Annabel column

The Botox and fillers rule book – 10 must-dos this beauty editor swears by

Botox, fillers and other anti-ageing treatments can help you cheat your way to younger-looking skin, but if you don’t want to look ‘done’ follow these ground rules, says beauty editor Annabel Meggeson

A respected face doctor once told me about fallow periods. They’re the months in between injectables, lasers and the like, when you should let your skin go back to normal. Otherwise you lose sight of normal and end up looking like more like an over-inflated lilo than a human being.

My latest fallow period has gone on so long it has become a furrowed period. With all its rumples and shadows, my poor old face looks like a ploughed field. With too much time on my hands, I sit here scrutinizing every flaw and fold. I know, it’s not healthy.

Really, I should grow old sensibly. But I’m too vain – and too informed

Really, I should just let the collagen continue its slow breakdown, the pigmentation its steady build up (minimized by rigorous good-girl applications of SPF), and grow old sensibly. But I’m too vain – and too informed.

As a beauty director who has had every treatment at her disposal, I know what a few sprinkles of Botox, a couple of rounds of Intense Pulsed Light (IPL, a type of laser) and maybe a shot of the latest ‘It ‘treatment (in early 2019, that’s still Profhilo – see below), can do.

These so-called tweakments can make the difference between waking up every morning looking so altered your own phone doesn’t recognize you versus feeling ready to take on the world 24/7.

Once you’ve had a taste of the good stuff, it really is hard to go back. You can get some satisfaction from good skincare, but it’s never quite enough. It’s why recently I’ve been dreaming of all the high-octane things I’d like to do to my skin again, if I ever win the lottery.

I’d start off with a few sessions of IPL. It’ll sting, but hopefully lots of that last-summer sun damage will be drawn to the surface, form crusty bits and drop off to reveal a brighter, somewhat more even-toned complexion underneath.

Then I’ll load up on the Profhilo – two rounds a month apart, involving multiple injections of Hyaluronic Acid just below the skin. This treatment has been dubbed ‘the injectable moisturizer’ and while I need to give it another go to be sure of what I think (I only had one round when I first tried it and you need at least two to get the desired results), the reviews have been glowing.

Once that has settled, I’d be back for Botox – tiny drops in my forehead, around my eyes and sprinkled round and about the place in the way that the top doctors do, using a combo of experience and artistic flair to dispense it round the face for an overall freshening effect. (The masters of this are the female doctors at Medicetics.)

Annabel Meggeson column

In the same session: filler. A couple of ml in my chin and cheeks, to add a trace of extra volume – just enough for other people to register my face as younger without being able to put their finger on why.

Knowing what to do, what works and who to see has been hard-won, though (if you can assign that term to the pursuit of vanity).

I’ve ended up with cheekbones I definitely didn’t dream of and lumps in my face that have had to be dissolved. I’ve had one eyebrow higher than the other and wrinkles in my hair line where there were none before. (If you’re not careful, Botox behaves like Spanx – it smooths skin in some places, but the rest has to go somewhere; in this case I got the excess roll right at the very top of my forehead.)

The anti-ageing treatment rule book

To that end, here are some golden rules to follow if you, too, are dreaming of next-step skin solutions.

#1: Use Botox lightly

Botox often gives the best results when it’s used lightly and widely across the face, rather than lots in one spot, especially when you’re older. Mention this to your chosen aesthetician and if they look at you blankly, move on.

#2: …same goes for filler

It’s the same for filler. ‘The new approach is to inject it micro-quantities in several different areas,’ says Dr Jonquille Chantrey, who’s a consultant for Allergan (one of the biggest manufacturers of injectables), and a cutting-edge injector. ‘It’s when you overfill a few areas that the eye starts to detect something as different/odd. In one single needle injection point, you wouldn’t inject more than 0.3ml of filler.’

#3: Enlist an objective eye

Recruit a tweakments jury – a couple of friends who promise to tell you when you’ve gone too far or something looks weird. In turn, you will promise not to resent them for their honesty.

