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Male and female aesthetic treatments

Men are becoming more open to the idea of facial aesthetic treatment but are still in the minority in numbers treated. Both can benefit greatly, so what are the differences in treating male and female patients? The American Association of Plastic Surgeons statistics for 2013 show females as having 91% of cosmetic procedures overall, broken down to 94% of all botox treatments, 96% of all dermal filler treatments and 92% of all chemical peels. Within this, the most requested female treatment was botox (55%), then fillers (20%), peels (11%), laser hair removal and microdermabrasion (each 7%). For men botox was again the most requested treatment (41%), followed by laser hair removal (20%), microdermabrasion (19%), peels then fillers (each 10%).

Physical – male and female faces have some general differences, even with masculine female faces and feminine male faces. Men’s skin is 25% thicker with more collagen (one of the most important   building blocks of skin) and oilier with larger pores and more hair follicles. This makes it more prone to acne and smoothing out irregularities often requires more treatment. Sun damage is more common in men due to work and lifestyle with a greater resistance to using sunscreen. Women have an advantage as beauty and skin products often containing sunscreen as an ingredient. Wrinkles in women tend to be more numerous but finer, men’s wrinkles tending to be fewer (due to thicker skin and support from hair follicles) but deeper. Horizontal forehead lines in men often appear earlier as the forehead muscle (frontalis) is continually working to hold up the brows which are heavier than for women.

The development of the face is an important factor to consider as when infants boys and girls are often difficult to tell apart. Essentially all faces start as feminine and develop gender characteristics over time. Numerous studies have shown that feminine faces are intrinsically more attractive to males, females, children and infants so this feature provides a protection and survival mechanism in infancy. Faces become distinctly male or female in childhood and continue to differentiate in maturity.

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-          The overall shape of the face is characteristically different. In women the upper half of the face is more prominent with a taper to the lower half whereas men’s facial shape is more angular and square with larger jaws which evenly balances the upper and lower parts.

-          Forehead: male foreheads are muscular with flatter eyebrows and larger brows, whilst the female brow is more rounded. The heavier brow, notably towards the center, can often look assertive and dominant (the current Dr Who, Peter Capaldi, has what were described as “attack eyebrows”). Male foreheads show earlier wrinkles which may deepen if the forehead muscle needs to act (generally subconsciously) to stop the eyebrows dropping further over the eyes. Female eyebrows are often shaped or even tattooed to alter the appearance of the eyes and the face.

-          Eyes: male eyes are deeper set, narrower and slightly less open. As a fresh, youthful appearance is highly prized in women, a wide-eyed look is desired and make-up is used to accentuate this. There are a number of eye shapes that were detailed in the Focus on eyes blog.

-          Cheekbones and mandible: the mid-to-lower face shows an important difference between men and women. The female face tapers in to the chin which accentuates the cheekbones and eyes. This smooth and slightly rounded appearance of the cheeks in youth is a very important sign of a young face, but leads to jowling earlier in women. This is because there is less support for the cheek from the jaw as the fat pads of the cheek drop and the thinner skin becomes less elastic and sags. For men the cheekbones are less prominent and the lower jaw is larger and squarer with the muscles being larger as well as the bone. Very flat cheekbones are a sign of aging and this can affect even young men. Women normally have more jowling.

-          Nose: in general the nose is slightly larger in men, this can be longer, wider or both. The nose-to-upper lip (nasolabial) angle is more open in females which displays the upper lip better.

-          Lips and chin: although there can be a wide range of different lip and chin shapes, in general the female chin lies slightly behind the lower lip which again accentuates the lips. Female lips are smaller in width but more voluminous with more of an upturn at the corners of the mouth (the commissures). The male chin is stronger, males have larger mouths and thinner (especially upper) lips.

-          Facial skeleton: the facial skeleton is different for men and women as well, surprisingly. The major differences are larger brows, jaws and nose opening (pyriform aperture) in male skulls and the shape of the eye sockets is slightly different between aged male and female skulls.

 

These differences lead to a general trends in what men and women are interested in correcting or improving when they attend an assessment. Women will request treatment earlier so the aging process is not as advanced. Often male patients are more concerned with cheek and neck lax tissue and deep nasolabial folds which have formed in the 30s and into the 40s, whilst women focus not only on the lower face but also on the forehead and eyes with finer lines from the 20s and 30s.

