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The new no-trace nips and tucks

Meet the men celebrities pay thousands of pounds to – for their no-trace nips and tucks

Today, anyone who can’t spot bad plastic surgery isn’t looking hard enough.  Breasts as round as cantaloupes, serially overstretched skin and the creepily blank upper face that remains still and staid while the lower face moves freely during a conversation are tell tale signs.

A raft of celebrities including Dannii Minogue, Jennifer Aniston and Amanda Holden claim to have joined the Botox-detoxed ranks and renounced face freeze.  Plus, the PIP scandal’s wake has made potential patients more wary of the dangers of cheap surgery and more of us can spot the creepily overdone work that enters the room before its wearer. As a result, a new demand for naturalism is emerging in plastic surgery.

Meet the men at its forefront.

Mr Norman Waterhouse

STEALTH LIFTS For years the object of facelifts was to take away as much skin as possible by pulling the facial skin hard, says Norman Waterhouse, a leading consultant plastic surgeon and former head of the Cranofacial Unit at Chelsea and Westminster Hospital.

‘As a result, we got the wind tunnel look or operated look that was instantly obvious,’ he explains.  ‘That’s where the warmth has gone from the eyes and the face looks unnaturally swept to the side, what surgeons call a tell-tale ‘lateral sweep’.’

Hollywood examples include include Joan Rivers, Latoya Jackson, Kenny Rogers and Donatella Versace.

‘This look was common in people with thick, leathery and sun-damaged skins who weren’t suitable facelift candidates but went ahead with them anyway,’ says Mr Waterhouse.

‘If you look at someone and think ‘that’s a facelift’ then it’s a bad facelift,’ he says. ‘No good surgery should ever look done.

‘I opened the paper recently and saw a well-known celebrity who I have facelifted twice saying she has never had a facelift. The fact that everyone believes her means I have done my job.’

‘Now, doctors like myself who work in facial reconstruction surgery are redefining their concept of what makes someone look younger.

‘Looking older isn’t about having lots of extra skin, it’s about the muscle and soft tissues in the face descending,’ he explains.   ‘As women age, they get neck laxity, jowling and a deepening of the nose to mouth lines which is why people might say ‘You look a bit stern’ when really it’s their jowls that are dropping.

‘Facial surgery isn’t about pulling skin anymore,’ he explains, ‘it’s about putting volume and shape back into the face and achieving a more youthful shape to the jaw. We do that by repositioning the muscles and tissue in the face, not only the skin.’

As an alternative to old-school facelifts, Mr Waterhouse has pioneered a new, more subtle, natural-looking procedure which is a refinement of the traditional SMASectomy, a facelift that involves manipulating the SMAS muscles (which run parallel to the nose to mouth lines) of the lower face in a variety of directions.

Known as a ‘Modified lateral SMASectomy’ Mr Waterhouse’s new technique tightens the muscles in the SMAS layer in a lateral direction which a achieves in natural look where the neck, jowls, cheeks and nose to mouth lines are rejuvenated.

Scarring too has become more discreet.  Instead of a line down the front of the ear, in the Waterhouse Lift, there is only a scar behind the ‘tragus’, the small piece of cartilage at the entrance of the ear canal.

‘Additionally, the scar at the back of the ear is often much shorter and unless there is too much skin in the neck, may not even have to go into the hair anymore,’ Mr Waterhouse explains.  The Waterhouse Lift is done under general anaesthetic with an overnight hospital stay.

‘This is a gentle facelift but still a surgical operation,’ he says.  ‘It’s not like a ‘lunchtime lift’ and requires at least two and a half weeks recovery time, though swelling and bruising will generally be less than with traditional facelifts.’

As part of this new no-trace surgery trend, Mr Waterhouse has also pioneered a new brow lift that astonishingly, leaves frown lines in the forehead.

‘Old fashioned brow lifts used to take out frown lines by lifting the whole muscle over the brow, resulting in an unnaturally high brow that ends up looking scary,’ says Mr Waterhouse.

‘But a more attractive brow isn’t about lifting the brow it’s about making the brow look more feminine,’ he explains.

‘Look at pictures of models with naturally beautiful brow lines and they all descend in the middle and rise at the sides’.  To maintain that look, Dr Waterhouse lifts the brow by leaving the frown lines and moving the brow slightly sideways instead of upwards.  Surgeons who bring the middle part of the brow up end up with patients that look startled, a common look in Hollywood,’ he says.

Dr Michael Prager

MOBILE BOTOX ‘Standard Botox procedure is about eradicating all facial movement,’ says Dr Michael Prager, an anti-ageing physician known for his no-trace Botox (which he administers to a long line of celebrities and magazine editors, few of whom would admit to having had more than a holiday).  ‘But we now know that no facial movement doesn’t equal attractiveness or youth.’

Old school Botox is usually used on the forehead only which means the lower face doesn’t change, he says.  ‘You end up with a line-free forehead and a lower face that ages at the usual rate.  That’s instantly recognisable as too much Botox,’ he says.

