed on the street for the programme either had had such a procedure or knew someone who had. The effect lasts from six to eighteen months and is designed to ‘plump’ areas like lips and cheekbones to create the big ‘trout pouty’ lips and sculpted face shape beloved of the Kardashians. To create the effect, hyaluronic acid in various degrees of firmness is injected into the given area to create the padding. As hyaluronic acid is a naturally occuring substance in the body, there are very few allergic reactions to the fillers themselves. The danger comes from the fact that literally anyone is legally allowed in the UK to inject these fillers into another person’s face. No training is required and there are no safeguards. You may be unsurprised that such treatments can go badly wrong with excessive swelling and bruising, especially to the delicate lip area and an organisation set up to help victims called ‘Save Face’ knows of five cases of blindness caused by fillers injected accidentally into blood vessels with devastating results.

2. Lasers and Micro-Needling

Two female volunteers for the programme agreed to test these procedures which are both designed to wound the skin and create enough trauma that new skin and new collagen is created. Both are therefore moderately painful. The lasers use heat which leaves the skin very mottled with reddish brown patches and within days there was excessive flaking of skin. With micro-needling, the facial skin is pricked all over with tiny holes which bleed so that the skin is red, bloody immediately afterwards, and sunburnt looking for about a week.  Subsequent tests showed some effects, however the micro-needling only showed marginal gains in collagen production. The laser showed a greater benefit but also had more side effects. Neither treatment showed much difference in the actual appearance of the skin. Asked if she’d pay £300 again for her treatment, the volunteer who’d had the laser treatment said ‘No, I’d not go through all that pain for no discernible result.’

3. Botox

This is a multi-billion pound industry and like dermal fillers, is entirely unregulated and very widely available. It works because Botox paralyses the muscles which work your face - so your face takes on that ‘frozen’ immobile look ubiquitous nowadays on TV. The programme showed a young builder who has regular injections into his forehead to prevent the potential wrinkles from forming. And there’s the rub; Botox used to be promoted as a way to reduce or eradicate existing wrinkles and now, because there is no regulation and no minimum age requirements, children as young as 13 (I kid you not) are apparently getting Botox in the hope that they will never become wrinkled, or maybe they are deluded enough to believe that this will actually prevent ageing of any kind. The problem is that no-one knows whether prolonged use of Botox is potentially disastrous for the face. Paralysed muscles atrophy through lack of use - just as they do after illness if you are bed-ridden for several weeks. This facial muscular atrophy is irreversible and as Dr. Moseley said ‘probably isn’t a great idea’.

4. Stem Cell and Fat Injections

This was the most invasive, the most scary and, at £6000 the most expensive cosmetic procedure investigated by the programme. Fat is ‘harvested’ from your own body in an operation in which you are heavily sedated. The stem cells are separated out and injected back into the face at points where smoothing and plumping are required alongside the fat as appropriate. At the same time the bones of the face are ‘scratched’ so that this trauma stimulates bone growth, the loss of which overtime contributes to the ‘sunken’ look of an older face. I have to admit to watching this through my fingers as it looked quite violent and extremely unpleasant. However the woman undergoing the procedure pronounced herself delighted with the results. As I might have done if I’d just paid £6k for something as painful looking as she’d just submitted herself to!

The Final Results in Objective Tests...

I am fairly sure that all the people who seek these cosmetic procedures and part with their hard-earned cash will defend their right to do so and also claim that the treatments have had a beneficial effect on them in one way or another. And who am I to say otherwise? However I was very interested in the final part of the programme which sought to answer the following questions:

  1. Do others find you more attractive after the procedure and do they rate you as any younger?

  2. What impact do these procedures have on how you feel about yourself?

A random group of people were firstly asked to evaluate the ‘before’ photographs and then the ‘after’ images of people who had undergone various cosmetic procedures. The result was a ‘very modest’ increase in attractiveness in the ‘after’ photographs, but also a sense that they’d all moved closer together in looks, so had lost some of their individuality and personality. Overall the perception of age had shifted downwards by an average of just two years. In terms of personal outcomes and satisfaction with their cosmetic procedure - this was much higher with everyone saying that they felt better about themselves after their treatments. However the tests also showed an increase in preoccupation with their looks and a greater likelihood that they would want further treatments to maintain the improvement or to seek further treatments to enhance their looks.

As all of you who regularly follow this blog will know, I have always had a deep personal aversion to all such cosmetic procedures, although I understand why people seek them. This programme confirmed all three major concerns I have with this extremely lucrative industry: 

The first is that here in the UK these procedures are entirely unregulated. As a consumer you have no protection in law if the procedure goes wrong and you are left with permanent damage. I could set myself up tomorrow as a practitioner and start charging to inject dermal fillers and Botox into peoples’ faces and no-one could stop me from doing so. 

The second objection I have is the profoundly ageist premise on which all such procedures are based. No-one seems to question why they are deemed to be so obviously necessary. There would be no market for these costly and invasive treatments if normally aged faces were seen as both acceptable and beautiful. Why are we not more horrified that so many people are disgusted by the thought of a few wrinkles?

And finally I object to the claims that are made for such procedures. As was shown in this programme, people who have such interventions look neither younger nor more attractive. Maybe I am just showing what an old fogey I am, but I really am so glad that I’m too old to fall for the notion that happiness, confidence and good looks are to be found in a syringe of something that freezes all normal facial expression and makes everyone look more similar - and actually a bit weird.

Please do leave your comments below! Tricia x