Facefit (& Beauty Bonus)

“We can’t beat Old Father Time… no – but some women drive a mighty close bargain with him”?

For over 40 years I have worked within the exercise and fitness world. For many of those years I was also employed a fashion and photographic model. The work was demanding, but it enabled me to travel to locations and destinations all over the world, which I might otherwise have never seen. Throughout all the years I religiously looked after my dry, sensitive skin. A good figure and a glowing skin are prerequisites for a successful model. In 1980, at the grand old age of 40, (ancient for a model) I was delighted to be chosen by Oil of Ulay to appear in their UK and European TV advertisements for their classic pink moisturising lotion, which I can even remember my grandmother using! Imagine how flattered (and amazed) I was when, 9 years ago, at the ripe old age of 55, I was selected to launch Oil of Ulay’s new range of moisturising creams, specifically designed for MATURE skin! I became “the face” of Oil of Ulay’s Pro-Vital range of skin care products and appeared in extensive TV, newspaper and magazine advertisements world-wide for several years.

It was unusual, but refreshing to discover a product made especially with older women in mind. It was equally surprising to find a company bold enough to go against the flow, to want to use a “real live fifty something” woman, to promote its new product! Proctor & Gamble who produce Oil of Ulay, had undertaken a comprehensive survey in which it was shown, that the majority of mature women preferred to see a woman of their own age featured in advertising, instead of a younger woman.

SKIN CARE

Moisturising is essential for middle aged skin to retain its suppleness and healthy glow, and to replace the natural oils that dry up as part of the ageing process. In the past few years technological advances and scientific research, have resulted in huge improvements in the skin care products that can be bought over the counter. Unfortunately many mature women are not taking advantage of them. (By contrast I have noticed many more young men taking an interest in caring for their skin!)

When you are next selecting a moisturiser, stop and look at the list of ingredients on the back of the bottles and jars. You will often find that the low cost products contain almost identical ingredients to many products, which cost twice or maybe three times more. These days the European Cosmetics Directive prevents companies from making false claims for their products, claims that cannot be backed up. That has to be good news for us all. From recent research, it appears that many women are relying increasingly on cheaper moisturising lotions and creams. It seems that in many instances they are just as effective as the expensive big-name brands. Good low cost moisturisers are an absolute must for a mature woman’s skin, in order to maintain the skin in a healthy and comfortable condition, and to delay the signs of ageing.

Cleansing the skin is very important for a healthy skin. If we didn’t wash our skin it would take 25 days to cleanse itself. But a dilemma many women have these days, is whether or not to use soap for cleansing their faces. Personally, I find soap dries my skin and leaves it feeling taut and uncomfortable. Many of my generation have found their skin prematurely aged, from years of removing make up with cold cream, popular in our youth, but which was too harsh for many delicate skins. But soap and cleansing creams have moved on since then and skin care products have improved a great deal. Nowadays, with so many products on the market, it’s simple to find a cleanser to suit your skin type – and most importantly, your pocket. Because I don’t often wash my face with soap, I find that exfoliating my skin once a week helps keep my skin in good condition.

Exfoliates are gels which contain tiny scrubbing grains. You simply apply the gel to your skin, rub gently, and leave for a few minutes. During that time it can do it’s magic whilst you busy yourself elsewhere. Finally, you must rinse off the gel with water. You will find that your skin feels so smooth and fresh, and your complexion will have a healthy glow. Exfoliating, removes dead skin cells and surplus grime from the face, both of which make skin, look dehydrated and dull. If you have been overworking, are under stress, have had too many late nights, or are recovering after being unwell, why not give yourself an extra treat and exfoliate your face? Finally, after exfoliating, apply a mask that will moisturise, brighten and firm your skin. If you have the time as a pick-me-up routine, I can thoroughly recommend it!

Many young women think older women are “past it” if they are over 50. Well, I for one refuse to be written off. And I know I speak for the majority of women of my generation, when I say that I’m enjoying this stage of my life, and I’m reasonably happy with my lifestyle and my appearance. I don’t consider it conceited to look after my looks, although I do sometimes think that some people look after their cars better than themselves! However what I do think is wrong, is that much of the media and many cosmetic companies, put pressure on women to try to make themselves look 20 years younger than they are. Looking good should be about making the most of which you are at whatever age.

For many of us, the better we look, the better we feel about ourselves – and vice-versa! People who look after themselves and take pride in themselves often appear to be the ones who lead busy, interesting lives. They seem to positively glow with good health and have a zest for life. It’s a well known medical fact that doctors often know when a patient is unwell or depressed by the way that the patient stops bothering about their appearance. Conversely, it’s a sure sign to the same doctor that the patient is on the road to recovery, when he or she starts taking a renewed interest in their appearance.

For several years I have been involved in Look Good… Feel Better a charity within the Cosmetic, Toiletry and Perfumery Industry, which helps cancer patients during and after testament. It holds monthly (and sometimes fortnightly), workshops for women cancer patients in 24 Hospitals in the United Kingdom, from Glasgow to Plymouth, from Belfast to Norwich. The aim of the workshops is to make the women feel better about themselves

Each of the invited patients receives a complimentary box of 16 cosmetic
products worth between £80 and £110, a donation from the UK Cosmetic, Toiletry and Perfumery Association. The 2-hour workshop is free and conducted by a trio of local volunteer Beauticians from local stores who are product neutral. The Beauty workshops focus on the facial effects of cancer treatments. Radiotherapy creates dry skin, and 9 out of 10 women who have Chemotherapy suffer hair loss. Advisors teach how to shape eyebrows and enhance the eyes if lashes are lost, give practical advice on wigs, and show how scarves can cover a bald head.

The demo and a chance to experiment, is a welcome distraction from the clinical side of life. Loss of body image is a distressing side effect of cancer, and for women at their lowest ebb, a makeover builds confidence, adding a little joy and hope. A positive frame of mind is an important factor in fighting off cancer, and any help to patients to feel good about themselves, is most welcome. The makeovers are restorative for the women, and their loved ones, who are cheered to see the patient with a brighter face and an optimistic outlook. I have been privileged to see letters from grateful patients who had benefited from the Look Good Feel Better workshops. Barbara from Edinburgh who suffered from Bone Marrow cancer summed it up “the LGFBetter makeover made me feel really wanted and normal again”. Self-confidence is very important. Patients need to look normal- even when they don’t feel normal.

The individual facial image a woman presents to the world is very important to her. That image is how we see ourselves, and it is also how we want to be seen by others. The majority of females learn from an early age, through years of trial and error, how to make the most of what nature has bequeathed them. Most of us as young girls experimented with hairstyles and tried out our mother or big sister’s beauty preparations. We discovered ways to enhance our features, and eventually we developed our own individual styles. Quite literally we learned how to put on our best face in order to brave the world.

However, women find this process more difficult than others and sadly many adult women are never really confident of their image. Quite understandably the sheer variety of products on sale in the shops confuses plenty of women. A few feels genuinely intimidated by the sophisticated appearance and superior attitude of some skin care and beauty consultants in the cosmetic departments of the shops and stores. Many women find a lot of the products are too expensive, and cannot afford to make mistakes.

When older women leaf through magazines for help and guidance, many feel that much of the advice dished out is aimed at youngsters, and the information isn’t applicable to them because of their age. As a result some become depressed and give up on themselves, whilst other women find that as the years increase, their own confidence in themselves sadly decreases. Some just stop experimenting and play safe with the familiar products they’ve used for years. Those, too nervous to make changes, get stuck in a visual time warp for the rest of their lives.

It takes time to prepare to “face the world”. But not only can women waste time doing so, they can also waste a lot of money by buying the wrong products. When it comes to skin care and beauty products, mistakes can be very expensive. It might be assumed that after years of practice, trial and error most mature women would be able to avoid making mistakes. Apparently not and women’s magazines have seen an increase in requests for makeovers and advice from this older age group.

