REFRESH ISSUE 2 JUNE 2023

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How the MENOPAUSE affects your body & how to fight back

All you need to know about the latest HOLLYWOOD

MENOPAUSE SKIN

Head to toe, how menopause affects your body...

VITAMIN DRIPS

Soul singer Beverley Knight lets us in on the secret to her boundless energy...

HARLEY STREET PRESCRIPTIONS

From beauty ideas to surgical solutions, we answer all your questions...

BUCCHAL FAT

REMOVAL

The cheek of it!

The lowdown on Hollywood's latest trend...

Editor in Chief: Lesley Reynolds

Creative Director: Gino Tambini

Cover picture: Valua Vitaly / stock.adobe.com

ELCOME to the second edition of our magazine THE REFRESH. I’m delighted that over SIX THOUSAND of you read our first issue and I hope you all enjoy this one as much!

This month, we explain the benefits of the Vitamin Drip. Singing sensation

Beverley Knight is just one of our celebrity clients who swears by them.

Beverley does seems to have boundless energy for a woman of 50...

How does she describe it? ‘It feels like a surge of energy around my bloodstream,’ she said. ‘It knocks out the tiredness and my skin is brighter.’

What’s not to love about that!

I’ve had these injections, too. I find a course leading up to a big occasion, such as a wedding, can have an astonishing impact on my skin’s clarity and leaves me fighting fit from the first moment. Why not book in for a free consultation? And if you are tempted, prices start at £300.

Menopausal? Fear not. We tell you what your skin really needs for all those confusing and frustrating changes. In a nutshell, there are three essential rules - to protect, hydrate and nourish. On page 16, Dr Aamer and I answer all your questions. Please keep sending them in to Lesley@harleystreetskin.com. We give you the lowdown on Hollywood's latest trendBuccal Fat removal.

Plus we have another great offer for you.

See you next month,

Photos: Dmitry Ersler

Menopause and y TO LOO K

A F T E R

yourSkin YOUR S

Over the last few years, it seems every skincare brand under the sun has launched a product designed for the 50-plus age bracket, countering the effects of the menopause. But what does your skin really need ...

WHAT’S GOING ON?

Studies show that around 30% of our skin’s collagen is lost during the menopause, leaving skin lacklustre and less firm. With lower levels of oestrogen, our skin becomes thinner and the amount of melanin the body produces is less controlled. This causes age spots to appear and skin regeneration and repair to slow down significantly, while ageing processes are accelerated which causes sagging and wrinkles. We're also more redness-prone too during the menopause and the ceramides that act as cement in the skin barrier reduce making skin drier and often more irritated. So what can we do to help redress the balance...

LIFESTYLE SWITCHES

What you put into your body is even more important than what you put on it. Aim for a healthy, balanced diet that's rich in good fats, such as oily fish, flaxseeds, avocado, nuts and soy. Vitamin B intake is also crucial to skin health and helps with the hot flushes. What you eat can have a huge impact on your hormones - vegetables and fruit will provide your body with some of the great building blocks for hormone creation in your body as well as oily fish, nuts and soya. It’s vital to keep hydrated, ideally by drinking water or herbal teas. Avoid eating too much sugar or salt, which can exacerbate menopausal symptoms, such as loss of collagen and itchy skin.

Add a daily supplement, such as calcium, evening primrose oil or fish oils, which will help support the skin's barrier, while Vitamin D will help keep skin firm and aid its repair mechanisms.

Levels of friendly bacteria in the gut drop during the menopause causing sluggish digestion and bloating so try a daily probiotic drink or eating some live yogurt. Avoid drinking beverages that contain caffeine or alcohol, since these can make hot flushes more uncomfortable. Cut down on red wine, chocolate, and aged cheeses. They contain a chemical that can trigger hot flushes by affecting the brain’s temperature control centre

• Don’t smoke. Smoking can make flushes worse plus rob your skin of essential nutrition. It will also age you and your skin faster than anything else.

• Avoid hot showers. Because hot water can be harsh and drying, take shorter showers using warm water. Use gentle, non-irritating soaps and cleansers. Always moisturise after showers using rich body butter, as these are high in coconut oil, beeswax, and olive oils.

PROBLEM SOLVING

OILY SKIN

If you're having a greasy reaction to the menopause this is usually down to excessive oil production, as testosterone becomes more dominant and produces more oil.

Treat: Don’t be tempted to over wash or cleanse your face. as this can make things worse by activating further oil production, Use a milky cleanser, as this will dissolve dirt and debris without disturbing the barrier function or natural moisture levels of the skin. Choose a cleanser with BHAs (or salicylic acid), which will help unblock pores and keep spots at bay. Also be wary of using products designed for oily skin as some can be too harsh to use during the menopause using ingredients that sweep away every last drop of sebum from the skin. Steer away from products containing alcohols, astringents and sulphates, benzoyl peroxide and daily use of AHAs. Go for an old-school toner and don’t ditch the moisturiser – but go for a lighter formula with ingredients such as

THINNING SKIN

The skin’s support structure decreases during the menopause, causing slackness and sagging of skin.

Treat: Use targeted products with ingredients that increase collagen and elastin production, combat free radicals, and boost hydration. For lifting and plumping the most potent anti-ageing ingredients to include in your daily and morning skincare routine should be peptides to prevent sagging, a vitamin C serum and hyaluronic acid moisturiser to plump. Fight collagen decline in the evening with one of the best collagen boosters, Vitamin A found in a retinol product.

