The future of anti-ageing - AMWC 2018
This is my report (pic from today's Mail) on the AMWC - the Aesthetic and Anti-Ageing Medicine World Congress - which is held every spring in Monaco. If you follow me on Instagram, you'll know this was a few weeks ago; I was waiting until the piece came out before posting. And I know we all hate the term anti-ageing, but forgive me, it's a useful shorthand to say what sort of post this is. This is the pic and headline from the Mail - I've no idea what that treatment is but it looks like a version of the PlaySkin mask.
Here's my original draft of the story for the Mail - studded with a few pics that were highlights of the trip. (Disclosure: I was traveling as one of the UK press cohort, with Allergan).
Standing outside the vast Grimaldi conference centre on the seafront in Monte Carlo and enjoying the bright spring sunshine, I gaze from behind the safety of my sunglasses at the extraordinary faces in the crowd around me.
On my right, there’s a pair of lips overblown with fillers into a stand-out trout pout. Beyond the lady with the lips are three smartly dressed women all with super-smooth foreheads and unnaturally slanted eyebrows who look like they all see the same, heavy-handed Botox doctor. On my left, there’s an older woman with so much filler in her face that when she smiles, her eyes almost vanish behind her bulging cheeks. Scary.
Welcome to the AMWC, the Anti-ageing and aesthetic Medicine World Congress, 2018, the frontline of anti-ageing. If this is the face of the future, it’s looking alarmingly plastic.
Not all the 12,000 delegates who gather annually in Monaco for this, the biggest meeting in the global anti-ageing calender, look as peculiar as this. Not all of the doctors, surgeons, nurses and dermatologists here have gone overboard on their own medicine. As well as the practitioners of these cosmetic arts, there are many businessmen who run the companies that make the toxins and fillers, and the lasers and ultrasound and radiofrequency machines that tighten and refresh the skin, all of which are represented here in the exhibition floors of the conference centre. And there are plenty like me who, though no strangers to cosmetic procedures, prefer to keep things to a minimum and stay looking normal. But even for someone like me who has been around the world of aesthetic anti-aging medicine for nearly 20 years, it is an eye opener.
Everyone is here for a four-day jamboree of a conference: listening to talks from doctors, surgeons and ‘thought leaders’ in the huge amphitheatres on every conceivable cosmetic topic from thread lifts to ‘intimate rejuvenation’; learning the latest hands-on techniques in sculpting the face with injectable fillers or honing the body with fat-busting lasers from the global superstars of each genre, or having breakout meetings, lunches and dinners in the grand hotels – the Fairmont to the west, where there is a casino in the foyer and a pool with a ‘Nikki Beach’ club on the roof, or Le Meridien, to the east, at either end of the bay.
It’s heady stuff, geed up by the sunshine and the sheer excitement of being in this bizarre little seafront principality with its palm trees and pastel-and-ochre coloured apartment-blocks that are stacked on the steep hillside by the seafront, and miles more glamorous than the average cosmetic conference, though there’s still a lot of walking. Flat shoes are a must, with heels for later in a handbag.
Every hotel room in town is full. Anyone who didn’t book before Christmas is obliged to stay in Nice, a 20km drive away that can easily take 90 minutes when the traffic is bad (and it’s always bad), unless you can persuade your boss it’s worth splashing out for the helicopter that makes the hop along the coast in 7 minutes flat.
It might not sound like fun to you, but for me, it’s a complete blast. As well as catching up with top UK cosmetic doctors, I got to meet Dr Mauricio de Maio, the Brazilian plastic surgeon who has become the rock-god of injectable fillers, Dr Arthur Swift, the Canadian surgeon whose elegant, amusing lectures explaining the art and science of modern beauty are legendary in cosmetic circles, and over dinner at Nobu with Brent Saunders, CEO of Allergan (the giant pharma company behind Botox and leading filler brand Juverderm), I picked up the latest intel on new developments in this fabulous, bizarre field of cosmetic aesthetics. What’s hot now and what’s coming next? This is what you need to know.
The new wonder-substances are the latest forms of injectable gels made from hyaluronic acid, a naturally occurring substance which holds many times its own weight in water. Much runnier than normal filler gels (which are also made from hyaluronic acid), these injectable moisturisers sit just beneath the surface of the skin and moisturise it from within. Several brands offer them; there’s Volite, from market-leaders Allergan, Skin Boosters from Restylane, and Redensity from Teoxane, but the one all the doctors are raving about it PROFHILO.