Perhaps one reason for these requests is that recent economic instability has left mature women making sacrifices, and many see it as frivolous, to spend money on themselves. Women of 40+can find themselves returning to work, many as a result of divorce, bereavement. Others, alarmingly and unexpectedly, find themselves as the main breadwinner, as a consequence of their husband or partner being made redundant. It’s these newly independent women, who are looking to update their image. All too often these women find themselves, when they least expected it, having to compete with youngsters as young as eighteen, in both the workplace and socially.

I find it easy to get out of touch with products myself, and I too am constantly confused by the endless array of new products and their amazing claims. Many of these heavily promoted products are extremely expensive, and I for one want to see value for my money. However, price doesn’t always put people off buying, and recent surveys have shown that mature women will spend if they are convinced by the positive claims. In other words they want to see and feel positive results.

We can’t turn back the clock, nor should we want to, but we can learn simple ways to make the most of ourselves. So let’s make a start with our skin. Our bare skin is the base, or our canvas, on which we can learn to enhance our features, disguise our faults and create illusions with colour and contour. It’s not conceited to take pride in yourself, and nobody else is going to do it for you on a regular basis. When we feel good about ourselves, we are more confident and outgoing and can enjoy life to the full. I for one don’t want to look 21 again, nor do I want a face, which is blank and expressionless. We should be proud of our laughter lines – they show character and a sense of humour. Eyes in particular are said to be the window of, or reflection of our souls.

Our skin reflects our lifestyle, and scientific tests indicate that stress, lack of sleep, smoking, taking excess iron supplements, over exercising and over exposure to the sun, can all contribute to the ageing process.

How well or how badly our skin ages depends more on our skin type, and how well we look after it, than it does on our actual age. People, who have looked after their skin properly throughout their lives, are more likely to have healthy skin, and to look years younger than they actually are. All skin will show some signs of ageing as the years roll by, but in order to help ourselves to better skin, we need to know what causes it to age.

10% of skin ageing depends on genetics, and is inherent. To get some idea of your chances look at your parents and see what type of skin they had. Some people will be luckier than others will! This type of ageing is subject to the forces of gravity and everything, naturally, begins to drop a bit and it becomes particularly noticeable from our 50’s onwards! This is because our bones start to shrink, and the skin and muscles around them start to sag. It is particularly noticeable in someone who has recently lost weight; the face begins to look longer, especially around the jowl area, the eyelids, and the nose.

Smokers often age badly; some have hollow cheeks, which can be caused by the inhaling motion in the cheek muscles. Many smokers have tell tale lines running down from mouth to nose, and some have discoloured skin and stained teeth, caused by the cigarette smoke. The skin, hair, and also the clothes can smell unpleasantly of smoke.

But by far and away the most damaging factor in ageing skin, is over exposure to the sun. The sun causes the skin to have a leathery appearance and texture, age spots also appear and so too do coarse wrinkles and small broken blood vessels. This type of skin ageing can be prevented. Sun can affect the skin cells and cause cell damage, but it also poses health threats, including skin cancers. The effects from the suns burning rays may not be visible for years, but the harmful rays will have done their damage. Sunburn is unpleasant, and the painful redness indicates deep skin burning. When eventually the delicate skin heals itself, the burnt skin peels off. It is paramount to protect your skin, particularly the sensitive facial skin, from the sun’s harmful rays.
Use a sunscreen containing SPF 15 (sun protection factor 15). Anything higher than SPF 30 is not considered necessary.

TRICKS OF THE TRADE

There are ways in which we can help ourselves to an instantly younger look and brighter complexion. One, is by simply changing the way we apply our make-up. I meet many actresses and TV personalities in the course of my work, and most are not stunningly beautiful all the time. In fact lots are very plain and a few are downright ugly. But they are all human, and when they look in the mirror, they too can see blemishes that make them cringe. They notice the odd spot, a few more lines and a face that has lost its firmness and become a bit too fleshy. But they are fortunate, because in their business, help is often on hand, in the form of a make-up artist. From these skilled people they learn some tricks and know how to make the best of themselves. I too am lucky enough to have worked with many of the best make-up artists and hairstylists. I’ve learnt a few tricks of the trade and I have seen for myself, how the use of colour and good technique can enhance beauty and disguise faults.

At home we can learn to adapt some of these tricks to our advantage. So start by taking a long hard look at yourself in the mirror. Be honest with what you see! The problem is that most of us will focus on the things we don’t like about ourselves. If you do that you won’t see a thing! We need to scrutinise our faces and acknowledge what is attractive about them. Recognise the good points you see in the mirror today, not to be confused with what you used to see, what was attractive, some years ago! We need to be honest and realistic about what we see now and to be realistic with ourselves. Only then can you learn to play up your good points, rather than just trying to hide the bad ones. You need to be positive in your approach, not negative.

Think back to your youth, do you remember when you were 17? I do, and I remember wanting to wear make up in order to make me appear grown up, and older than I was. I know I applied it very badly, and I must have looked absolutely ghastly. I had very little skill or technique, and the awful result probably added 5 years to my looks! Today, many mature women are still applying the same colours and techniques as they did 20 or 30 years ago when they were first experimenting with make-up. Make up artists and beauty consultants are able to judge a woman’s age, simply from the way she wears her make up. Many mature women let themselves get stuck in a time warp, and some won’t have changed their p products, colours, or application, since they first tried things out as a teenager.

Correctly applied make up can easily take 5 or 10 years off a face. It’s just a question of knowing how to do it correctly! But remember a good make -up is one that looks good for you, regardless of fashion, brand or price. Whether you wear lots, little, or no make up at all, one golden rule must apply. Always protect your skin. Protect it from pollution, the elements, and particularly the sun, with creams and gels containing a SPF (Sun Protection Factor).

Like it or loathe it, make-up is a godsend when it comes to hiding signs of fatigue. Over recent years, beauty scientists have been able to design cosmetics specifically for weary skin. They now put light reflecting pigments into foundations, blushers and eye shadows. These light reflecting pigments brighten the face, and put lines and blemishes into soft focus. These products are a boon for mature skin – I know!

FOUNDATION

Do you have trouble trying to buy a suitable foundation? Well you are not alone; it is a common problem for many women. You select a bottle or tube which you think is just right for you, but when you apply it at home, it’s likely to be the wrong colour, and probably also the wrong texture. Many women think they can compensate for age by hiding behind more make-up, or one of a darker, or thicker texture. Well doesn’t work. On the contrary, rather than disguising the flaws, too much make up accentuates them, because too much foundation simply collects into the lines on the face.

When a television make-up artist wants to age a character, they will apply a thick layer of foundation to the face. The actress or actor is asked to wrinkle up their face, powder is then applied, liberally. The result is an older face, with every line and wrinkle accentuated!

Foundation tends to stick to any dry patches on the face. This also has an ageing effect and will make the patches even more noticeable. The result is an even older looking skin than it would have appeared without any make up at all. A light and youthful look can be achieved by making up without any foundation at all. You could experiment by just using moisturiser and a little pressed powder. As the years go by I have personally found, that “less is best” when it comes to make up. Regular use of make-up is thought to accelerate facial ageing and the some of the best complexions of middle aged women I know, are those who have used very little make-up.

As we grow older our skin, like our hair loses some of its colour, so it’s important to keep changing the shade of your foundation with the years. Foundation is designed to even out skin tones. Try to choose one which matches your skin tone exactly and one of a texture which you feel is comfortable. Don’t make the common mistake of trying to add colour to your face with foundation. You can do that with blusher or lipstick. The rule is to only apply a light foundation to the areas of your face where you need a little coverage. You can always mix the colours of your foundation to make making your base a little lighter or darker according to the season. Alternatively try diluting your foundation with moisturiser for a lighter effect, or add some sunscreen for extra protection in the summer.

