Our recent infographic on What’s big in the cosmetic industry highlights the increasing trend for dimpleplasty, a quick and minimally invasive surgery that has tripled in popularity in recent years. Although dimples are actually a genetic medical deformity, they are in many cultures considered a sign of beauty, good luck and prosperity. In the western world, the continued popularity of dimpled celebrities has undoubtedly fuelled this trend, with Cheryl Tweedy possibly taking the dimple queen crown but closely followed by the likes of Katy Perry, Beyonce, Harry Styles and Ariana Grande to name a few.

But what does dimpleplasty entail? A muscle inside the cheek, known as the buccinator, is naturally indented in individuals who have dimples. The appearance of dimples can be formed by creating a defect in that muscle to surgically create dimples. The surgery only takes about 30 minutes and can be performed under local anaesthesia. Unlike some more invasive procedures, the patient should only experience minimal swelling afterwards and no noticeable stitches or a need for bandages.

Requests for dimpleplasty may have increased in part due to the ease of the procedure, the relative affordability and the lack of downtime afterwards. But surgeons have also noted the popularity of selfie photos and the impact of celebrities on this trend.

So, who is doing it? The key demographic seeking this procedure is women of the millennial generation, between around 22 and 30 years of age. Often heavily influenced by celebrities, women in this demographic are also keen to appear forever young and dimples have long been associated with youth. In some cases, patients like the idea of dimples because they work well with the overall proportions of the face. But in many cases, the rise in demand for dimples will simply be that dimples happen to be ‘in’.

Whilst dimpleplasty surgery is certainly less invasive than some other cosmetic interventions, it does nonetheless carry risks that could result in deformities that would be very difficult to correct. Thorough training and a clear understanding of the end result that the patient is seeking are essential, otherwise dimples could turn out to be overly dramatic, unnatural or in the wrong place, resulting in a dissatisfied patient and a potentially expensive insurance claim against you.


Cellulite affects up to 85% of adult women and can be extremely difficult to correct. Many treatments are ineffective or take multiple sessions to complete with very temporary results. “Orange peel skin” or “cottage cheese” affects all body shapes and sizes, from the slim to the full-figured.

It is common to confuse the concept of cellulite with that of normal fat and assume that cellulite is a direct response to overeating or lack of exercise. However, this is not the case. Normal fat and cellulite respond very differently to diet and/or exercise. When you diet, your body automatically burns its own reserves of stored fat. But cellulite is fat that is trapped in the dermal layer of skin and the body cannot effectively process it as fuel, so it remains.

Given the perplexing nature of cellulite, how can it be treated? Fortunately, there are a number of options available. Topical creams contain retinol or caffeine that can increase blood flow to the affected area, thus temporarily reducing the appearance of cellulite. Rollers (like Endermologie) can similarly reduce swelling and inflammation in the affected tissues and temporarily reduce the appearance of cellulite. Radiofrequency devices (e.g., BTL Vanquish, Thermi) can reduce the connective tissue in the affected area and increase blood flow to reduce the appearance of cellulite. However, each of these approaches is limited by the fact that the results are reversible and may only last weeks, days, or even hours. Similarly, they can only address relatively minor areas.

For more significant dimpling and for permanent results, patients require more intensive treatment. Liposuction and/or fat grafting can improve the appearance of cellulite in properly-selected patients. But for the best results, techniques that are specifically designed to treat cellulite are most often the best. Laser therapy (e.g., Cellulaze, CelluSmooth) works by placing a small laser probe under the skin through small stab incisions. The laser then specifically melts that fat and cuts through the fibrous bands that cause skin dimpling. These treatments require a single session and show immediate results. However, they do cause significant bruising and swelling, and can require touch-ups yearly.

Cellfina is the development for the treatment of cellulite. The treatment targets the fibrous bands which are the source of the dimpling in cellulite. It is most effective for the treatment of deep dimples and depressions of the buttocks and back of the thighs. It is less effective in the treatment of generalized waviness. To perform the procedure, a vacuum hand piece is placed over the dimpled tissue through which the surgeon will deliver a local anesthetic. Then a small, needle-like microblade is inserted to release the fibrous bands causing the cellulite. Investigational studies for Cellfina show a patient satisfaction rate of 85% at 3 months, 94% at one year and 96% at 2 years. This is a very exciting solution for the many women who suffer from the embarrassment of cellulite.

As always, it is essential that patients have an in-person consultation to develop a treatment plan that specifically addresses their personal surgical goals anatomy. I recommend that patients find a board-certified plastic surgeon with whom they are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your plastic surgeon and review before and after pictures of similar patients whom have had this procedure.


Which is better for your goals?

