‘This is the nearest I’ll get to being Michelangelo,’ observes Dr Ali Ghanem as he carefully, so carefully, works a laser beam beneath my skin, ‘sculpting faces with an optical fibre laser, with human collagen as my medium.’
I want to smile, but as it’s my collagen Dr Ghanem is remodelling right now and his laser beam, emerging from an optical fibre thinner than a human hair, is tracing its path along the inside of my lower cheek, I daren’t move a muscle for fear of getting the wrong bit of my face zapped.
Why is Dr Ghanem lasering my face from the inside? Well, it’s the latest and most direct non-surgical method of tightening up sagging skin — a no-knife alternative to the traditional face lift.
You might quibble with the ‘non-surgical’ bit. Didn’t I just say that this laser is used on the inside of the skin? I did, but no scalpels are required and the device can be slipped through a tiny hole into the skin which in itself creates no damage. Perhaps minimally invasive is the best term.
No-knife facelifts aren’t new. There are liquid facelifts, whereby fillers are used to redefine the cheeks, jawline, chin and nose; thread lifts, which see filaments threaded through the skin to lift it; and FaceTite, which uses radio-frequency to tighten skin. But this is the first time a laser has been used to anti-age under the skin.
What makes this treatment, the Endolift, so groundbreaking is the way it stimulates collagen, the protein that gives skin its firmness and bounce. The concept is relatively easy to grasp: create a laser small enough to slip inside the skin without the need for surgical incisions, so you can heat-treat ageing collagen from inside the skin without causing damage on the surface, and kickstart it into re-growing, stronger and tighter.
British writer Alice Hart-Davis (pictured with treatment lines on her face) has tried a new no-knife treatment that promises to regenerate skin by lasering a person’s face from the inside
But three months after the treatment, Alice (pictured after) admitted: ‘It’s hard to see much difference’
The device can also be used for fat reduction in the face. Using a different treatment head, the laser beam melts the fat underneath the skin. It’s popular with many of Dr Ghanem’s patients, but it’s not something I need doing.
The world of tweakments is always coming up with astonishing new procedures, and this is one of the most intriguing. My ears pricked up when I heard about it a year ago, but I know that it is rash to rush in and try something before it has been thoroughly road-tested by expert practitioners.
After all, even in a great pair of hands, the first 50 procedures are going to be experimental, as they learn how to get the best out of the treatment, so I hold back from being one of the original guinea pigs.
Then I heard that Dr Ghanem, an elite plastic surgeon, had started using the treatment, so I went to see if I’d be a good candidate for it. I’m 57, and even with all the tweakments I’ve had over time, I’ve got a bit of sagging going on around my mouth, and more of it under my chin.
‘We are all trying to turn back the hands of time,’ Dr Ghanem says. ‘We lose soft tissue, fat and collagen from the age of 30, when our bodies can’t replace what is lost quickly enough.’
‘Endolift is a form of laser technology. We can treat the skin and see both an immediate tightening effect and delayed, progressive collagen production over the next six months, which makes the skin healthy-looking as well as tighter.’
However, her doctor reassured her that it’s early days, and that the injured collagen goes on repairing itself for six months. Pictured, Alice during the procedure
Most practitioners trained in the Endolift will only be using it for the lower face. But because Dr Ghanem is a plastic surgeon, and I know he has been trying it out on crepey skin below the eyes, I ask him to have a go at that area for me, too.
Using a laser near the eyes is a delicate business, and I have to wear thin, protective metal shields under my eyelids. They are as uncomfortable and squirm-making as they sound, though thanks to numbing drops applied to my eyes beforehand, it’s tolerable.
For each of the areas he treats, Dr Ghanem inserts the laser through a pinprick-sized hole made with a needle, then teases its beam along the inside of my skin until that patch has been zapped.
Non-surgical facelifts: Seven of the best
Three or four filaments are threaded through the skin from the temples down across the cheeks.
Your skin is then lifted by nudging it along the threads, which have little cones on them to stop the skin sliding back down.
Clinical microneedling creates thousands of tiny wounds, to stimulate the healing process and give you a tighter complexion.