One of the best ways to look younger is to avoid applying foundation over the entire face, so concentrate only on the areas that need it, and blend your foundation out to leave the rest of the face looking natural. One of the best tricks I learnt from my favourite make-up artist to the stars, Martyn Fletcher, is to never put foundation over the lines around my eyes or my mouth. Remember that TV ageing trick!

For the best results apply your foundation using a small sponge with light feathery movements. Or, as I do, use your fingertips, the middle finger is best. Extra cover can be used to disguise flushed cheeks, veins, and spots and under eye bags. Use foundation or a concealer, again applied with a little brush or sponge. Or you could use one of the new magic wands, which contain light reflecting pigments, which are quick, and easy to use and can add brightness to tired under eyes in particular.

Because I am so often in the public eye, and very often photographed or filmed as part of my work, I prefer a matt look for my face. A matt face is more photogenic than a shiny one. However after dusting my face with a little translucent powder to achieve this look, my personal trick is to press a dampened sponge over my face. This creates a natural look by settling the powder which then stays in place all day looking good.

LIPS

When it comes to choosing lipsticks some women make the mistake of wearing the same colour for 15 years or more. It has to be said that, in one way she has been lucky if this is the case! It’s been my personal experience that whenever I found a colour I really liked the cosmetic companies discontinued the shade! I have a favourite shade of lipstick and lip pencil at the moment, so I do what other actresses and model friends of mine do. Being nervous that the colour will be discontinued I have bought several of them and am keeping them in the fridge for future use.

But unfortunately lips, like your complexion, tend to change with age. Their sharp outline softens; skin becomes dry and the colour of lips turn more blue. Beautiful full “Cupid bows” disappear, and the corners of the mouth begin to droop as the facial muscles relax. Fine lines begin to appear running down from nose to mouth, these are most noticeable on the faces of people who smoke. Lipstick has a tendency to “feather” on older lips, and is exaggerated even more if a lip-gloss is applied.

To outline your lips, and to avoid feathering, use a proper lip pencil but keep it sharpened. Alternatively use a lip brush. Using a shade slightly darker than your lipstick, and by outlining carefully and generously, you can create an illusion of fuller lips. I find that by lightly “filling in” the lips with a pencil or brush after outlining, it ensures that some colour will stay on my lips throughout most of the day. This is because many outline pencils seem to contain more stain than softer lipsticks, which come off too easily when we eat or kiss. Next, fill in the outline and cover with a lipstick of your preferred colour and texture. To help lipstick stay in place all day, you could also try powdering your lips before, and after applying your lipstick.

I have had to experiment with many lipsticks over the years in order to find a satisfactory one for me. Many women experience difficulties finding lipstick to suit them personally. Skin types and individual chemical make ups vary dramatically from one individual to another, and as many know to their cost, can change the colour of a lipstick over a period of time, quite dramatically! If you find your lipstick changes colour after some time it’s a good idea to apply a special barrier lipstick first. This forms a layer of protection from both the allergy to the colour, and the drying effects of sun and wind.

If you can’t find just the right colour you want, but like the texture of a particular product, try mixing several colours with your brush, until you get the one you want. If a lipstick is not the texture you like, the solution could be to add a little nourishing face cream. This is especially beneficial if your lips are very dry.
For further information see COSMETIC SURGERY- lips on page…..

BLUSHER

One of the biggest make-up mistakes we make comes from not knowing how to apply blusher and which areas are best to put it. The first trick is to use a large brush of good quality, don’t attempt to use the small brushes included when you purchase a blusher. They are quite useless. A soft, natural coloured blusher worn high on the cheekbones, will give a tired face a much needed glow, and enhance the eyes. No blusher at all, or too little blusher, can leave a face looking tired and washed out. The next trick is to apply blusher sparingly at first, and to gradually build up if a more dramatic look is required. Great for evenings or special occasions.

Experiment with colour and effects by brushing the blusher sparingly on the sides of the temples, or the chin, or lightly around the neck to create a pretty natural glow. When a powdered look is not required, cream blushers can give a particularly natural finish. If you mislay your blusher, or can’t find the right shade, you can avoid the dry look, by using your lipstick on your cheeks as a blusher. Whether you use a cream or a powder blusher is a question of personal choices, but always avoid using too many colours, it can appear harsh and false. Colour is a very individual choice, but whatever colour you choose, take care not to overdo it. Remember less is best.

EYES

For the purpose of make up, the eye can be split into 3 areas. The lid, the brow, and separating the two, the crease. The crease folds when the eye opens, so it can take the most colour, but what colour eyeshadow to use is a very personal choice. For many years I wore bright green and bright blue, because I thought they complimented my green eyes. At my first professional meeting with make-up artist Martyn Fletcher, I was introduced to brown and beige, which I soon realised were intensely flattering, and far less obvious than any colours I had worn previously. Personally, I avoid shimmer finishes because I find they accentuate every flaw and make my eyes appear tired. Their sparkle content irritates both my eyes and sensitive skin so I am happy to avoid them and to leave them to the youngsters! I have heard that some products contain fish scales, which may account for the reaction.

Using too much of any eye colouring isn’t flattering, and any excess tends to creep into lines, creases and folds drawing attention to an ageing skin. After 40 it’s best to avoid all dramatic colours. The subtle use of colour should attract attention to eyes, but not overpower them. Too much of any colour across the lids isn’t flattering. When the wearer looks down and exposes a large splash of colour along the crease line it can look particularly unattractive. It’s fun to experiment with the application and colour of eye shadows and the right colour can work wonders for a worn out face. Silvery-grey and pink eye shadows work especially well on mature eyelids and can give a face that required lift.

The delicate skin around the eyes naturally loses elasticity with age and the crepey skin needs to be treated delicately. Avoid drawing attention to crepey skin by concentrating your eye colour nearer to the lash line. A great way of achieving a flattering effect is to use a foundation on your eyelid, which is four shades darker than the one you would use on your face. When you blend it in well it can give the illusion of a good eye shadow but it looks extremely pretty and natural. When you do find the correct colour to use on your eyes you will discover that it makes a dramatic difference to your looks. Slate blue eyeshadow is fabulous if your hair is grey. Brown eye shadow seems to flatter all eye colours and I find this most suitable for my green eyes. Plum and lavender eyeshadows have the effect of making green eyes even greener. Try an experiment with the following eye colours and shadows – you could be pleasantly surprised by the result.

• Brown eyes mauve, olive, plum, camel, taupe, green
• Green eyes camel, taupe, orchid, plum lavender
• Blue eyes grey, mauve, olive, plum, navy, rose
• Hazel eyes grey, heather,olive, cocoa, apricot, peach
• Violet eyes taupe, olive, mauve,dark green

If your eyes are puffy it could be that you are not getting enough sleep. Tiredness soon shows. Perhaps alcohol or stress is making your circulation and lymphatic drainage system, which is around your eyes sluggish. Being a non-smoker I find that the smoky air in pubs and clubs makes my eyes itchy, red and uncomfortable. There are many preparations and soothing eye gels on the market to help soothe tired eyes. But I find simple home made remedies can really help. A couple of used cold tea bags or a couple of slices of cucumber (preferably straight from the fridge) placed on my eyes for 10 minutes, effectively reduces any puffiness or redness.

Whether to use Kohl or eyeliner can depends on a persons individuality, age, and occasion. Using too much Khol or eyeliner can have the effect of closing the eye up. All too often it is badly applied and quite frankly, looks a mess. Brown eyeliner is more flattering than black on an older face. White eyeliner is another option and worth experimenting with. By running it along the lower rims of your eyelids it has the opposite effect and can open up your eye. Applying any make up can be a problem as we age, due to the changes in our eyesight, and most mistakes occur whilst applying eye make up. It could be worth investing in special make up glasses, which have lens that can be individually lifted to facilitate easy and accurate application.