Sociopsychological– men and women have different wishes for what treatment they desire and why it is necessary. Women normally request therapies for rejuvenation and beautifying with important social and emotional aspects. Treatments for men are normally with the aim of restoration and enhancement, often wanting to look fresher for professional reasons rather than 5 or 10 years younger. There are social pressures which are felt throughout populations with trends that may be influential (for example the ‘metrosexual’ look), and occasional social events such as weddings or interviews can be the impetus for seeking treatment. Discussing appearance is very different for men and women with men feeling anxious and considering their concerns as vain and  unimportant, although when they decide to have a treatment men are generally less price-sensitive and more focused on their cosmetic target. Often the pressure to seek treatment comes from a partner or spouse, and even being married itself slightly decreases the perceived age although this is more evident in women (1.9 years) than men (1 year).

 

Treatment– a combination of aesthetic anatomical differences, reasons for wanting treatment, number of areas to be treated and recovery time from treatment must be considered when considering male and female aesthetic therapies. Minor asymmetry in male faces is less crucial than in female faces and needs to be planned in to the treatment. With men’s wrinkles being deeper by the time treatment is requested, some degree of wrinkling is natural so complete correction is not normally desired. As women have finer wrinkling, especially if presenting for treatment in the 20s to 30s, complete correction is a preferred aim. The most common male concerns are forehead wrinkles, crow’s feet, telangiectasia (spidery red lines on the skin), lentigines (flat brown individual   freckles), acne scars, jowls and laxity of neck and brow skin. The common female concerns are forehead and glabellar lines, crows feet, dull skin, jowling and lax neck skin. In general male patients are less tolerant of pain with higher anxiety levels about treatment. Men are also more concerned about healing and time issues, with treatment evidence afterwards a concern as they do not have     the benefits of using make-up for concealment. Thus overall men prefer single treatments for a single area of concern with long-lasting benefits whilst women prefer more frequent treatments over a more widespread area with an appearance that can be modified periodically.

 

Botox – for all patients undergoing their first treatments there is a need to explain carefully the differences that will be achieved but men often find the change to a less mobile look more disconcerting. The treatment areas most frequently requested by men and women are the forehead, glabella (the ‘angry 11s’ between the eyes) and crow’s feet. Treatments almost exclusively requested by women are brow lifts and nose ‘bunny lines’.

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Jaw reshaping is possible with botox placed at the corner of the jawbone which narrows the face and this again produces a more feminine look. Tiny amounts of botox can be placed in the lower eyelid to provide a wider-eyed look which appears more awake and refreshed, and a large eyed look is much more appropriate for women in general. As males have larger muscles (including the face) more botox is required. Additionally the male forehead is larger with the potential for a receding hairline so a larger area needs to be treated.

Fillers – fillers are generally associated with enlarging cheekbones and lips so are often thought of as a purely feminising treatment. However masculinising treatments are possible with fillers such as augmenting the chin and corners of the jawbones, and some male faces have flat cheekbones or unusually thin lips which can benefit from a small, but important amount of carefully placed filler.

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Men often need more filler in areas such as the nose-to-mouth nasolabial folds due to the thicker, heavier nature of the skin. For the glabella men often require botox and filler in combination to reduce deep creases with hyperactive muscles which have been present for a long time.

Peels – chemical peels will work for men as well as women. The treatment is essentially the same   with the same results and the differences come with following the recommended creams for optimal results during and afterwards. The most important of these is sun cream and men are less likely to   continue using the cream for the time after the active treatment has finished.

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Focus on: eyes

Aesthetically, as well as anatomically, the eyes dominate the upper part of the face. Studies have demonstrated that it is the eyes that are focused upon most when a face is looked at, and that women will focus most on the eyes during a conversation (men focus more on the lips during conversations).

There are a variety of eye shapes, and these are formed by a combination of the shape of the corner of the eye (epicanthal fold) and the internal shape of the fat pads that surround the eyeballs.

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Some research has suggested that the highest point of the upper eyelid is 1/3 from the inner corner of the eye but gradually moves to the middle of the eye with age. This subtly changes the shape of the eyes with aging.

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Eyebrows and eyelashes also influence this appearance, with male eyebrows ideally being only slightly arched but female eyebrows gull-wing shaped.

Over time the there are multiple changes around the eyes, affecting the muscle and fat, as well as the skin. There are surprisingly few muscles in the upper part of the face. The forehead frontalis muscles lift the eyebrows and a combination of the orbicularis oculi, depressor supercilii, corrugator supercilli and procerus muscles pull the eyebrows down and towards each other. These muscles work against each other to provide a balance and a natural position for the eyebrows.This balance is important to maintain with botox treatments.