By continually injecting Botox into it the forehead muscles, these eventually drop and patients end up with lowered eyebrows, another tell-tale sign.

‘Doctors then compensate by injecting it in a V-shape on the forehead that raises the outer edges of the brows giving the face a creepy arched eyebrow look,’ says Dr Prager.  ‘None of that occurs in nature, how can it look attractive?’

Another problem with routine Botox is doctors using it in crow’s feet, an increasing trend over the last ten years.    ‘This relaxes the muscles that lift the cheeks when we smile and leaves patients with fake grins, saggy cheekbones and the empty expression you see on celebrities such as Peter Andre and Jordan,’ he asserts.

‘To combat that sagging, doctors then inject fillers into the cheeks to lift them but then you only end up with cheeks in all the wrong places, as is the case with celebrities such as Courtenay Cox and Cameron Diaz,’ says Dr Prager.  ‘I believe repeated Botox use has meant the muscles around their cheeks have atrophied and dropped’.

Lines are the result of a loss of collagen in the skin and Botox doesn’t address this, he says. As an alternative, Dr Prager has created his own style of ‘mobile Botox’ that maintains facial expression while giving the face a subtle lift.

He achieves this by focusing unusually, on the lower part of the face and aiming to treat the muscles in the jawline that pull the face down and lead to jowls, instead of those in the forehead.

‘Some people develop jowls as early as 35 because they have strong muscles in the lower face that tend to pull downwards, leading to a sagging, jowly look,’ he explains.  ‘These muscles are often genetic but can also be prominent in people who do a lot of yoga, Pilates and weight lifting.

‘When we inject Botox, we now maintain the movement and animation that makes the face attractive, which is the ability to move the eyebrows in surprise, happiness and empathy and get rid of the movement that makes the face unattractive and sad-looking which is the jowl and sagging jawline that pulls the face down’.

To treat lines in the forehead and the rest of the face, Dr Prager applies tiny amounts of Botox of light fillers to soften frown lines and techniques such as dermaroller, a skin needling therapy, to enhance natural collagen around crow’s feet.

‘Looking more youthful requires a thoughtful approach, not only pumping the skin with botulinum toxin,’ he says.  People report looking happier and hearing remarks such as ‘You look great, what have you done?’

‘I have people coming to me who had Botox years ago and were scared off because they looked frozen and their friends could pick it,’ he says.  ‘Now they have it and never have to admit it.’  Cost:  From £390

Mr Patrick Malucci

NATURAL BOOB JOBS It’s by far Britain’s most popular surgical procedure but gone are the bigger-is-best days of huge, over-sized implants.  Patients are now requesting a more subtle, natural-looking result, says consultant plastic surgeon Dr Patrick Malucci, founder of

‘The first thing women say to me is ‘Don’t make me look like Posh Spice or Jordan!’ or ‘I don’t want two big see-through balls’,’ he says. The problem with old-style breast surgery is the thoughtless boob job, says Dr Malucci.

‘Surgeons stuffed massive implants into skinny girls without thinking,’ says Mr Malucci.  ‘That thins the breast skin and squashes the natural breast substance leaving the patient at risk of distortion later, which is why you see so many celebrities needeing repeated breast surgery and having their implants removed.

‘There was no thought to the dimensions and proportions of their bodies and the result was visible implants, creasing, rippling and wrinkling of the skin.’

To define the characteristics of attractive, natural breasts Dr Malucci and his team studied the breast dimensions of 100 topless models to come up with what he has called the ‘golden ratio’ of the perfect breast.

‘An attractive breast has a balanced proportion between the upper and lower half, with a nipple that sits slightly skyward,’ he explains.  ‘The ideal is 55 per cent of the breast volume sits on the lower half of the breast and 45 per cent in the upper half.’

But this is usually the opposite of what patients think is an attractive breast. ‘I often get mums asking for breast surgery after having had their children. They point to the flatness of the top of their breasts and say ‘I need volume there.’  I have to explain that if they want to look natural, we need to fill the breast from the bottom upwards with most of the volume in the lower half.  They eventually get it but not without some convincing.’

To recreate these natural breast aesthetics, Dr Malucci opts for ‘highly projected teardrop implants ‘ or anatomical implants that mimic the natural shape of a breast and can help the nipple appear to point pleasingly upwards, without having to move it surgically.

The procedure is usually done under general anaesthetic as a day case and patients are encouraged to get back to work the next day though they won’t be able to do manual work, weight lifting or swimming for up to eight weeks.

Examples of breasts with perfect ‘golden ratio’ proportions include model Keeley Hazell and actress Caprice, says Dr Malucci.

‘Now I am seeing girls that had boob jobs in their younger years coming in and saying ‘I know I look ridiculous, I just want to look natural now,’ he explains. ‘That will often require another, more subtle round of breast surgery because they have lost so much volume through having oversized implants for years and they may need lifting and tightening as well.’

‘You would never believe that 90 per cent of the people I have operated on have had their boobs done.’  Cost: £5-8000.


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