When it comes to applying mascara my personal tip is to apply brown mascara (more flattering for mature women) first down over the to p of the top lashes, then brush it up from underneath. It has the effect of giving eyelashes that extra oomph! Be selective when buying your mascara. It’s best to leave the dramatic fibre enriched mascara for special occasions only. Waterproof mascara needs to be removed with special eye cleanser, which I find can be harsh on the delicate skin around my eyes. As far as I am concerned waterproof mascara is best kept for beach holidays or emotional moments. Removing non-waterproof mascara is easier and kinder to the skin! One way to make your eyes sparkle and open up for special occasions is to use eyelash curlers. Another way to give your eyes an instant lift is to shape up your eyebrows. If you are fainthearted have it done professionally. Conversely encourage definition by using an eyebrow pencil to fill in if your brows are sparse.
For further information see COSMETIC SURGERY – eyes on page ……

EQUIPMENT

Your makeup will be easier to apply and the results will look so much better if you use the right tools. Remember “a bad workman always blames his tools”……. Make a start by throwing away those horrid little brushes, which come in the box when you buy a new eye shadow or blusher. The majority of them are useless, hard to use and with bad results. Treat yourself to a decent set of brushes – the best quality you can afford. If you look after them well they can last you for years. Brushes will stay in better condition if you keep them upright and it’s important to keep them clean and in shape. For travelling I remember a trick I learnt from my good friend and makeup artist Martyn Fletcher. He uses a loo roll to protect the big brushes (blusher), and protects the smaller ones (eyeshadow, eyeliner and lip brush) with a straw. Both are most effective. A small combined eyelash brush and eyebrow comb can put the finishing touch to well shaped eyebrows, and can be used to separate eyelashes clogged up with mascara for a well-groomed finish.

COSMETIC SURGERY

Ageing American film stars with a desire to hold onto their looks started the craze for cosmetic surgery back in the 1950’s. Nowadays it’s rare to find a 50 year old American woman who hasn’t undergone some form of cosmetic surgery. Plastic surgeons on the other side of the Atlantic have been busy for years seeking to eradicate the signs of ageing. By contrast, British women have taken their time to pluck up the courage to go “under the knife” in order to hold back the passage of time. One major reason for them not taking the plunge was that until recently cosmetic surgery was extremely expensive here in the UK. Far too expensive for the average British woman to even contemplate. But without doubt the biggest deterrent of all, apart from expense, has been public opinion.

In past generations the majority of women in the UK regarded cosmetic surgery as unacceptable and vain. Even correcting birthmarks or defects of nature was considered to be conceited and was viewed as “meddling with nature”. Defects were to be stoically accepted as merely what one was born with, and along with irregular features, poor skin lines and wrinkles were to be stoically accepted. In short you were expected to accept and put up with your lot. In Britain up until the 1950’s vanity was discouraged and young girls were taught that looks were unimportant. It was a woman’s inner beauty that was important, and that was all that mattered

However recent market research has shown that these traditional British attitudes are changing dramatically and a recent report by market analysts Mintel showed that there has been a 30% rise in cosmetic surgery operations over the past 5 years – for both women and men. Four women out of ten now say they would consider plastic surgery. Figures for facelifts eye surgery, resculpturing of the nose and removal of liver spots, just a few of the many operations available are increasing rapidly. Today you don’t need to be an ageing film star to either want or be able to afford surgery. Nowadays many more women are financially independent and in consequence if they require it, expensive cosmetic surgery is within their reach.

There is also evidence to prove that women are being pressurised into maintaining their looks youth and beauty for as long as possible, in order to compete with other younger women, both in the workplace and on the social circuit. The attitude of society towards women (and men) who undergo cosmetic surgery is changing too. It is now very nearly considered to be acceptable! However the secretive and negative attitude still persists with few women admitting to having had surgery. A recent poll showed that four out of ten women would consider having an operation to enhance their appearance, if they could afford to. Cosmetic surgery doesn’t come cheap

That I haven’t considered facial cosmetic surgery for myself is I suppose largely due to the fact that I have had to undergo extensive surgery many times already for medical reasons. Of course I too see the familiar signs of ageing every time I look in the mirror and I observe that everything appears to be gradually slipping downwards, due to gravity! On a bad day I wish I could wave my magic wand (as I do in my role as Pantomime Fairy Godmother) and reverse the trend with an instant face-lift. But I’m a coward, and for the time being I am content to observe with great interest, my girlfriends who have succumbed to the surgeon’s knife. The majority appear delighted with the “lift” it has given them – both physically and psychologically.

Some people put themselves through their ordeal of cosmetic surgery, not only to hold back the passage of time, but more importantly to correct an abnormality (albeit small) which has constantly upset them throughout their life. Rid of their “flaw” which quite possibly had grown out of all proportion in their mind, they report that they finally feel normal, uninhibited, and happy. Some women confess to having previously felt some form of isolation even since their childhood, caused by what they had perceived as their “deformity”. Surgeons who are convinced that a patient is genuinely distressed by their flaw can recommend that for the patients psychological well being the operation could be considered being performed on the NHS. But there can be a delay; the waiting lists are long.

Critics of cosmetic surgery should be reminded that most women use expensive make up every day to improve or make changes to their looks without any conscience. Cosmetic surgery simply makes many of these temporary improvements more permanent. It is interesting to note that cosmetic surgery is no longer confined to any one group, women in all sections of UK society and income groups are either considering, or having it done. Now a few more women are prepared to talk more openly about their surgery. Many consider it not as a vanity or self-indulgence, but purely as necessary self- maintenance, which can enhance appearance and may improve career prospects. This attitude is particularly relevant to mature professional women, and women at the top of their chosen careers, who wish to stay there. They view holding onto their looks as an element in helping them do so.

In the United States women have had this attitude for a long time and the media, TV, films and magazines, promote the feeling that superficial beauty means happiness and success. Sadly many women can be left feeling condemned losers without it. American women are constantly updated with details of the latest personality or star to succumb to the knife. They are regaled with the details such as which who performed the procedure, and at what cost. They can read reports and comments from the recipients of cosmetic surgery, women who assure them that surgery has perfected their beauty, given them confidence and has generally enhanced their life.

For many ordinary women it seems only fair for them to wish to follow the example, and if they can fund it they too undergo surgery. Expectations are high. They hope and desire the cosmetic surgery to improve not only their looks, but also the quality of their life, including their love life. But is the expense really worth it, and do the results come up to the patient’s expectations?

For some women feelings of inadequacy can disappear along with the wrinkles and if the surgery does come up to their expectations it can produce huge psychological effects. Many women report dramatic improvements in their social standing due to their new-found confidence as a result. Women who have suffered from severe bouts of depression may discover that as a result of successful cosmetic surgery they feel much better about themselves and some that have been dependent on anti-depressants many finally gain the confidence to kick the habit. Others who have been able overcome their shyness after surgery are so confident about their looks that they no longer cringe from the intimacy and scrutiny of their partners. They report that their sex life improves and finally, feeling young and flirty they can make love with the lights on! But in their moment of abandonment perhaps they should remember that face and hands wouldn’t necessarily match!

Successful cosmetic surgery can have dramatic consequences; it can change the way a woman feels about herself. With new-found confidence some women discover they suddenly attract more interest from men and out of their previous character they find themselves responding to these advances with interesting results. The surgery can change a women’s way of life itself and consequently can create permanently changes in other people’s lives. Some women feel a sense of new found freedom and leave their partners to seek a new life and equally, some men find that they too may want to quit a relationship after their woman partner has had surgery. Some discover that the partner they once knew and loved has changed not only physically, but emotionally too, and the quiet, shy woman they loved to protect, has changed into a strident women who they find quite overbearing.

Of course there is good and bad news when it comes to cosmetic surgery, and there are bound to be some failures. Surgical failures are rare but very real, and the results can ruin a woman’s life. But many more are perceived as failures by patients who had put too much faith in cosmetic surgery, hoping it would be the miracle cure and solve some major crisis in their life. Unrealistic expectations can occur when patients think they will be able to hold onto an erring partner or a job, by resorting to cosmetic surgery in order to make them look younger or more attractive. An unsuccessful and disappointed woman may regret her surgery and blame it for her failure or loss. But in reality there can be no promise that expensive cosmetic surgery will solve problems.

