Faces age due to several genetic and external factors that have an impact on the underlying structures of bone, fat, muscle and tissue, as wells as the “canvas” that covers your face (and indeed your body) - skin.

This influences the approaches I will consider when embarking on a facial rejuvenation journey.

Patients often intuitively know what is required, but it helps to understand what each procedure addresses specifically. The treatments and procedures are discussed from least invasive to most invasive:

Medical grade skin care

  • Medical grade skin care should start at the age of 2.
  • The best protection against aging is adequate sun protection in terms of applying at least an SPF50 from the age of 2.
  • Sun protection is essential for the rest of your life, but supporting this with the correct products, with the correct ingredients, as well as specialized treatments tailor-made for your skin will ensure a healthy skin – and healthy skins age better.
  • Skin quality issues, such as pigmentation, rough texture, scarring, dull complexion, skin laxity and large, open pores cannot be addressed successfully by any other means but medical grade skin care. There are many options, with various levels of complexity and downtime, and a consultation is best to explore your options.


  • Many myths and fallacies abound when it comes to Botox, and patients still fear frozen faces, prominent fish-like lips and all kinds of other imaginary mishaps.
  • As with all medical procedures, especially cosmetic procedures, the art and beauty of the treatment or surgery is in the hands of the artist (the surgeon or injector). It is therefore sensible to be injected by someone who is experienced, well-trained and an artist who understands the facial anatomy, and who is prepared and experienced enough to adjust the number of units and the areas that are being injected to your unique anatomy and facial expressions, rather than following a text book prescribing x number of units of Botox for x number of injection sites.
  • It is also important to understand what Botox can and cannot do – Botox does not plump your lips, and the fat, fish lips you see on TV is not from Botox, but from dermal fillers. Botox does not add any volume to any area of the face, instead, it makes all dynamic lines (those that move when you move your face, i.e. when you frown or smile), static – so that they no longer move, and cause wrinkles. Botox is therefore specifically used to address fine lines and wrinkles that occur due to repeated facial movements.
  • Botox can also be injected to assist patients who grind their teeth, to address the platysmal bands of the neck, and to address excessive sweating of the axilla, arms and feet.

Dermal fillers

  • Dermal fillers address the loss of facial volume (due to fat, muscle and bone loss), and does not address dynamic lines and wrinkles – so if you sit in front of the mirror with a serious face – all those resting, deep lines can be addressed by dermal fillers.
  • Dermal fillers cannot address lots of excess skin but can improve slight skin droopiness.
  • Dermal filler technology has improved tremendously over the last couple of years, and specific dermal fillers have been developed to address specific problems. One can even address skin quality, finer lines and wrinkles, and volume can be added to many areas.
  • Dermal fillers are particularly popular to address cheek volume loss, lip volume loss and the so-called barcode lines around the mouth and chin area.

Thread lifts

  • For patients with slightly droopy skin, but who are not ready for a full facelift, thread lifts are a temporary solution. It would be incorrect to believe, however, that a thread lift can be successfully used in stead of a facelift.
  • Thread lifts are a nice non-surgical option for younger patients with limited ageing, who would like to have a slight pull for a fresher looking face.


  • Facial cosmetic surgery consists of either an upper and/or lower eyelift (blepharoplasty), a facelift (rhytidectomy), a combination facelift and neck lift or neck liposuction alone or together with a neck lift. These can also be enhanced by adding fat grafting to any of these procedures, or to perform fat grafting on its own.
  • Most suitable patients for surgery are those with excess, loose skin of the upper eyelids, the face or the neck, as there are no non-surgical procedures that can address these issues effectively.