Combine it with radio-frequency — the energy is delivered deep into the skin via microneedles — and the results are impressive. Judy Murray had this done last year.
Hydrating gels such as Profhilo, Volite or Skinboosters encourage the skin to remodel itself. The injections can make dry, post-menopausal skin glow.
LASER & INTENSE PULSED LIGHT
Intense pulsed light zaps away age spots or red thread veins, while more intense laser treatment, which also uses light energy, can tighten and clear pigmentation.
High intensity focused ultrasound (HIFU) can tighten the skin at a deeper level than other treatments. The best-known brands are Ultherapy (Kirsty Gallagher is its ambassador) and Ultracel.
THIS uses heat to stimulate collagen. The FaceTite system uses a probe that delivers radiofrequency inside the skin for impressive tightening and fat-busting.
Injectable fillers can be used in a liquid face lift. Our faces start off full of fat pads which deflate over the years, leaving our cheeks and even our temples looking hollow.
Stiffer fillers can improve the structure of the face, while softer ones can replace lost volume.
Thanks to injections of local anaesthetic, I barely feel the tiny device being slipped into my skin, and there is only a trickle of sensation as the laser works its way about beneath my eyes. I can tell from the excitement in the photographer’s voice that it looks pretty extraordinary, what with my eyes all alien-green from the shields, and the red dot of the laser shining through from under my skin. Being squeamish, I’m glad I can’t see it, and concentrate on keeping still.
Next, Dr Ghanem moves onto the main business — tightening loose skin in my lower cheeks, below my jaw and under my chin. It’s not painful, but knowing that something bizarre is going on in my face means I lie rigid on the treatment couch and it is impossible to relax.
This is such a delicate procedure that you need to be confident in your practitioner. As he works, Dr Ghanem cautiously pinches my skin, to assess the degree of tightening he’s achieving with each pass of the laser.
I remark that a powerful laser can do an awful lot of damage to collagen from inside the skin. Is my collagen being destroyed? ‘It’s like cooking a piece of fine Wagyu beef,’ he says. ‘We are making it medium rare. We’re not turning it to charcoal [as that would kill it], we are just delivering enough heat to make the collagen contract, but we need to keep it alive.’
In other words, my face is being flash-fried from the inside out. You know how a steak shrinks when it sizzles in a pan? I’m just thankful I can’t feel it. After 45 minutes, I’m cooked.
When I sit upright, I’m not a pretty sight. My eyes are so sore from the ocular shields that I can’t open them with any degree of comfort, and without more anaesthetic drops. There are bruises coming through on the delicate skin below my eyes, which is already starting to puff up into bags. The skin around my jaw and under my chin is swelling in protest.
My whole face looks lumpy and misshapen — worse once I am strapped into the pressure garment (a not very fetching beige surgical stocking for my face), which I must wear day and night for five days to support my traumatised skin.
What with the garment and the bruises under my eyes, I spend the next week doing very little, not least because by some freak of bad luck, my eyeballs have been badly abraded by those protective shields. (I asked around among my doctor pals who use them, and all say that injury from the shields is vanishingly rare.)
This is in no way a ‘no-downtime’ procedure, unless you’re happy to go out and about in a balaclava and sunglasses.
But the bruising and puffiness is gone after a week, and what’s encouraging is how firm and tight all the treated areas feel — I notice this for a month, when I stretch my jaw and neck, so I anticipate good results.
Three months later, I get back to the clinic for ‘after’ photos taken on the latest Vectra camera system, which produces a detailed three-dimensional image of my face.
Dr Ghanem is pleased. ‘They clearly show a subtle but positive improvement in facial skin contour and laxity of the face and neck,’ he says.
I’m puzzled. I can feel in my skin that there has been a change, but in the pictures? There’s a bit less shadowing beneath my eyes, a fraction less sag in my lower cheeks, but frankly, it’s hard to see much difference.
Dr Ghanem reassures me it’s early days. The injured collagen goes on repairing itself for six months. I may see more improvement by the summer and the results should last for a couple of years. Here’s hoping.
Endolift costs from £2,200 (cranleyclinic.com). Alice Hart-Davis is founder of thetweakmentsguide.com