This does more than moisturise; it works as a ‘biostimulator’, which is proven to kick-starts production of collagen, elastin and hyaluronic acid within the skin, making it look and feel softer and smoother. Clinics that use this say that patients love it and are having it injected in their faces, on their décolletage and even on crepey tummies to make them smoother. (Around £900, at salons including waterhouseyoung.com in London, the Riverbanks clinic in Hertfordshire www,riverbanksclinic.co.uk and Dr Sarah Tonks in Knightsbridge (thelovelyclinic.co.uk)
‘BODY IS THE NEW FACE’
So says Dr Tracy Mountford, who has attended almost every AMWC conference in its 16-year history and who is observing this trend in her practices in the UK (in Buckinghamshire and Devonshire Place London, www.cosmeticskinclinic.com). Many of her middle-aged female patients are already having regular cosmetic procedures such as Botox, fillers and pigment-busting IPL treatments on their faces and are now turning their attention to their bodies. What are they doing? ‘Everything – from Tixel skin tightening & resurfacing, via CoolSculpting fat-freezing to reduce love-handles and the tummy-fat that is harder to shift after the menopause, to ultrasound collagen stimulating and remodelling to tone up the upper arms.’
One of the most unstoppable trends at the AMWC for the past few years has been the growth of ‘intimate rejuvenation’. Which, close your eyes, any maiden aunts out there, involves using lasers or radiofrequency probes to rejuvenate and tighten slack or prolapsed tissues in the ageing vagina. Rejuvenating your lady-parts sounds all sorts of wrong, but although the procedures are being offered by cosmetic clinics, these treatments are not so much about the appearance of your private parts as restoring health to the vagina and strengthening it from the inside. That means these treatments are really helpful in treating mild stress incontinence and prolapse after childbirth. In the UK, many cosmetic clinics (including revereclinics.com, phiclinic.com, cosmetic skinclinic.com) are offering these treatments.
Leading gynaecologist Dr Tania Adib is championing intimate procedures as part of an all-round approach to women’s health before, during and after the menopause. She offers ThermiVa radiofrequency treatment at the Mallucci London clinic in Chelsea, from £3,000 (mallucci-london.com)
YOUNG GIRLS AND BIG LIPS
All the doctors I spoke to at the conference are very bothered by the way so many young women in the 18-25 age bracket are chasing the full-lipped look and request treatment with lip filler. It’s a huge problem for all reputable practitioners who are understandably reluctant to give young women the disproportionately big lips that they think they want, because that is the look they are seeing on social media. What they can do to deflect them, without refusing them outright? The trouble is that if good doctors refuse to do the job, the young women are likely to find their way to less reputable practitioners who, as well as leaving them looking over-done, may use products that aren’t well-accredited and which might cause problems such as cysts, swellings or tissue necrosis.
Dr Arthur Swift, a leading plastic surgeon from Montreal, has developed a method of explaining to potential patients that beauty is all about proportion – in the face as in the rest of the world. To this end, he measures up their facial features, quite literally, with a special pair of calipers, and shows them what adjustments could be desireable, and give them a small but appropriate dose of filler. It also means that he can clearly demonstrate that, if you have, say, a small jaw, large lips will look comically out of place – and can thus convince women not to go overboard with lip fillers. ‘Then,’ he says, ‘I can tell patients, “Now, you are perfectly proportioned -- don’t do any more!”‘ www.drarthurswift.com
Dr Swift does not practice in the UK, but cosmetic doctors who do similarly careful work with lips include Dr Jonquille Chantrey in Alderley Edge, Cheshire (drjonquille.co.uk), Yvette Newman, a highly qualified nurse-injector at Absolute Aesthetics in central London (absoluteaesthetics.co.uk) and cosmetic surgeon Sherina Balaratnam at S-Thetics in Buckinghamshire (sthetics.co.uk). Prices for lip fillers start from £500.
THE NON-SURGICAL GROW-YOUR-OWN FACELIFT OF THE FUTURE – USING YOUR OWN BLOOD, FAT AND STEM CELLS
You may have heard of PRP – the ‘Dracula Facelift’ technique where the platelet-rich plasma (that’s the PRP bit) is extracted from your own blood then reinjected into your face, to stimulate the growth of new collagen and elastin in the skin. Well, the version of this uses concentrated PRP (cPRP) with stem cells (the kind of cells in the body which can grow into any other kind of cells) extracted from your own fat – to rejuvenate the face.