#4: Have fallow periods

Respect the fallow period, even if it does become a furrowed period after time. Let everything fade out for at least five months every year or so – that way it will be very hard to ever cross the line and, actually you’ll be able to go on fooling people for a lot longer.

#5: Get a few things off the menu

Be prepared to go all in. If you want to look fresher, better, younger, it’s going to take more than a one-off dollop of, say, Botox , even though that’s the most accessible of these treatments in terms of price and availability, as faces age on lots of different levels at once. A good doctor will recommend a few things – say, laser for resurfacing, and Botox + micro- filler for structure and volume.

#6: Selfie up

Take lots of photos of yourself, or get someone else to, in the same spot and in the same light before, during and after treatment. It’s the closest you’ll get to being able objectively to assess if treatments are working, whether you like the results, and – in my case at least – whether you really do look like your grandmother or is it just the paranoia talking now all the good stuff has worn off.

Annabel Meggeson column

#7: Be very careful with lips

They can quickly look grotesque if they’re not accompanied by an increase in volume in the mouth/chin area as a whole. Really, if you want your lips done, you should address the rest of your face first. Gently plumped lips are then the icing on the cake.

#8: Be cautious about claims

Be cautious about treatments that claim to increase collagen through heat or needling. They can give a temporary boost, but unless you’re really committed to keeping them up over a long period of time, I’m not sure they’re worth it in terms of noticeable results.

#9: Start saving

None of this is cheap and once you start, I’d need about £2000 to achieve my dream skin plan – and assuming your treatment is successful, you may not want to stop.

#10: But be philosophical

If you do stop treatment for whatever reason and feel a bit mournful, console yourself with the thought there are no miracles and everyone continues to age – and to look their age, more or less – no matter how many expertly placed tweakments they have.

Now, wondering which doctor to trust with your face?

Here are the doctors two of the over-40s on the Healthista team trust implicitly

Annabel Meggeson, 41, beauty editor (pictured below):  ‘I’ve seen all sorts of people about my face, but the person I keep going back to is Dr Vicky Dondos at Medicetics. She’s pretty much the only aesthetic doctor I’ve ever met who looks great without looking like she has had anything done (she has), which says everything I need to know about her judgement when it comes to working on other people’s faces. She has a holistic approach to skin, which I rate, treating with lasers and injectables across a range of concerns – surface, volume, laxity – and producing a genuinely natural look as a result. I trust her implicitly to never overdo it. If anything she errs on the side of caution – but in an area where the less is more mantra carries such high stakes, this is definitely a good thing. The only downside: she’s so good it’s almost impossible to get time with her. Book now for an early summer zhuzh’.

Anna Magee, 49, editor (pictured left):  ‘I swear by Dr Maryam Zamani at the Cadogan Clinic in Sloane Square, she is actually an ocular plastic surgeon so she knows the facial muscles very, very well. Maryam has been doing tiny tweakments – a little Botox, a bit of filler here and there – for me for about three years and the work is barely recognisable.  Now people constantly tell me I have amazing skin and tend to get quite surprised when I tell them my age. Maryam is not cheap, but it’s my face, so I spend what I have to and I 100 per cent trust her judgement to tell me what I need and never give me anything I don’t.  The picture left was taken about four weeks ago and hasn’t been airbrushed.’

See Healthista’s anti-ageing treatments videos here in which Dr Maryam Zamani explains what you need to know about lip fillers, Botox, eye fillers, lasers and more as part of our Doctor chats Youtube series (plus what she has done herself).

Annabel Meggeson

Annabel Meggeson is the former beauty director of Red Magazine and Healthista’s new Beautista columnist.

Annabel’s columns will appear every Friday and feature honest, refreshing coverage of the best anti-ageing treatments, products worth their pricetag, beauty bargains that deliver results and seasonal trend updates. Don’t miss it.

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