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Above the eyes under the tail of the eyebrows the skin’s natural fat is partly lost, and this combines with less elastic skin causing drooping, loose skin over the upper eyelids. As this is a sign of the years passing, people may unconsciously use their forehead frontalis muscles to hold the brows up. This can be a very successful disguise, although it does lead to an increase in horizontal forehead lines. Beside the eyes crow’s feet lines form through smiling and squinting. Smoking and sunbathing can play a part here too as they lead to additional squinting. The muscle of the lower eyelid is stronger than the muscle beside the eye and can pull the outer corner of the eye downward, another subtle change of aging. Weak lower eyelids can lead to the white of the eye (sclera) being seen under the pupil and over time this can increase with looser eyelid skin also being culpable. Under the eyes bags appear which are partially due to the fat under the eye herniating and pushing out behind the weakened muscle orbicularis oculi which circles the eyes. Grooves can appear with loss of fat under the eyes and over the cheekbones, making the eyes look more hollow and tired. Between the eyes vertical lines form from the action of the muscles over many years, and these lines can become etched into the skin (the ‘angry 11’s).

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Fortunately, there are many treatments that can be carried out around the eyes to help hold back the ravages of time. For the upper third of the face botox is commonly used. The ‘angry 11s’ scowl lines between the eyes are a very frequently requested correction with botox, although if they are still present when the muscles are at rest some filler may be needed to complete the treatment. Crow’s feet treatment is another of the most popular botox treatments. Eyebrow lifts have become popular, normally using botox but filler can be placed here as well to help recreate a youthful look or to improve on one which is already there. The bridge of the nose can show horizontal wrinkles, often called ‘bunny lines’ and botox is used here again. An indented appearance of the bridge of the nose or lower forehead can be corrected with very carefully placed filler. Under the eyes filler is used to correct a deep-set, hollow appearance. Botox can be used under the eyes as well, to relax the lower eyelid for a more awake or refreshed appearance. All around the eyes chemical peels can be used to refresh the surface of the skin and fine lines can also be reduced this way.

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Unlicensed products – fake fillers and faux-tox

www.securingindustry.com

Aesthetic treatments continue to be increasingly popular, but along with this the number of counterfeit facial aesthetic products available is increasing. Last week discoveries of counterfeit botulinum toxin being supplied to clinics in the US brought up once again the problem of fake facial aesthetic products being available to the public. Although in this case the products came through an unlicensed supplier, these potentially dangerous materials are normally found online, often for what seems like a remarkably low price, but what is in the packaging will not be worth the money paid out. An online search for containers of botox and dermal fillers soon came up with a range of results, the majority being from the manufacturers themselves or via practitioners. However products that could be mailed to a home address with ‘diy’ instructions on how to use them were also available. Large, reputable sites such as Ebay and Amazon had no listings, but searches in European, Chinese and US sites found providers for botox and fillers with no questions asked, only payment. The volume of counterfeit injectable aesthetics products over last 10 years is enormous – $75bn worldwide of fake pharmaceuticals is estimated to have been sold.

So what is in counterfeit facial aesthetic products and what are the potential effects? The simple answer is that it is very hard to tell as counterfeit products could be made anywhere with anything. Even if the correct medications are present the dosage is very unlikely to be accurate. The result of this is that the effects of using unregulated products is also very hard to tell, but infection is much more likely as non-sterile material and/or needles are pretty much a certainty. And as it is impossible to provide a correct dosage, the effects are pure guesswork with a real possibility of an overdose.

How can black market products be spotted? The most obvious clue is a price for products or treatments that is consistently very low compared to recognised providers. There may be legitimate offers but these would be noted as such and the prices for other treatments would be average amongst reputable practitioners. Botox that does not need a prescription, according to the provider, should also be treated with suspicion. Botulinum toxin is a ‘prescription only medicine’, although large clinics may order it in bulk legally using a single prescription. In 2004 the US Food and Drugs Agency jailed several people, including some doctors, for using botox vials which were for research use but passed off as Allergan Botox Cosmetic. The vials had the markings for the manufacturer Allergan but also “For Research Purposes Only. Not For Human Use” stamped on them. Fillers and peels can be ordered through companies although the Keogh report reviewing the Regulation of Cosmetic Interventions published in 2014 recommended that fillers should also be prescription only medicines, but this recommendation was rejected by the government.