Those opposed to cosmetic surgery will argue that it is preferable to grow old gracefully with a pleasant face wrinkled with character. Looking at recent press reports and photographs of Mrs Wilderstein, the wife of an American cosmetic surgeon, it is apparent that we all have different perceptions of beauty and success. To many of us Mrs Wilderstein’s extensive and expensive surgery appeared quite terrible. Her face looked like a mask, stretched out and devoid of character. However the lady herself seemed more than thrilled with the hideous results and like a minority of women addicted to surgery. Most women contemplating surgery are content with less and more subtle improvement after a face-lift or other facial surgery. Gentle and natural rather than extraordinary! A younger and fresher look that provokes comments and compliments as to how well one is looking, must surely be preferable to an inquisition about obvious facial changes. Surgery is a risk and expectations vary. There can be no absolute guarantee against disappointment.

Those who have had a face-lift inform me that it helps to have a surgeon recommended. One whose work you can see on the face of your other friends and acquaintances! So check out the surgeon or consultant and his/her reputation. Communication with whoever is going to perform the operation is particularly important. The surgeon must know and understand what your expectations are and equally you must understand his/her limitations. The surgeon will make a careful examination of your face and this is the opportunity for you to explain exactly what you want. . Before any final decisions are made or permission is given for an operation to place, it is essential to know all you can about the procedure and possible complications. Ask questions and find out where the incisions are proposed – and how long the scars and bruising will take to fade. Check whether the surgery may produce a temporary or permanent loss of sensation, you need to be prepared for slight numbness. If at all possible ask to talk to a former patient who has undergone the operation or procedure you are contemplating. Ask for the details of your proposed operation to be written down – it’s all too easy to forget what is being suggested in the heat and confusion of the moment.

If you can arrange to meet up with someone who has previously had similar surgery remember that we have individual skin and healing properties, and that we respond differently both physically and mentally. The only person who can make the final choice to have cosmetic surgery is you. You alone take the risk and the responsibility for what is going to happen to your face. Perfection and satisfaction is strived for of course, but it cannot be guaranteed. In any operation some pain and discomfort is unavoidable and there is an ever-present risk of complications, bad scarring or at worst, deformity. Patients must be convinced they are undergoing the discomfort for the right reason. They must only undertake cosmetic surgery for their own satisfaction, never for someone else’s.

Earlier we looked at what causes skin ageing, and found that skin looses its plumpness and becomes thinner and dryer with the years. Collagen and elastin in the skin break down, bone shrinks, muscles lose their tone and stretch with age. Faces sag and “drop” helped on by the forces of gravity resulting in drooping eyebrows, wrinkles, lines, hoods and bags around the eyes, jowls and turkey necks. Sun damaged skin begins to feel rough, pore size increases, tiny broken veins start to show and age spots and dark patches appear. Oh dear it sounds all too familiar, I think we all get the sad picture! Include all our worst habits such as inactivity, poor diet, smoking, drinking, sunbathing, stress, lack of fresh air, and add facial habits like frowning and squinting to complete the gloomy picture.

But help could be on hand, so check out the following cosmetic surgery-shopping list – if you have the cash and the courage. (Alternatively the fainthearted can check out “ The natural face lift” facial exercise programme on page… ……)

FACE LIFT

A Rhytidectomy or a face-lift is an operation to reduce or remove lines and excess skin around the temporal region, neck and jawline. It improves loose skin on the cheeks, the deep nose to mouth lines and the chin. The forehead, eyes and nose to mouth lines need to be treated in other ways. A facelift will not change the shape or expression of a face but to some degree will help to restore it to how it was previously. As the years go by ageing will of course still occur, but the effect of ageing will have been delayed. In years to come when these further signs of ageing are of concern, it is possible to undergo another facelift.

The ideal age to have a face-lift is between 40 – 50 when the skin is still elastic. At this age the result is less obvious and dramatic. Increasingly even younger women are opting for a face-lift in order to postpone the effect of ageing before it starts to show. By the age of 50 the skin will have lost much of its elasticity and the resulting facelift on someone of this age may be less natural looking. Cosmetic surgeons claim that a face-lift can be performed with reasonable success on women of 70 – 80 years of age. All but the simplest face-lift requires a general anaesthetic and recovery time varies, although some surgeons are working under a local anaesthetic with sedation. The most common minor complication is a haematoma, a collection of blood under the skin. This is either removed soon after the operation, but many usually disperse naturally over a few weeks. Major complications are rare. There are many face-lift options for you to consider:

Sub-cutaneous lift
A simple skin tightening procedure for older skin.

SMAS lift
(Superficial musculo-aponeurotic system)
A deeper procedure for pulling up the neck skin

Extended SMAS lift
A deeper procedure as above for neck plus nose and mouth grooves

Composite lift
A procedure which includes all of the above plus lifting eyebrows, and removing eye bags and improving cheeks.

Mask lift
A procedure, which lifts all, the facial structures off the bone
Endoscopic lift (Keyhole)
A procedure for younger skin, which does all the above, plus mouth through small incisions.

It takes from 2 – 3 weeks for the swelling, scars and bruising to disappear after the subcutaneous lift, the SMAS lift and the Extended SMAS lift. For the Mask lift it can take 6 – 12 weeks. The more complicated Composite face-lift procedure may take up to 6 months for the swelling, bruising and scars to fade. Swelling has usually disappeared by 6 – 8 weeks after the Endoscopic (keyhole) lift.

The incisions for a facelift are usually made, and the scars hidden, in the hair, in front of and behind the ear. Horizontal neck lines, the throat and the upper chest are delicate areas and are more difficult to improve. When there is work done to the neck, the scars are under the jaw and may take longer to fade. Many people feel depressed immediately after surgery because they look worse than they did before the operation. Recovery times and scar healing varying from one patient to another. .
Finally when the swelling goes down and the bruises fade the majority of patients are pleased, but a small number remain unhappy with the result.
Cost of a face-lift vary enormously according to the procedures used, but you could be looking a bill of £4,500

JAW

To define a jaw line liposuction is used to remove fat from a double chin. A person with a weak chin or one that recedes can have silicone chin implants inserted to lie against the front of the original chin in order to build up the shape of the chin. This simple operation of chin augmentation called Mentoplasty is usually performed under local anaesthetic with sedation. The incision is made inside the mouth, the result is permanent and there is no visible scarring.

NOSE

It would appear that many people are dissatisfied with the shape of their noses. A mishapen nose can cause distress and embarrassment. A small alteration can make a big difference. Rhinoplasty is an operation to reshape or correct an ugly nose and one of the most commonly performed cosmetic surgery operations. It may be performed for aethestic reasons to re-align an asymmetric nose or it could be for corrective reasons such as to relieve breathing problems or to repair damage. Nostrils can be altered, and tips and bumps, humps and bends can be improved. A general anaesthetic is required for rhinoplasty and most incisions are made inside the nose. The nose itself can be slightly enlarged or made smaller by changing, or adding to, or removing bone and cartilage. Nasal tips can be treated as a day case under a local anaesthetic. But the trick is to keep the nose in harmony with the rest of the face and not to make dramatic changes. The new nose should be looking pretty good 3 weeks from the time of the operation but nasal bones and tissues continue to change for many months after the operation and it may take up to a year for the final result to be appreciated. Costs for Rhinoplasty are approximately £3,000

EYEBROW

Today keyhole surgery (endoscopic) can be used to raise droopy eyebrows. Small incisions are made through the skin under the front hair. The procedure of eyebrow lift surgery can also be employed to lift and raise droopy hoods up from over the eyes.
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EYELID

Blepheroplasty is cosmetic surgery on the eyelids – an eyelift – which can result in less tired and younger looking eyes. As we get older the ligaments around the eye weaken and are unable to support the fat in the eyelid. The eyelid becomes increasingly swollen, skin may overhang and the eyes feel heavy and tired. The surgeon can remove excess fat, skin and bags from above and below the eyelids. The upper lid incision is made in the crease of the eyelid. The lower incision starts at the outer crow’s feet and runs underneath the lower lashes. The patient is usually operated upon as a day patient under general anaesthetic or local anaesthetic and sedation. The operation does not remove wrinkles, creases or laughter lines. Although the surgery is most unlikely to affect your vision it’s a good idea to have your eyes checked before contemplating any cosmetic eye surgery. Blepheroplasty costs approximately £3,000 and is often performed at the same time as a facelift.