This technique is being pioneered by Mr Kambiz Golchin, a consultant plastic surgeon who practices in London and Dublin, and his talk on the topic created a real buzz at the conference.
If this ‘SVF’ cocktail is injected into skin that has been lightly ‘damaged’ by laser treatment, ‘the stem cells will go to work and act as building blocks. They can regenerate as fat cells or skin cells, whatever is needed,’ says Mr Golchin [nb subs: Mr because he is a surgeon, not a doctor]. This means the procedure creates an extraordinary, grow-your-own-facelift effect. Fat can be added into the cocktail to, say, counteract hollowness under the eyes. It’s a lengthy and expensive procedure which takes around three hours and costs upwards of £10,000, but the results are similar to a facelift and will last around five years. www.kambizgolchin.com
THE INJECTION THAT DISSOLVES A DOUBLE CHIN
A decade ago, there was an injectable treatment known as the ‘flab jab’, which used a chemical called deoxycholic acid. This dissolved fat in the area where it was injected [the dissolved fat was then excreted by the body] and was effective, if uncomfortable but because the technique did not have official approval, it was eventually banned. Now a new injectable fat-buster called Belkyra is due to be launched later this year, also made from deoxycholic acid but with a much better pedigree. It is from industry leaders Allergan and has official approval from the American FDA (Food and Drug Administration) which polices such products. It is expected to need two treatments of Belkyra to treat a double chin, and each will cost from £800. Does it work? Yes, though there is, as before, a certain amount of stinging when the product is injected and swelling for several days afterwards.
Even more exciting, says the latest gossip from insiders, is the way that Belkyra is being trialled on the body. When injected into, say, a stubborn roll of fat on the lower tummy, it can flatten it as effectively as liposuction, and also works on ‘moobs’ – fatty male breasts. Meanwhile, in London, Dr Sach Mohan offers Aqualyx, another type of fat-reducing injections at www.revereclinics.com
NEW HARD AND SOFT OPTIONS FOR TACKLING CELLULITE
The newest – and decidedly hardcore, uncomfortable and invasive – way to tackle cellulite is with a process called Cellfina, which was on show at the conference. This involves using a miniature scalpel to slice through the fibrous bands that pull fat into the lumps that appear as cellulite. This might not sound too enticing, but people who have tried it rate it highly (in the UK, the key practitioner to see is Dr Apul Parikh at www.phiclinic.com.)
And the one we are all waiting for? CoolSculpting, the fat-freezing company, has been developing a new method of treating cellulite with extreme cold. Tantalisingly few details are yet available about this (last year, I was told it would be launching in 2018; now, I’m told it will be early 2019) but watch this space.
MEET THE LEDBEDS - THE NEW TAKE ON SUNBEDS
LED canopies and face masks have become a familiar sight in salons and skin clinics because a short session under red LED light calms inflammation in the skin and stimulates the growth of new collagen, leading to firmer skin – so why not create a whole-body treatment.
Full-body LED beds will soon be the big new thing – a 21st century take on the now-disgraced sunbed. Just now, there is only one, the BodyBoost bed, in the country, at trustedlighttherapy.co.uk in Suffolk, which is said to ease back pain and improve eczema as well as skin firmness. A 25-minute session costs £70. The company will be importing more in the near future.
LIGHTER BREAST IMPLANTS
Breast implants made with silicone gel filled with hollow spheres – so that they are 30 per cent lighter – also look interesting and they are more transparent under mammography. Cosmetic surgeon Chris Inglefield is already using this new brand, called B-Lite, at London Bridge Plastic Surgery (lbps.co.uk). These could be the way of the future, though after the PIP breast implant scandal, experts in the area advise caution over new types of implant that can’t yet show long-term safety trials.
Mr Rajiv Grover, a leading cosmetic surgeon and former president of BAAPS [the British Association of Aesthetic Plastic Surgeons] says: 'There are 35 or more implants on sale in Europe because they are classified as medical devices which only require a CE mark. A CE mark can be obtained by treating a handful of patients with a 6-12 month follow up. Often the real issues with medical devices take longer than this to emerge. In the USA, breast implants need to be tested on at least 500 patients over 5-10 years in order to gain medical approval from the FDA, which is more reassuring. As a consequence there are only three implants that have ever received FDA approval and that gives a different level of reassurance to a CE mark.'