There have been reports of dermal filler materials being drawn from large containers into syringes for use and these would be counterfeit products. All legitimate fillers are packaged in small syringes with amounts varying from 0.55ml to 1.8ml which are produced in an aseptic (surgically clean) laboratory environment. Sometimes small amounts may be placed in sterile syringe via a sterile connector or mixed with anaesthetic solution (with Radiesse and Sculptura this is commonly done) but usually fillers are used in the original packaging.

Names of facial aesthetic products are multiple. For botulinum toxin the major manufacturers are Botox Cosmetic (Allergan), Xeomin, Bocouture (both Mertz), Dysport (Ipsen) and Azzalure (Galderma). Myoblock is a very rarely used type of botulinum toxin manufactured by Solstice. Fillers are manufactured by a number of companies and the best known are Restylane, Juvederm, Teosyal, Radiesse and Sculptura. As there are over 200 fillers that have been awarded the CE mark, some fillers legitimately manufactured may not be known to even the most experienced practitioners. This makes fillers harder to spot as counterfeit, but the treatment should always be carried out by a qualified practitioner who will know about the product they recommend and would be able to provide reassurance that could be checked online. There are a huge range of creams and lotions on the market, including homeopathic ones that have not gone through any recognised testing procedure. Recognised, established websites are useful for reviews of their effectiveness but advertising claims are often pitched at an aspiration instead of a reality. My personal preference is for SkinTech products, but ranges such as the Obagi and Glo lines are also very popular. I have also commented on news stories about creams on my Facebook site.

Creams containing ingredients such as alpha hydroxyl acids, beta hydroxyl acids, hyaluronic acid can be found in shops and online. There is a wide variety of manufacturers and any unknown cream claiming remarkable results should be viewed sceptically. There are no clinically recognised creams with botulinum toxin on the market but clinical trials are taking place. ‘Botox creams’ may prove to be beneficial for hyperhidrosis (excessive sweating) in the future, but are very unlikely to be effective for wrinkle reduction. The creams incorporating hyaluronic acid, the main ingredient in the most popular dermal fillers, can be bought in shops or online. It is worth noting that the hyaluronic acid in a cream is no more than a good moisturiser which will only help with very fine lines as it cannot penetrate through the skin.

Counterfeit products are normally provided by unqualified practitioners, frequently working without any legal insurance. All treatment should be in an area where cross-infection can be controlled with gloves and antiseptic skin-wipes are used. Consent forms should be used and qualifications visible. Unfortunately this degree of training is part of the cost of the treatments, but the cheap alternative can turn out to be much more expensive and damaging.

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Focus on: chins

Humans are the only hominids to have chins and scientists think that they developed to spread the forces created with eating or stresses on the bone from the tongue during the evolution of speech. The jawbone, or mandible, provides the basic shape with a layers of fat and muscle under the skin providing the detailed appearance1

A strong chin is a masculine feature that dominates the lower third of the face in men. Kirk Douglas’ look was dominated by his solid chin and superheroes in comics such as Superman and Batman have always been drawn with square, prominent chins.17Although a masculine chin is important for men, the shape of a woman’s chin is very important in her appearance and the proportions of her face. Female faces ideally narrow from the cheekbones to a well-defined chin.

5It is important for a chin to be proportional to the rest of the face. Overall 1/3 of the face should be from the base of the nose to the lowest part of the chin. Within this, 1/3 should be from the base of the nose (the subnasale) to where the lips meet (the oral aperture). The other 2/3 is from the oral aperture to the tip of the chin (the menton).

18As well as the frontal appearance, the side-on appearance of the chin is important. A strong chin is especially important for men and correction of a ‘weak’ chin is a well-known request. Here a face in profile has just the prominence of the chin adjusted, but the change in appearance for the rest of the face is remarkable.8The prominence of the chin is linked to the appearance of the lips as ideally there should be a line running from the chin to the nose with a 4mm space to the upper lip and a 2mm space to the lower lip. This can be seen by resting your finger on the chin and nose and seeing the gap between the finger and lips. Knowing the correct proportions allows for any correction to be done in harmony with the rest of the face.9

Another important aspect of the chin is that in the youthful face it blends in with the jawline. Jowls appear over time as the middle part of the face (below the eye) sags with a characteristic, if unwanted, aged appearance. Lines running down from the corners of the mouth, often known as marionette lines, add to this appearance of the chin appearing to be isolated from the jaw.

10Fillers are the most common treatment for the chin and lower 1/3 of the face. They can be used to adjust the chin size and shape, and to smooth the marionette lines at the corners of the mouth to blend chin area to cheeks. Fillers can also be used to re-establish the jawline to define it and recreate the straight line of youth.