A healthy diet and consistent exercise are commonly touted as the fail-safe formula for achieving a slim and toned physique. While diet and exercise are indeed essential to health and wellness, many people discover that despite a strict diet and consistent exercise, certain areas of their body are resistant to change. For individuals unable to achieve their aesthetic goals by conventional means, a suitable surgical or nonsurgical fat reduction procedure may offer auspicious resolve. While liposuction remains the gold-standard surgical treatment for excess subcutaneous fat, nonsurgical treatment options, such as cryolipolysis (aka CoolSculpting), continue to gain popularity among patients seeking less invasive measures. While both liposuction and CoolSculpting have proven to be effective in reducing adipose tissue and improving body contour, these two cosmetic procedures are, in fact, very different.


Liposuction is one of the most commonly performed surgical procedures in aesthetic plastic surgery. According to ASPS Statistics, liposuction was the second most popular cosmetic surgical procedure in 2016, with over 235,000 procedures performed in the United States, alone. Liposuction is a surgical approach to removing excess subcutaneous fat and improving body contour. During a liposuction procedure, a plastic surgeon makes one or more very small incisions in targeted areas of excess fat. A long, narrow suction tool called a cannula is inserted though the incision(s) and functions to remove fat from the targeted treatment area. Depending on the number of body areas treated and the amount of fat removed, liposuction may be performed under general anesthesia, local anesthesia, or under sedation. Liposuction effectively treats a wide range of body regions and is commonly performed for fat reduction in the abdomen, waist, back, hips, buttocks, thighs, knees, upper arms, chin and neck.


From 2015 to 2016, nonsurgical fat reduction procedures increased by nearly 6%. CoolSculpting is a noninvasive, FDA cleared device that uses cryolipolysis technology to reduce localized subcutaneous fat. The device uses a vacuum applicator to deliver controlled cooling at the surface of the skin. By exposing fat cells to a critically low temperature, the CoolSculpting device induces crystallization and subsequent cell death in targeted fat cells. CoolSculpting is currently indicated for use in the submental region (“double chin” area), thighs, abdomen and flanks.

Which option is right for me?

When choosing between liposuction and CoolSculpting, the prospective patient should consider a few key questions:

What are your treatment goals?

  • The CoolSculpting device is designed to treat focal pockets of fat. For patients seeking a nonsurgical method to reduce fat in a localized area, such as in the love handles or outer thighs, CoolSculpting may be the appropriate treatment. Patients undergoing a CoolSculpting procedure should expect mild to moderate improvement in the area being treated. It is important to note that multiple treatment sessions may be necessary to achieve the best results. The number of necessary treatment cycles is dependent on the treatment area. Additionally, patient should understand that the results of CoolSculpting are not immediately noticeable. Changes in the treated area may become apparent as early as three weeks after CoolSculpting, and the most dramatic results can be seen one to three months after treatment. Your body will continue to process the injured fat cells from your body for approximately four months after your procedure.
  • For patients looking to treat excess fat over a larger area of the body or for patients desiring a more dramatic change in body contour, liposuction may be the more suitable choice. Liposuction is a more aggressive treatment option and allows for more fat to be removed during a single session. Further, liposuction can be performed in conjunction other surgical procedures, namely autologous fat transfer, for patients that desire more extensive body contouring. The fat that is extracted during liposuction can be reinjected into areas of the body where more volume is desired, commonly the breasts, buttocks and face. As opposed to CoolSculpting, an overall reduction in fullness and improved contour is noticeable within days after the procedure.

How long is the recovery period?

  • CoolSculpting is a nonsurgical procedure and, as such, offers patients a quick recovery, minimal associated discomfort and a low risk of complications. Typically, patients can resume normal activities immediately following the procedure. Occasionally, patients will have experience redness, minor bruising, tingling, numbness or discomfort in the treated area. These signs and symptoms can be expected to resolve quickly.
  • Following liposuction surgery, the recovery is relatively quick. Patients can typically return to work and resume most normal activity within a week of surgery. Swelling, bruising and numbness are common after liposuction and will subside over the weeks to months following surgery. It takes several months to one year to see the final results of most surgeries, as the body continues to make adjustments for up to a year after surgery. However, within days after liposuction procedure, you will notice an overall reduction in fullness and improved contour. It is important to note that the recovery is dependent on the amount of fat removed and the number of areas treated.

Are you a good candidate?

  • The ideal candidate for CoolSculpting is in good physical health, exhibits localized fat deposits and minimal skin laxity and has realistic expectations of the procedure. Patients considering CoolSculpting treatment should have expectations of mild to moderate improvement and understand that it is not designed for weight loss.
  • The ideal candidate for liposuction is in good overall health, exhibits excess fat deposits and has realistic expectations about the procedure. Liposuction is best suited for patients with minimal skin laxity as liposuction intervention can exacerbate the appearance of loose skin in the targeted treatment area. Discontinuing the use of any tobacco/nicotine for several weeks before and after a liposuction procedure is essential as tobacco/nicotine use can impair the healing process and increase the risk of complications. During the surgical consultation, you will discuss your aesthetic goals with your surgeon and your surgeon will determine whether liposuction is a good option for you. It is important to note that liposuction is not a substitute for proper diet and exercise and it is not an alternative to weight loss or a treatment for obesity.