In another procedure to correct drooping eyelids the cosmetic surgeon will make a long incision on the line the crease of the upper eyelid. This will be extended out to the side if there is excessive hooding. Skin and fat are removed opening up the eye and making it appear brighter.

EYEBAGS

The wall that supports the fat, which pads out the eye, weakens with age. Cosmetic surgeons can remove the fatty deposits and excessive skin from under the eye by operating from the outside. It can be a tricky procedure.
The condition can be inherited and its appearance can cause younger people distress. For this reason an alternative operation can be performed on the young from inside the lid. The fat only is removed and it leaves no scarring.

Both operations are performed under general or local anaesthetic as a day case. The surgery can alter the appearance of your eyes it will no change your vision. Swelling and bruising around the eyes will follow eye surgery, the eyes will be red and watery and feel gritty and irritated. Ice packs can help to ease the swelling and discomfort, which should lessen after about ten days. It can take several months or more for things to settle down. Don’t contemplate eye surgery without giving it serious thought. It can prove very uncomfortable. Contact lens must not be worn for approximately 2 weeks after the operation.

EARS

Protruding ears can be the subject of humour and cause great distress. Otoplasty is a simple procedure mostly performed under local anaesthetic with sedation used to correct protruding ears. The incisions are made behind the ear so no scar is visible. The surgeon carves the flexible cartilage into a more normal shape and trims excess skin away. A total head bandage is worn for 24 hours after which a night bandage is worn to keep the ears in place until healing is complete. Octoplasty has no effect on hearing.

CHEEKS

It is possible to alter the height and projection of the cheeks with silicone implants. The procedure is simple and carried out as a day case under general anaesthetic. The cheek implants are inserted through small incisions in the mouth and are designed to rest on the patient’s cheekbones. The result is permanent. Occasionally the cheek implants move out of position soon after the operation, or infection can set in. The implant is removed and reinserted after the infection has been treated successfully.

LIPS

To create the illusion of a thicker lip fat and skin usually taken from the patient’s bottom can be grafted into a tunnel in a thin upper lip. Another process uses skin tissue obtained from human donor skin as a permanent lip implant or to correct nose to moth furrows. The donated skin tissue is processed to remove cells, leaving only the dermis, the bottom layer of skin. With no components left to cause rejection or inflammation, the implant should become a natural, healthy part of the patient’s own skin tissue. It is grafted into position through tiny incisions under general anaesthetic. It will feel slightly firm for some time, but after a month or so should soften, as it becomes a part of the patient’s own skin. It costs around £2,000 and the effect is claimed to be permanent. Other surgical procedures can reduce fleshy lips, but some may leave permanent scars.

NON SURGICAL ALTERNATIVES

Not all modern cosmetic techniques require a general anaesthetic and hospitalisation – nor is it always necessary to go under the knife. Increasingly collagen injections, liposuction and lasers are being used extensively to make us more beautiful. But caution and consultation is required before contemplating any treatment. There are always risks to any procedure, or any invasion of the body. All beauty treatments cost and you will also need to decide whether you can afford the maintenance of some treatments.

FOREHEAD

Botulinum injections (Botox)

To flatten out furrows across the brow and frown lines down the centre of it there is an alternative to the surgical brow lift, in form of Botulinum Toxin (a substance produced from the bacteria, which causes the deadly botulism food poisoning). Small doses of this purified toxin are a chemical injected into the two down frown lines just below the inside of the eyebrows, and the four across the forehead. It’s a delicate procedure that requires skill but it has the effect of “freezing” the muscles in the forehead. It prevents the action of frowning and drawing the eyebrows together. Crows feet can also be successfully injected to lessen their appearance. Once the muscle is weakened it contracts with disuse and frown lines gradually fade away. The result lasts until the effects of the botulinum toxin wear off which can be between three to six months. There are some claims made by dermatologists that the effects of injections with Botox become permanent after some time, and the face just “forgets” how to make certain expressions which caused the lines.

Botulinum toxin is a well-established drug and the procedure has been used for many years to successfully treat “lazy eye” and uncontrollable blinking. The local injections cause slight discomfort and a chance of slight bruising. Approximately 1% of patients may develop a slight but temporary lowering of one eyelid, which may not even be noticed by them. If the injection is given incorrectly there may be little or no effect, which would be an expensive mistake. Botulinum Toxin injections have received publicity and find favour with well-known celebrities and older Peter Pan pop stars who report that it helps to keep them looking years younger. To maintain the results, repeat treatments up to four times every year are required, which at a cost approximately £250 a time becomes expensive.

EYES

Micropigmentation is a state of the art technique used for semi-permanent make-up. A bit like a tattoo. The procedure is performed under a local anaesthetic and can be used to create the appearance of eyebrows for those women with no eyebrow hairs at all, or make sparse eyebrows look fuller. Micropigmentation can be used to enhance the eyes with pigment applied in dots through a fine vibrating needle between the lashes into the most superficial layers of the skin for a soft natural look. When applied as bold or soft smudgy eyeliner it can give a more definite and semi-permanent made up look. The colours available are grey, brown or black – but not blue. The colour fades with time. Micropigmentation can also be used on the face and neck to create spots – beauty spots!

NOSE TO MOUTH GROOVES

To erase lines and wrinkles, smile lines, nose to mouth furrows a “filler” is used to reduce their appearance. Collagen replacement therapy is one of the most popular procedures. A purified form of the protein collagen (found in cowhide) suspended in a saline solution is injected into the lines and creases. The saline is absorbed leaving the collagen to fill out the lines. Although a trial injection is usually given in advance of treatment around 3% of women may develop an allergic reaction in the form of itchy red blotches. There have been other, albeit rare cases of anaphylactic shock resulting from the injections which makes some doctors cautious about using it. This process can also be used to disguise acne pits, depressed facial scars cheek depression, and marionette lines around the mouth. In time the body gradually absorbs the collagen with the effect lasting from just a few weeks up to six months. In order to maintain the effect a simple but nevertheless expensive top- up is required. Alternative non-animal substances are available such as Hylaform gel and Restylane a form of hyaluronic acid with plumping properties can be used for the injections. They work in the same way as collagen but there are less risks of allergic reaction and may be used without pre-testing. Like collagen they also need regular top-ups. It costs approximately £350 for each procedure. .

LIPS

Lips change shape as we age and lose their fullness. Today there is a fashion for full lips as we see constantly in our papers, magazines and on TV. To plump out lips cosmetic surgeons use collagen injections into the lips creating “bee sting” lips. The trouble is that the body absorbs the collagen and to maintain the effect, further injections are required every few months. Collagen is expensive.

Another method is to insert a thread of Gore-Tex through the middle of each lip to create fullness. Tiny Gore-Tex threads, which are non-allergic, are also used to plump up skin in order to disguise fine lines and rectify facial imperfections. The effect is permanent and the process costs from £1,200. A process called threading is employed to implant the Gore-Tex threads under the epidermis, which eventually gets surrounded by scar tissue. There can be complications.

Micropigmentation can be used to create a semi-permanent outline to lips with a natural or dramatic colour in order to make them appear more full or to redefine and balance uneven lips. Some people find the injections uncomfortable and there may be swelling and redness, but this should soon disappear.