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Botox can also be used in this area. An orange-skin appearance of the skin when the lips are pursed is due to a strong mentalis muscle and this can be reduced with botox. Where the marionette lines are in part due to a strong muscle pull at the corners of the mouth, which also causes a ‘sad’ appearance, botox may be needed in combination with fillers for a full correction.

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Sometimes the problem of the appearance of the chin can lie within the mouth. If the teeth are very worn or even absent the mouth, and face, can be over closed leading to a ‘witch’s’ chin appearance. Here a dental correction can be the most important factor and needed before any facial aesthetic treatment will be effective.

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Focus on: cheekbones

The cheekbones are an important frame for the face and having ‘great cheekbones’ is one of the best compliments that a face can have! Jonny Depp, Angelina Jolie and Sophia Loren have ‘great cheekbones’, but what is actually there and how can this look be achieved and maintained? Cheekbones 7

Although it is the zygomatic bones that provide the structure at the top of the cheeks, what creates a youthful face is the fat pad that lies under the skin.

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This malar fat pad rounds out the cheekbone and provides a smooth, unbroken curved appearance. Unfortunately it drifts downwards during the 30s and 40s leaving a flat mid-face (and contributing to the formation of the dreaded jowls look).

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In youth the face can be thought of as having a schematic outline of an upside-down triangle with the cheekbones providing the width and the face narrowing down to the chin. A combination of changes take place with aging – the maxilla bones in front of the cheekbones shrink inwards flattening the area under the eyes, the malar fat pad drops down and forward and the skin loses some of its elasticity and sags with wrinkles and folds becoming more evident. This upside-down triangle becomes more square and, as jowls develop and the nose-to-mouth folds deepen, develops into a pyramid with the base at the bottom of the face.

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As well as the cheeks losing their roundness of youth, grooves appear under the eyes as the boney margin of the eye socket, the infraorbital rim, is uncovered. These contribute towards the bags under the eyes that are a part of middle age with loose, wrinkled skin in evidence on the surface. The nose-to-mouth or nasolabial folds (NLF) deepen and are one of the most commonly requested areas for correction. This lack of volume in the cheeks may also be present from youth resulting in an early aged or tired appearance.

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Although these changes inevitably happen with ageing, facial aesthetic treatments can slow the process. The   current way of envisaging the face is as a balloon. Initially it is properly inflated but, with time, it deflates and wrinkles form. Fillers are often used now to ‘reinflate’ the balloon and regain the lost volume. Regaining the volume of the cheekbones that has been lost will lift and tighten the skin below and can produce effects beyond the immediate treatment area. Vectoring is a further filler technique that works against the pull of gravity. Vectoring lifts the mid and lower face with strategically placed fine lines of filler that provide support, normally anchored to the cheekbone area.

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Fillers are the most popular non-surgical treatment for the cheekbone area but other treatments can also be successfully used. Surgical face lifts can reposition the sagging parts of the face (but fillers are now commonly used to replace the volume of youthful facial fat that has been lost). Ageing skin can also be treated with ‘resurfacing’, removing the top layers of skin to stimulate new growth, and this can be achieved with chemical peels and dermabrasion. This will provide a ‘glow’ to the skin and can remove age spots, but only very deep peels, such as phenol, can significantly correct wrinkles and folds.

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Everyday methods for keeping the skin over the cheeks healthy includes good hydration by drinking enough water, a healthy diet, a good skin cleansing routine and sun care. The top of the cheeks are particularly prone to sun damage as they face upward and sun cream throughout the year is recommended. There is a more detailed explanation of these in the General skin care advice section of the site.

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Focus on: lips

The lips dominate the lower part of the face and are a natural focus of attention with a notable place in culture and aesthetics. Their main role is in creating a seal for the mouth, but they have evolved over millions of years with increasing emotional expression in the face, most notably in people due to the evolution of speech. Anatomically the lips are basically an oval shaped muscle (orbicularis oris) with other muscles radiating off so they can move in all directions as well as change shape.

1There is a very thin covering of skin that allows the superficial blood vessels to be seen, and this is part of the reason for their colour, although darker skin colours have more melanin (which gives skin its colour) in the lips so mask these blood vessels.