Ultimately, the most appropriate treatment option is that which aligns with the aesthetic goals and individual preferences of the patient. Consulting with a knowledgeable board-certified plastic surgeon to discuss your aesthetic objectives is, undoubtedly, the best way determine which procedure is right for you.


My Lip Filler Experience

I have been having lip fillers for the past 5 years *Shock Shock Horror*. Yes, thats right, before the Kylie Jenner lip obsession began! However, over the past few weeks people over my social media channels seem to have only started to notice since my last procedure. If you scroll through my YouTube or Instagram you will find the odd photo/video here and there of me with a larger pout but theres not many and none of my viewers noticed back then. The reason why there won’t be many photos/videos of myself with juicy lips despite having them done over the past 5 years is because the product never lasts very long on me. We’ve decided it could be that I have a fast metabolism so break down the product really fast or perhaps I didn’t use enough product for the desired result.

^ A couple of days after my first lip filler experience in 2010, I loved how they looked but they were still swollen. Side note, how orange do I look?! And those brows…urgh!

For years I went to a local clinic and would have 1ml of filler. I tried a product from Restylane, which now doesn’t exist, which lasted the longest out of all the products I had used. However, since that particular filler went off the market I have tried numerous products from Juvederm which only lasted for a very short amount of time, making it not worth the money. I tended to like the look of my lips when they were first done which meant they were still swollen. Therefore, by the time the swelling went down they weren’t much bigger than how they started, which is also a reason they probably didn’t seem to last too long.


Back in November I visited Dr Sarah Tonks at The Lovely Clinic inside Omniya in Knightsbridge, London. After a warm welcome we discussed the kind of look I wanted. I mentioned that filler doesn’t seem to last as long on me as it usually does on most people. Sarah explained to me how filler works and the different types we could try. Finally we decided to give 2ml of Juverderm Voluma a go as it is a stiffer, more robust product. This filler isn’t usually used in the lips so you must go to a Dr who knows exactly what they are doing when using this product. If you have the same issues as me please don’t just go to anyone if you want to try this product. I then had numbing cream applied. Sarah doesn’t always usually apply numbing cream unless requested by the patient, because the needle was a little bigger with Voluma I definitely wanted to be as numb as possible. The numbing cream she used was amazing and after no more than 10 minutes I was numb. The injections were all around the edge of the lip and the worst area for pain was, and always is, the cupids bow. Even with the numbing cream my eyes still watered a little when the needle went in there. After giving my lips a massage we were finished. I left the clinic feeling satisfied but Sarah mentioned that she would like to see me in a couple of weeks to check everything was perfect. Once the numbing cream wore off my lips started to ache but were fine by the next day. My lips gradually got more swollen as the evening went on and by the next day they were even more swollen but this wasn’t cause for concern at all. After a few days the swelling started to go down but it took a little longer than usual because of the product we used.

A couple of weeks past and I headed back to London for my check up. This time Sarah noticed a little bit of asymmetry , I didn’t notice but she’s the expert. My lips are naturally wonky so I want this corrected when having fillers but this is hard to get 100% correct at first because of the swelling so its always good to re-evaluate once the swelling has gone. She decided she wanted to inject a little bit of Juvederm Volift which would help feather in the Voluma making the lips softer. I know it seems like I have had a lot of product , almost 3ml, but I am so happy with the results. Hopefully going the extra mile and using a stiffer product will make the filler last longer.

Juvederm Voluma lasts up to 18 months and Volift lasts up to 14 months but doesn’t tend to last as long in the lips. However, once you have had filler you get new collagen formation in that area making the product semi-permanent rather than temporary – although this never seems to be the case for me.

I’ve had such a mixed reaction over my social media platforms about my lips from ‘your lips look perfect’ to ‘no need to change your lips’ – but we’re all different. If I want to do something to myself and it doesn’t harm me or anyone else I don’t see what is bad about it. Sometimes I think people forget that I am a human and I do read all of my comments. After 5 years of having my lips done I just love how they look but it doesn’t mean I’m not comfortable in my own skin when the filler wears off. Do what makes you happy! Cosmetic procedures can make such a positive difference to someones life but you have to be 100% sure you want something done for the right reasons. Always do your research and make sure you find an amazing Dr to carry out the procedure.


^Top-bottom; Before, straight away first appointment & straight after second appointment



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