SKIN

Lasers with high-energy beams of intense light are used in various processes by qualified dermatologists to treat the effects of skin ageing or disfigurements by resurfacing the face. Exciting new techniques involving laser treatments are constantly being developed different types of lasers and different colours are being used for a variety of treatments for the delicate skin on the neck and around the eyes, for sun-damaged skin, for fine lines and wrinkles. Others are used to treat age spots and freckles, and stretch marks on the tummy. Red port-wine stains, spider veins birthmarks and warts can be treated successfully by others. Whilst another laser can treat brown marks such as dark circles under the eyes, tattoos and liver spots. The procedures are extremely precise, and the carbon dioxide lasers are extremely accurate. The risk of damage is minimal because the surgeon can see exactly how deep, he or she is going. The effects are permanent. Redness like severe sunburn can be caused by the treatment and can last for many months, but the quality of the end result usually outweighs the potential risk of scarring. Some lasers are not suitable for black or Asian skin, which could look patchy because the laser stimulates colour pigmentation. Occasionally the treatment can precipitate an outbreak of the herpes virus. The cost of a Laser peel is in the region of £3,100

Laser treatment is fast replacing dermabrasion and peeling. Laser peels are invasive but are claimed to be effective – however laser treatment is not suitable for everyone and the results vary. Laser peels cost on average £3,100. The original laser was a constant beam of uninterrupted heat but recent developments have created lasers which “pulse”. Their beam is intermittent, repeatedly turning on and off at high speed in the space of a second, counterbalancing the potential harmful effects of the original constant laser, whilst achieving the desired effect without deep penetration or burning. For successful results from laser treatment it is essential to adhere to a suggested skin care programme for 4 weeks prior to treatment to maximise the benefit, and avoid complications of hyperpigmentation, scarring and infection.
Laser treatment is very varied, isn’t cheap and needs careful exploration. Treating an area such as the lines around the eyes could cost around £1,200 but laser re-surfacing of the full face could cost £6,000.

During the process of chemical peeling, chemicals will burn off the top layer of old skin and encourage new skin to replace the old. The process is not dissimilar to the effect of sunburn, where the skin reddens and eventually sheds its top layer. Cosmetic surgeons claim that by stimulating the skin’s natural shedding process, the resulting new skin will be tighter and smoother than the old skin, creating a younger looking face. A chemical peel could set you back £1,450.

SCLEROTHERAPY

Sclerotherapy is a treatment to get rid of thread veins and broken capillaries on the legs and occasionally on the face. Only small clearly visible veins can be treated. A small amount of Scleremo fluid is injected through a fine needle into the vein or capillary causing a spasm to the lining of the blood vessels. In response the vessel shrinks and breaks down. The treatment stings slightly and results in the injection sites looking like insect bites for a few days and will first become more prominent but gradually fade over several weeks. Very occasionally there is an allergic reaction or some pigmentation changes. It is best to avoid sun during the treatment period. The treatment can take 30 – 60 minutes dependent upon the area being treated.

FINDING A REPUTABLE COSMETIC SURGEON

Cosmetic surgery should not be undertaken lightly and for successful results the procedure needs to be carried out by an expert to avoid a disaster. It is imperative to check out credentials in order to find a good and reputable surgeon. But how to find out? One way is to make sure he/she is a Fellow of the Royal College of Surgeons……see page…. for details and that he/she is on the General Medical Council specialist register. The majority of cosmetic surgeons belong to The British Association of Aesthetic Plastic Surgeons (BAAPS). Most of the members have a background of being, or having been, consultant plastic surgeons in the NHS. They are members of the British Association of Plastic Surgeons (BAPS) and will have been involved with re-constructive surgery on the NHS. They can be found on the General Medical Council (GMC) specialist lists. BAAPS is part of the International Society of Aesthetic Plastic Surgery. It has The Royal College of Surgeons approval as the official education and training organisation for cosmetic surgeons.

Alternatively, the British Association of Cosmetic Surgeons (BACS) represents many of the surgeons who work in private hospitals and clinics. There appears to be some rivalry between their members and members of BAPS and BAAPS, who feel that BACS independent cosmetic surgeons have not had the intensive reconstructive training that their members receive in the NHS. BACS surgeons would argue that because they specialise only in cosmetic work, their skills are well practised and their work is of a high standard.

You can see for yourself that it’s well worth doing your homework, and advisable to talk to more than one surgeon before you agree to go under the knife! Be suspicious if you are offered a free consultation, any surgeon worth his money is going to want to charge for his time. The consultation should always be with the surgeon who is going to operate on you. You need to know how much the surgery will cost and find out the “hidden costs”. Private hospitals and clinics are expensive if you have to stay in for extra days and there could be the risk of extra surgery if something goes wrong. There is no insurance that you can take out to protect you if this were to happen. You might find it re-assuring to know if your surgeon has insurance arrangements for his/herself should a patient have cause to make a legal complaint. Most surgeons belong to the Medical Defence Union, the Medical Protection Society or the Dental Defence Union of Scotland. However if their track record was dubious they may not. It’s up to you to find out all you can in order to feel satisfied that you would be in safe hands. Should you be unfortunate and be dissatisfied with the result go back and tell the surgeon. If there is a genuine complaint a reputable surgeon may offer to re-operate at a reduced fee or no fee at all according to the circumstances. Or if may decide your case requires legal action. The options open to you are either to sue for negligence or assault and battery. Negligence needs proof that the surgeon has fallen short of the accepted standard of surgery, advice or aftercare. Assault and battery would mean he/she had carried out a procedure for which you had not given consent. The surgeon must have received informed consent from the patient before proceeding with treatment. Should you feel you have a genuine grievance against your surgeon you should take advice from the organisation Action for Victims of Medical Accidents. Claims should be made within 3 years of surgery and can be a lengthy business.

For further information see Usual Names and Addresses on page…….

USEFUL NAMES AND ADDRESSES

Royal College of Physicians
0207 7935 1174
http://www.rcplondon.ac.uk

General Medical Council specialist register
0207 915 3630
http://www.gmc-uk.org

British Association of Aesthetic Plastic Surgeons
Royal College of Surgeons (BAAPS)
35 -43 Lincoln’s Inn Fields
London WC2A 3PN
020 7405 2234
http://www.baaps.org.uk

British Association of Cosmetic Surgeons
17 Harley Street
London W1N 1DA
020 7323 5728

British Association of Plastic Surgeons
Royal College of Surgeons (BAPS)
35 –43 Lincoln’s Inn Fields
London WC2A 3PN
020 7831 4041
http://www.baps.org.uk

International Society of Aesthetic Plastic Surgery
C/o David Harris MS FRCS
British National Secretary ISAPS
Nuffield Hospital
Derriford Road
Plymouth PL6 8BG
01752 707 345

Action for Victims of Medical Accidents
1 London Road
Forest Hill
London SE23 3TP
020 8 291 2793

FACE ACTION PLAN

FACEFIT EXERCISE PROGRAMME – The natural face lift

The human face is the only part of the body where the muscles are attached directly to the skin instead of the bones. The emotions we experience, and our reaction to them, form the expressions on our faces, which over years give each of us our unique, individual looks. Ideally faces should be bright, full of emotion with an inner beauty shining through. Each time we react to people, or situations, we may tighten our lips, or flicker our eyelids, or smile, or frown in response. If we are happy and feeling well, positive signs will get etched onto our faces. A positive attitude can help delay the ageing process, since positive emotions use less facial muscles than negative emotions. A smile uses 7 muscles, whereas it can take 32 muscles to frown! A smile is so positive and can help people enjoy life more. If you see someone without a smile, give him or her yours! It could make all the difference and will cost you nothing.

The following facial exercises will help soften wrinkles, improve your complexion, and bring a sparkle to your eyes. They can be done at any time, in the comfort and privacy of your own home, no studio or equipment required. For this workout you don’t need to don a leotard! You can even do some of the exercises in your car, on a plane, on a walk, or watching the TV!

