Confessions of a serial filler: the cosmetic procedure detox
As more and more celebrities opt to reverse surgeries and fillers, Meadhbh McGrath finds out how it's done
Now 80 years old, Jane Fonda is frequently heralded in the media as an 'ageless wonder'. What's her secret? Well, there's the healthy diet, the fitness routines made famous in her exercise videos... and then there are the facelifts.
The actress told The Guardian earlier this year, "They bought me an extra 10 years", and has previously spoken of the addictive nature of cosmetic procedures. "The danger with surgery is you say: 'Oh this is good, let me do more.' It can be an addiction," she said in 2015.
But now, in a new documentary about her life, Fonda has expressed regret at having given into pressure to stop the ageing process.
"On one level, I hate the fact that I've had the need to alter myself physically to feel that I'm okay," she said. "I wish I wasn't like that. I love older faces. I love lived-in faces. I loved Vanessa Redgrave's face. I wish I was braver. But I am what I am."
Fonda isn't the only A-lister to have second thoughts about surgery. Earlier this year, Kylie Jenner told fans she had "got rid" of her lip fillers, and in 2017, Courteney Cox admitted she had undone her facial fillers. In 2014, Victoria Beckham had her breast implants removed, and wrote in a letter to her younger self for Vogue: "Don't mess with your boobs."
But a reversal procedure isn't as simple as you might think.
"You can't reverse a procedure completely," says Dr Ahmed Ramzi Salman of Dublin's Auralia Clinic. "You can try to either bring people back to how they were before, plus a scar, or you can try to correct a procedure that was badly done."
'Getting rid' of fillers means getting an injection of an enzyme called hyaluronidase to dissolve the hyaluronic acid-based dermal fillers in lips, cheeks or elsewhere in the face. The treatment can cost between €150-€300, although Dr Salman warns that certain practitioners charge up to €600.
"Of late, unfortunately, a lot of people are chancing their arms with Botox and filler in little beauty salons or substandard clinics. Up to the last two years, maybe in a year we would dissolve one or two fillers that went wrong," Dr Salman observes. "Now, I'm doing two or three a month."
Dr Peter Prendergast, Medical Director of Venus Medical in Dundrum, has noticed a similar trend. "Fillers are categorised as medical devices rather than medication, so people can get them from beauty therapists, for example, who certainly wouldn't be able to deal with complications," he explains.
"We see people coming in with lumpy fillers, unsightly asymmetries or, even worse, sometimes the blood supply of the face can be compromised if the filler gets into a blood vessel. That's really an emergency, where the filler has to be immediately dissolved before you get a permanent scarring around the eyes or nose."
He says that in the past, fillers would have used liquid silicone or bio-alcamid (substances that are still prevalent in South American buttock injections), which can prove very dangerous if there's a delayed allergic reaction or an infection. They require surgery to cut out, leading to scarring and complications.
Modern treatments to remove facial fillers are not without their drawbacks, however - patients can be allergic to hyaluronidase, so will need to undergo a patch test first, plus the substance can potentially dissolve all filler, even if a patient only wants to remove a bit of it. If the patient wants to top it up, they'll have to wait a few days and start from scratch.
"It's kind of a false economy where people look around for the cheapest place to go, then end up spending more trying to correct it than they would have originally if they'd gone to a reputable clinic where there are more experienced doctors performing the treatments," says Dr Prendergast.
Now, many of the treatments Dr Prendergast offers are largely reversible. The notable exception is Botox.
"Once it's been injected, if someone has a problem like a drooping of their brow or eyelid, you just have to let it wear off," he says, a wait that can take up to six months.
A reversal can cost double the initial treatment, and the figure only grows in the case of liposuction or breast implants, which are particularly difficult to correct. On top of that, you'll have to wait three to six months for swelling to resolve before proceeding with any touch-ups or reversals.
And yet, 'botched' jobs haven't put people off.
"When you look at the statistics of the amount of fillers and Botox used worldwide, the numbers are actually going up," argues facial plastic surgeon Dr Kambiz Golchin of Beacon Face and Dermatolgy.
"What is happening though is that there has been a shift over the last few years and people want a more natural look. It's the same with anything else in life: at some point the pendulum goes too far right or left and at some point, it has to come back to the middle."
Of Jane Fonda, he says: "One of the things I always say to people is that timing is crucial. You can have things done too soon and the reality is that nothing is permanent in life."
Dr Golchin emphasises the importance of getting "the right procedure for the right patient at the right time".
"The effects of a facelift last about seven years, so if you have it done too early in life it's likely that you'll have to go back for a revision. Let's say someone is in their mid-40s when they get their first facelift. By the time they are in their early 50s, they are at their second and by the time they are in their 60s, they are at their third. At that point, it doesn't look natural anymore and that's part of the problem."
This is when you go past the tipping point, where smooth becomes immovable and plump skin becomes pillow cheeks. It's the 'too-far' face.
Back in 2015, when Kylie Jenner first admitted to having lip injections at the age of 17, her doctor, Simon Ourian, mused: "I saw a new trend of younger women who suddenly felt empowered to unapologetically want to look more beautiful." But the trend for super-sized lips seems to be gradually dying down, again spearheaded by Jenner.
"The Kylie Jenner [look], that doesn't suit everybody and, to some extent, that is the job of the practitioners and the doctors. They should be responsible about it and say, 'You're too young and you shouldn't be getting this at this point'," says Dr Golchin.
"There is an onus of responsibility for the doctors, but also for the patient themselves. They have to be mindful of these fashion things, because we know fashion changes."
But he warns: "There is no doubt about it - if you have too much of any of these procedures, that's not the right approach. It's not a good look and in fact it can make people look older rather than younger."
Additional reporting by Katie Byrne