Is having ‘tweakments’ cheating? Mixed messages are causing misery says Dr Mayoni

I long ago realised the extent to which women just put up with stuff. Although I’m now an aesthetic surgeon, I started out in a very different sector. My professional career began in medical surgery and I specialised in fecal incontinence and pelvic floor dysfunction. In my work I encountered women who had not received medical help after suffering birth trauma and for years had struggled on, suffering pain during sex and incontinence. It was a real OMG moment to realise how much they had endured, suffering in silence.

Eventually the stress and overwork of my job led to a rethink. I started looking at alternative careers and aesthetic surgery was one of them. Initially I thought “Botox and fillers? This is so beneath me, how awful, I would never want to make a women look a certain way”. But I did the training, and once I started working with my first few patients and opened my clinic it was the most incredible thing – a revelation. How just a small tweak could make all the difference to how they felt about themselves, because instead of looking tired and weary they looked their best self.

These women were mums returning to work who just wanted to look and feel good. And yet the overwhelming message from all of them was ‘I shouldn’t be here, this is terrible, I’m spending money and time and I shouldn’t be… But I’m so sick of looking and feeling tired and awful and I’m returning to work and will be surrounded by 20 year olds and I don’t want to feel crap”. 

Having botox and fillers is not about wanting to look like a certain person, but looking and feeling your best self. However the guilt about having treatments and spending money to do this is all-pervading. Even down to having separate bank accounts for this kind of thing so it doesn’t show up in their statements and their husband or partner remains oblivious. Some come in with cash so they can ‘hide’ the expense. They literally go out the back door so no one can know what they’ve been in for.

The reasons for the guilt are complicated. As women we get these constant mixed messages. While youth is celebrated, inexperience and naivety are not when it comes to the work place. What employers want is the benefits of someone who looks youthful but with the skill base of someone who’s done a lot more. And I think some women have this weird dichotomy in their heads – the sense that how they look should be ‘enough’, yet society and the world of work judges them for looking their age. 

And there’s also guilt about admitting to themselves and their partner that they’re spending money and time on themselves. Clients who come in for botox and fillers will say ‘Oh God my husband’s worried I’m going to run off with someone else. They don’t understand I’m doing this for me’.

Some women fear that by having treatments they’re somehow cheating, letting the side down when it comes to their friends and peers. While a lot of my patients come through referrals, many really don’t want their friends and family to know. There’s almost a shame in it. I was at a party recently and I knew most of the women there and many didn’t want to acknowledge me. Because they had been to me for treatments and didn’t want their friends to know how come we were already acquainted.

In the last couple of years I have seen a shift in views on these treatments into a more positive light. And I do understand the initial negativity. When I first contemplated injecting Botox I thought oh God this is horrific, but when I saw the difference I was making in a really subtle way to a patient’s life I realised it’s really rewarding. In my previous career I’d never see the patients again, but because I see these people more regularly I get so much satisfaction from it. The rewards they show me are life changing. 

All of this flies in the face of the belief that we should be good enough and look the age we are.

I too struggled with this, but actually there is a lot of research that looks at certain expressions and lines that convey a certain emotion. Studies show a demonstrable decrease in depression scores in patients suffering with depression looking in the mirror at their face before and two weeks after their botox treatment. So that shows that how we look and how we feel inside are very closely linked. 

My patients aren’t depressed – it’s a widespread issue. There are certain lines in the face that convey a certain emotion, like the ‘elevens’ lines between the eyebrows. They don’t necessarily make you look older, but grumpy and tired. When you soften those it means your natural features are brought into focus. 

Understanding ageing helps with rationalising it. Ageing means volume loss in the cheek area and this results in a massive drop of the fat pads under the eyes which manifests as hollowing or tiredness. So by using repositioning fillers you’re making people look fresher or more awake. I’m not necessarily going to make you look younger. Ageing isn’t about lines and wrinkles, it’s actually about volume loss and the emotion that your face is conveying. I try not to eradicate every line, it’s a ‘tweakment’ and it’s about softening the edges a little bit. What I try not to do is just focus on a line or wrinkle. I don’t just treat the line but the skin too, via non-injectable treatments to soften lines and refresh skin.

The fact is, looking old is just not acceptable in some sectors and the concept of what is an ideal way to age is controversial. But the focus is shifting. Instead of wanting big lips and an ‘unreal’ look, many patients are saying “I want to look a bit fresher. I want to look well. I want to look rested”. We don’t need to put up with something that’s making us unhappy. If it matters to us, we should stop beating ourselves up about wanting to look our best selves.

Words: Marina Gask. www.drmayoni.co.uk

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