From saggy eyelids to drooping jawlines: doctors share their non-surgical solutions

Heather Stephen

Considering a cosmetic procedure but don’t want to go under the knife? Well, these days there are plenty of alternatives. Top doctors give their top tips.

If you’ve started to notice your face is heading South as the years go by, chances are you’ll be looking for something to slow it’s progress. But is surgery the only option? In many cases, advancements in aesthetic medicine mean you can now turn back the clock without going anywhere near an operating table.

Dr Rupert Critchley, director of the Viva Skin Clinics chain in London, says non-surgical aesthetics “is really beginning to bridge the gap between surgery and non-surgery” with results, in some cases, on par with with their equivalent surgical procedures. One example he says is a non-surgical nose job (non-surgical rhinoplasty).

“And this kind of treatment, carried out by a trained, experienced clinician, can yield excellent results. … There is invariably less downtime [and less] complication risk. And treatments such as Botox and dermal fillers are non-permanent so if clients dislike the result they just have to wait for the filler or toxin to wear off, unlike with surgery which could mean going back for a corrective procedure.”


So what are the some of the non-surgical options available?

Problem: Whole face sagging

Dr Critchley recommends the ’24 point MD codes’ facelift for anyone over 35 concerned about the effects of gravity.


Before, courtesy Viva Skin Clinics

“The non-surgical facelift is a technique in which small amounts of dermal fillers containing hyaluronic acid are injected in certain parts of the face to improve volume and reduce deep set lines providing a lifting effect and more youthful appearance,” he says.

The procedure can lift the jawline, improves jowls, brightens the skin and reduces dark circles and eye bags too.

“Effects are immediate and last for up to 18 months,” explains Dr Critchley. “The procedure takes 45 minutes and you experience a slight pricking sensation similar to Botox. Some patients have slight bruising and mild swelling afterwards but these side effects subside after around seven days.”



Most people need two sessions spaced up to four months apart for optimum results and each session may cost upwards of £700.


After, courtesy Viva Skin Clinics

Is there anyone who shouldn’t have it?

According to Dr Critchley you should not have this treatment if you are allergic to hyaluronic acid and it should be used cautiously if taking blood thinning medications such as warfarin or aspirin as these increase your risk of bruising.

Will it suit everyone? No, says Dr Critchley. “If they have severe skin laxity or ageing problems which are beyond the realms of non-surgical correction then other options such as surgery should be considered.”


Problem: Turkey neck

Consultant facial plastic surgeon Kambiz Golchin from the Cadogan Clinic in London, says it is important to tailor treatments to the individual.

“Although we all have the same bones and muscles we are all different so assessment is key,” he says. “Whenever I see a patient I look at what they are hoping to achieve, the severity of their problem and their lifestyle to decide on the most appropriate treatment.

And when it comes to turkey neck he has two preferred options.

“We might suggest either Ultherapy and INTRAcel – highly focused ultrasound treatments combined with microneedling which tighten both superficial and deeper levels of the skin.

“Ultherapy lasts up to two years and INTRAcel between 12-18 months. The results don’t last forever but then neither does a face lift. And with these treatments there is no scarring or downtime and people don’t have to go through the anxiety of having an operation with all the risks involved.”




Ultherapy – Lower face and neck – £2,000 to £2,500.

INTRAcel – A course of three treatments is recommended 4-6 weeks apart. Prices range from £400 to £600 per treatment – so a facial rejuventation could end up costing upwards of £1600.


Who shouldn’t have it:

 -Ultherapy: Pregnant women should not have this treatment as the effects are not known on the unborn child. 

-INTRAcel: It’s advised that pregnant or breastfeeding women should not have this therapy nor should those who are using anticoagulant drugs, have keloid scarring, a skin infection, bleeding disorders, a skin malignancy or have a pacemaker.


Problem: Double chin

Dr Rita Rakus, who has a clinic in Knightsbridge, London, and is a founder member of the British College of Aesthetic Medicine, recommends CoolSculpting for chubby chins.

“This procedure freezes fat cells and dissolves them permanently within a period of the next three months,” she says.

But she always warns patients that they must watch their weight afterwards as they will still gain in other areas in exactly the same way as they did before. “It might not go back under their chin but could end up somewhere else … like their bum,” she says.

Dr Rakus says sometimes patients are left with loose skin after the fat has dissolved but she says this can be treated with radiofrequency or ultrasound treatments like Ultherapy.

“CoolSculpting takes 35 minutes and on the whole is a very comfortable procedure, but it is not a weight reduction treatment and should not be carried out if you are seriously obese as you would not notice any noticeable reduction,” she adds.




CoolSculpting – £600 to £800 for a small area.

Radiofrequency – the price will vary depending on which machine is being used and of course, the  individual clinic but you can expect to pay upwards of £2,500 for jaw and neck treatment.


Who shouldn’t have these treatments:

CoolSculpting is generally considered safe but is not recommended if you are severely overweight.

Radiofrequency –There isn’t anything to suggest this treatment is harmful for pregnant women but it’s probably best to wait until after you have given birth.

It’s not suitable for people with pacemakers or metal implants, heart valves or dental plates, as the RF current flowing through the body may interfere with the device or heat up the metal implants.


Problem: Sagging eyelids/eye bags

Dr Rakus uses various treatments to tackle signs of ageing around the eyes.

“I might try radiofrequency, lasers, PRP (where platelets are removed from your blood and reinjected back into your body to stimulate collagen) or Botox to tighten and lift crepey skin.

“All of these treatments last from three months (Botox) up to two years (radiofrequency). I talk to patients realistically about what I can achieve and 98 per cent of my patients are very happy with the results,” she says.

“These kind of treatments are perfect for people who don’t want any down time, may be nervous about surgery or just want to take preventative steps to look their best.”



Botox – £150 to £300 per treatment.

Laser treatment – £100 to £300.

Radiofrequency – £100 to £350.

PRP – Average cost £350 to £500 per session.


Who shouldn’t have these treatments:

Botox – If the injection site is infected, you are pregnant or breastfeeding or you have a neuromuscular disorder such as myasthenia gravis.

Laser – if you are prone to keloid scarring, have active herpes or skin infections such as impetigo you should avoid this treatment as should people who have photosensitive epilepsy or are light sensitivity. You should also avoid it if you have had isotretinoin in the last year. Darker or recently tanned skin may be unsuitable for treatment with some machines are also unsuitable as are people who are taking medications which increases photosensitivity.

Radiofrequency – as we said above, if you’re pregnant it’s probably best to wait until after you have given birth and people with pacemakers or metal implants such as heart valves or dental plates are not suitable as the RF current flowing through the body may interfere with the device or heat up the metal implants causing damage.

PRP – If you have sepsis, cancer, any infection, acute or chronic liver condition or are having anti-coagulant therapy. People with platelet dysfunction syndrome, critical thrombocytopenia, hypofibrinogenaemia and haemodynamic instability are also unsuitable candidates.

And it is not recommended if you are pregnant, breast-feeding, trying to conceive or have implants in the treatment area.

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