Babies have the classic cherubic look with lots of volume and this is matched by the large amounts of baby fat in the face. The lips are best shaped for suckling and for discovering what objects are like with their huge amounts of touch-sensitive nerve-endings. This is why anything within the grasp of babies will very quickly find its way into their mouths! With growth and development the amount of fat under the skin ‘fits’ the size of the skull better with the best balance in the late teens to early twenties, and at this time the lips appear at their best.

2A roll of tissue is present at the junction (the vermillion border) of the lip and surrounding skin. This roll (indicated by the blue dot in the picture) has a ski-jump profile when seen from the side in young lips and is one of the most important parts of rejuvenation for a natural look.

5The Cupids bow appearance in the middle of the top lip is present in young lips but is lost gradually with the lips eventually becoming flat and deflated. Over time some of the fat under the skin around the mouth is lost and the muscle thins. This leads to loss of support for the skin (which also loses some of its elasticity) and the appearance of fine lines which radiate out from the lips and create the curse of the ‘lipstick bleed’. Replacing the lost volume around the lips and at the vermillion border is a vital step to helping correct these fine lines and rejuvenating the appearance.

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A further change in the lips seen over time is the down turning of the corners of the mouth (the commissures). Fat loss is the cause of this and when combined with sagging cheeks (appearing as jowling), deep lines can appear here. Even at an early stage the mouth has a neutral or even sad appearance.

 

 

7The Golden Ratio, a classic standard for aesthetics for 2000 years, can be used as a guide for the proportions of Caucasian lips with the lower lip ideally being 1.6 times the size of the upper lip. Normally this is judged as the top lip being 1/3 and the lower lip 2/3 of the overall size of the lips. For African and Asian lips the ratio is closer to a 1:1 ratio, but again this is a guide rather than an inviable figure and every face is subtly different. Famously well-proportioned lips belong to Angelina Jolie and Scarlett Johansson who have large, full lips. This size does not suit everyone and they are genetically lucky in having faces which frame their lips very well.

 

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Similarly famous large lips belong to Rolling Stone Mick Jagger and Steven Tyler. Here they look too big, and this shows that the shape and size of the lips needs to match the face.

 

 

 

 

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The old style of lip rejuvenation was for a voluminous pout for everybody, but this is much less popular nowadays. Although younger women like the look of Angelina Jolie and Scarlett Johansson, older women prefer the look of classic faces such as Audrey Hepburn and Marylin Monroe who had less volumised but still very well defined lips. Something that they all share in these images is the well-defined border of the lip and surrounding skin which is a sign of youth.

When lip shaping is considered, a famous ‘trout pout’ case that is always mentioned is that of Leslie Ash. She had a silicone lip implant that caused a reaction and scarring, unfortunately within the muscle of the lip where it could not be corrected. Now the vast majority of lip treatments are done with hyaluronic acid fillers (hyaluronic acid is found naturally throughout the body) which are designed specifically for the lips and have an excellent record of safety and results.

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An often overlooked part of lips is what is behind them – the teeth. If the front teeth are placed further back than normal, or some are missing, the lips will collapse inward and no amount of filler will correct this properly. Where the teeth, or dentures, are very worn the mouth ‘over closes’ with the sides of the lips lost and folds deepening at the corners of the mouth. This correction can be made dentally and makes a very big difference.

There are a variety of treatments for lips and they generally involve hyaluronic acid dermal fillers to recreate lost volume, although botox can also be used to modify the muscle movement. Fillers can redefine the vermillion borders, add volume, create symmetry, reduce or remove lipstick bleed lines and refresh the skin. Around the lips the corners of the mouth can be lifted to correct a ‘sad’ appearance.

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Botox can also correct downturned corners of the mouth and reduce fine lines around the mouth. A ‘gummy smile’ where the upper lip lifts in an unaesthetic way can be corrected with botox also.

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Lip care is as important as skin care, and as the skin of the lips is thinner than normal skin it is more vulnerable to dehydration. Most people have experienced dry and chapped lips at some time, especially in the winter. Hydration is particularly important and achievable in various ways. The most straightforward way is drinking water which is important for general hydration. Lipsticks contain emollients so are beneficial and lip balms are excellent, especially those with a sun protection factor (SPF) which are essential for time in the sun.

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egypt

A brief history of facial aesthetics

From the very depths of time appearance has always been an important part of people’s lives. Facial markings made from tree ash may have been used as long as 50,000 – 100,000 years ago, and all known civilizations have used some sort of make up to appear more beautiful, powerful or successful. The ancient Egyptians are known for the classical beauty of Queen Nefertiti and the well-known limestone bust of her is still used as an ideal for proportions and symmetry today.

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