The Phase Of Beauty

From The Sunday Times - April 12, 2009
Fish-hook facelifts and other new hair-raising beauty procedures
Fancy hoicking up your face with tiny hooks or injecting pig collagen into your wrinkles? The latest beauty procedures are not for the squeamish
BY : Joanna McGarry

Those with a delicate constitution, look away now: for what you are about to read could make you feel more than just a bit queasy. Imagine, if you will, having lots of small hooks implanted into the sides of your face to yank up the flesh around your jaw. Or how about filling up syringes with collagen from pigs’ tendons and injecting them into the creases of your face? It may sound like a scene straight out of a slasher movie, but these are the latest in a series of gruesome cosmetic procedures that have become part of the modern-day weaponry used by women in the battle against ageing. Or, to give them their surgical names, the Endotine ribbon facelift, a procedure widely thought to be behind the recent pictures of Madonna’s face looking decidedly taut, and Evolence, a filler containing parts of the common farmyard pig that is causing a storm in America.

Relatively new to Harley Street (it has only been offered since late 2008), the ribbon facelift is a marginally less grisly option than its more established predecessor, the thread lift (aka the fish-hook lift). Both procedures involve inserting hooks, either connected by a thread or a ribbon-like material, into the face to pull back loose skin around the jaw. The difference is that the hooks used in the ribbon lift dissolve after a couple of months, whereas the thread lift stays put.
This is a risky business, says Rajiv Grover, a consultant plastic surgeon and secretary of the British Association of Aesthetic Plastic Surgeons. “When you put something under the skin with tension around it, it becomes palpable,” he warns. “People [having thread lifts] were complaining of guitar strings in the skin. And for the unlucky ones, the effect was visible — there was a clear ridge along the jaw.” The procedure has proven unpopular with most surgeons, rendering it practically obsolete in the UK.

So, is the ribbon lift any better? Dr Mervyn Patterson, a leading dermal surgeon, isn’t convinced. “Thread, ribbon, Band-Aid lifts, whatever you call them, they all involve implanting foreign bodies under the skin. It’s an uncomfortable concept, especially when you consider that there are no regulations in the industry.” Absurd as it may sound, in this country, anyone can pick up a scalpel and play plastic surgeon — the lack of a regulatory body leaves you wide open to botch jobs. Grover has already seen what happens when the ribbon lift goes seriously wrong. “A high-profile patient of mine had it done in New York five months ago, but she developed a fold of skin near the ear. That’s the problem with it: you can pull up a fold, but it will reappear elsewhere. She’s having it taken out and opting for a lower facelift, instead.”

The real cosmetic-surgery success story, though, is the booming world of fillers. Since the invention of the naturally derived synthetic formulas Restylane and Juvéderm (both of which contain hyaluronic acid, which occurs naturally in the body), we have become a nation of needle addicts. In 2005, 230,000 nonsurgical procedures were carried out, compared with a jaw-dropping 472,000 in 2007. Still, even the needle-friendly may baulk at the idea of injecting animal tissue into their face. Evolence, a filler made from the collagen found in pigs’ tendons, was approved in the UK four years ago but was granted permission for use in the United States only last June. Now, wealthy Manhattanites are flocking to try out the latest wonder filler on the block.
Back in Britain, the pigs’ tendons have been received with a dose of scepticism. “I tried Evolence on a few of my patients, but it didn’t give the desired results,” claims one leading surgeon, who didn’t wish to be named. “When inserting a foreign body into the skin, there is a greater risk of allergy, and some patients developed lumps that had to be corrected.”

Sara Hamley, 44, an events organiser and Restylane devotee, also has her reservations. “Restylane is the gold standard — it’s a naturally derived product, not from an animal. There’s just something not right about putting an animal’s chemical make-up into your body. I would prefer a piece of plastic, to be honest.”
Finally, a sobering piece of advice from Grover: “When you read about something new, if a product sounds too good to be true, it probably is.” By the same principle, if something sounds utterly gruesome, it probably is, too.