Before we start it is important to prepare. Dry and taut skin can be easily stretched and damaged, so begin by using your own favourite brand of moisturiser. Apply it to your face and neck with upward sweeping movements. (The most beneficial time to apply your moisturiser is after a bath or shower, when your skin is still moist). Clean hands and short nails are kinder to the delicate skin on your face.

Now we’re ready to move muscles, work wrinkles and control contours. The movements and exercises are small but precise. For them to be beneficial practice in front of the mirror to make sure you are doing them correctly. Practice makes perfect.

PREPARATION & POSTURE + illustration

• Check your posture. Sit comfortably with your bottom well back on the seat of your chair with both feet flat on the floor. Pull in your tummy and sit upright. Keep your shoulders back, down and relaxed and hold your head high with your chin parallel to the floor.

• Bend your elbows and lift your shoulders up, pull shoulders back, and them press them down and take them on around, drawing circles with your elbows. Repeat 6 times. Finally relax your shoulders and remember your posture!

EXERCISES FOR THE NECK
If you suffer from neck problems try doing some of the following exercises lying on the floor or bed, using a small pillow to support your head. Ex

1. Look out + illustration

• Keep your chin parallel to the floor – shoulders facing to the front. Move your head only and look over right shoulder. Perhaps a little further and hold? Bring head back to centre and slowly take it over to look out left and back to centre. Keep shoulders relaxed and repeat 3 times either side to maintain neck mobility. But take care if you have neck problems and only go as far as comfortable.

Ex 2. Stretch out + illustration

• Take your right ear over to your right shoulder and hold for 8 seconds. Don’t drop head forward or backwards. Relax back to centre. Repeat to the left, hold for 8 seconds and feel the stretch in the right side of your neck. Relax shoulders.

Ex 3. Chicken neck + illustration

• Stick out you chin as far as you can then keeping it parallel to the floor pull it back hard into your neck and upper chest. Repeat this chicken like movement 6 times relaxing your shoulders. Excellent for posture and for helping to prevent osteoporosis (fragile bone disease) in the upper spine.
• But take extra care if you have neck problems.

Ex 4. Swan + illustration

• Drop your chin to your chest. Now carefully take it up and back – as far as comfortable and hold for 8 seconds to lengthen out your neck like a graceful swan. Don’t do this exercise if you have neck problems.

EXERCISES FOR THE JOWL, NECK & THROAT (take care if you have neck problems

NB. Familiarise yourself with the following exercises looking in the mirror keeping head up chin parallel to floor. Once the movement is established tilt head back and feel the added movement in jowl, throat and neck.

Ex 5. Goldfish + illustration
• Stick out your chin and open your mouth. Tilt your head back a little further and pull your lower jaw up and out hard, with a glugging action. Repeat the movement 6 times and feel the muscles under your chin and throat working

Ex 6. Pelican + illustration

• Head back slightly and chin forward. Bring your lower lip up and over top lip (softly bite it if you can).

Ex 7. Lion + illustration

• Simply open your eyes wide and stick out you tongue as hard as you can to prevent a double chin and to invigorate your entire face. Repeat 6 times.

EXERCISES FOR THE MOUTH (smokers are more at risk of developing lines)

Ex 8. French Connection + illustration

• For mobile kissable lips open mouth wide and say “Uh” then “Ee” then “Ah” – 10 times to help prevent small vertical lines above upper lip, and to relax the mouth and jaw.

Ex 9. Whistle stop + illustration

• Whistle and see the ugly vertical lines in the top lip! Now, keep your upper lip taut and stretched out over your top teeth, pulling up the corners of the mouth. Put your index finger in the middle of your upper lip (to keep it taut) and now try whistling 10 times with stretched lips

Ex 10. Joker + illustration

• With your mouth open a little, narrow your lips and pull them tightly over your top and bottom teeth. Keep your lips mean and taut but pull up the corners of your mouth in a joker like smile. Hold for a count of 5 – relax, and repeat 6 times to help lift the corners.

EXERCISES FOR THE CHEEKS

Ex 11. Bitch + illustration

• With lips together lift the right side of your mouth. With a slow controlled movement snarl up your right nostril 6 times. Relax and repeat with the left 6 times. Control both the up and down movement.

Ex 12. Cheshire Cat + illustration

• Keep your teeth together but with your lips apart slightly smile up to your temples with a slow movement working the cheeks. First 6 times to the right side then 6 to the left. Control both up and down movement.

Ex 13. Cow + illustration

• Take you lips to the right side and lift your cheek to your ear as far as possible. . Open and close your mouth, imagine chewing the cud or even biting the inside of the cheek as you lift and work the right cheek. Keep left cheek relaxed. Exercise 20 times quickly then repeat with other side.

Ex 14. Blow up + illustration

• Breath in – keeping your lips soft and without pursing them slowly blow up your cheeks like balloons. Hold for 5. Repeat 6 times (relaxes the cheeks after the two previous exercises).

EXERCISES FOR THE EYES

Ex 15. Bright Eyes + illustration

• Look straight ahead – keep head still and chin parallel to the floor. Using eyes only look first with controlled eye movements, look first to the right and focus, now down to your lap and focus, look over left and focus, now up to the celing and focus. Repeat 6 times with control.

Ex 16. Uppers + illustration

• Without stretching the skin place your forefingers firmly on your brow bone, which is under your eyebrows above the eye socket. With thumbs on cheeks by ear hold the skin and muscle firmly in place. Close your eyes. Now work your upper eyelids only bringing them down against the resistance. Continue opening and shutting quickly and repeat this fluttering movement 20 times. (This fast, fluttering creates the effect of a 1920’s black and white movie!)

Ex 17. Downers + illustration

• Place your index finger under the centre of the eye, high up on your cheekbone to add resistance. Take care not to drag or stretch the delicate skin under the eye. Hold the muscle and skin firmly in place. Contract and squeeze up your lower eyelids only – 20 times. Feel the muscles under the eye working. (It’s a small movement which needs lots of practise!)

Ex 18. Crows feet + illustration

• Put the pad of your forefinger on the skin and bone at the outside corner of your eyes. Pull very slightly outwards to create a resistance. Take care not to stretch the skin. Squint hard 20 times working the muscles at the side of the eye.

EXERCISES FOR THE FOREHEAD

Ex 19. Cross lines + illustration

• Now place the pad of the forefingers on the inner corner of each eyebrow. Press the skin and muscle firmly against the eye socket and pulling the fingers slightly apart try to frown against the resistance 20 times.

Ex 20. Life lines + illustration

• Place index fingers above each eyebrow and hold skin and muscle down firmly. Close your eyes. As if surprised open eyes and pull eyebrows up 20 times – moving your scalp and ears working the forehead muscles against the resistance.

MASSAGE FOR THE FOREHEAD – FINAL RELAXION + illustration

Apply some more moisturiser or baby oil to the forehead to avoid stretching skin. These relaxing movements are best performed with eyes closed.

• Place your hands in prayer position with fingers in centre of forehead. With a firm brisk up and down sawing movement work out to the right temple. Now back to centre and on over to left. Repeat twice moving muscle and skin together. Hands down and relax shoulders.

• Change hands to horizontal position on top of each other and place on bridge of nose. With the sawing action work index fingers up the forehead into the hairline and back down again. Repeat twice. Slant hands and continue action to the right temple, return to centre, slant hands to left and continue action to left temple and back to centre. Hands down and relax shoulders.

• Using alternate forefingers only and with a light feathery touch delicately stroke up and over your nose the nose and forehead four times to help you relax.

• Finally, place all fingertips lightly on centre of forehead and with a continuous sweeping movement take them out over your eyebrows and forehead, on down the side of your face to your chin, then up over your nose and back to your forehead. Keep your eyes closed. Repeat twice and finally place your hands sofly down into your lap with fingers uppermost. RELAX for a minute.
Open your eyes. Congratulations – you’ve finished your facial work out!
C Copyright Diana Moran Nov 2003