WRINKLES

Because of depleting collagen levels skin won’t have the bounce-back ability it once had meaning wrinkles become deeper and more pronounced. Give your skin a three-pronged attack, extra protection, extra nourishment and extra hydration. Look for skincare containing peptides, fruit stem cells, antioxidants and niacin. Layer your skincare. Start with a serum containing antioxidants like vitamin C or E, resveratrol, or green tea, which will also help boost radiance. Over that, layer your moisturiser – look for one containing hyaluronic acid to boost hydration or fragrance-free if skin is sensitive. Use a rich night cream or facial oil to replenish and treat the skin. Make sure you use it on your neck, chest and the backs of your hands. To boost collagen, use a prescription retinol serum or cream at night.

diminished levels of oestrogen but also triggered by environment and lifestyle factors, such as stress, hot temperatures, alcohol and spicy foods, making the blood vessels dilate, leaving skin blotchy and red. Treat: Use a green tinted camouflage cream or mineral make up to conceal and cover up redness and veins on the cheeks and around the nose. If you find that you’re flushing a lot, or your skin is staying red between flushing episodes, then your GP may prescribe an anti-inflam matory ointment or antibiotics that work in lower doses to reduce inflammation or a prescription drug brimonidine that helps targets skin redness of rosacea. It restricts the dilation of blood vessels that cause redness and the effects last 12 hours. When it comes to skincare, it’s all about calming and soothing the skin. Try the latest anti redness skincare ranges, designed to reduce redness. Other red-re ducing ingredients to look for are peptides, caffeine, and vitamin B3 (niacinamide), both of which are vasoconstrictors. Protect your skin by always wearing an SPF50.

MENOPAUSE SKIN

ACNE BREAKOUTS

It’s thought that 70 per cent of menopausal women suffer breakouts, due to fluctuating hormones, which leads to an excess of sebum production and also a change of the consistency of the sebum making it sticky and more likely to block the pores. Breakouts can also be part of a more complex hormonal condition such as Polycystic Ovary Syndrome, which leads to unbalanced hormones and overactive sebaceous glands.

Treat: The most important thing you can do is to have a good skin care routine.

Light or gel-like formulations are best and ideally the product should be labelled as non-comedogenic. Avoid products that contain lanolin, mineral oil, or petroleum, which block pores. Focus on exfoliating, not degreasing with at-home peels and gentle scrubs.

Use gentle, fragrance-free products and a regime that includes retinol during the evening and a weekly glycolic acid treatment, which can all help dissolve the dead skin cells and oil that block pores Use a light oil-free non-comedogenic moisturiser during the day and look for ingredients such as hyaluronic acid and niacinamide otherwise known as vitamin B3, which can act as a soothing anti-inflammatory. Seek expert advice if the condition becomes worse.

be less astringent on dry skin than soap or foaming washes. Invest in serums, moisturisers and masks with skin plumping ingredients, such as antioxidants and hyaluronic acid, to help counteract the loss of oil. Avoid harsh scrubs or over exfoliation, and ingredients such as benzoyl peroxide, alcohol and perfume which can be drying.

Svetlana Boriscova Valentina Shilkina/ Imagehub / peopleimages.com

VITAMIN DRIP

It takes a LOT of energy to be a successful singer, songwriter, actress, radio personality and wife! Here, the British soul sensation shares her secret to lookingand feeling - this good at 50...

BeverleyKnight

It knocked out the tiredness. I noticed my skin looked BRIGHTER and felt more hydrated and I just felt HEALTHIER

Feeling full of energy makes such a difference to your life in general. From how you look, how you feel and for me, how I perform on stage. Appearing nightly in a fast-paced show like Sylvia can take its toll and endless caffeine is not the answer.

So, what to do when you’re run ragged and need a speedy fix to overcome that feeling of extreme fatigue? My solution? A turbo charge of vitamins delivered directly to my bloodstream to rev up my sagging energy levels.

As my life is full on, it’s often hard to maintain a truly balanced diet, and I’m always forgetting to take a supplement so a regular IV infusion suits me down to the ground.

Dubbed ‘Vit Drips’ the treatment not only makes me feel full of get up and go, but my skin also looks revitalised and glowy. I swear

BeverleyKnight F U

into account what I needed. Working in the theatre and leading a pretty hectic life, I was really in need of a boost. After the first drip, within 90 minutes of leaving the clinic, I felt so full of energy. Dr Khan recommended a course of 6 at regular intervals to maintain a higher level of nutrition in the body and so I booked myself in for the following week.

“The only way I can describe it is that it felt like a surge of energy making its way around my bloodstream and it felt great. It knocked out the tiredness and I noticed my skin looked brighter and felt more hydrated and I just felt healthier. I really would recommend them to anyone who's just going and going and going and you know you're not gonna get a chance to stop to keep on an optimum level of health. It was just

Dr Aamer Khan mixes up a special bespoke concoction of energy boosting vitamins including Gluthathione, Vitamin B complex and Vitamin C to specifically target my fatigue. The whole process takes about 45 minutes or so

I am a little squeamish about veins, so I close my eyes as Dr Khan sets everything up but once the IV is in place inserted in the crook of my arm, I put my feet up and relax as the liquid elixir drains into my arm and works its magic.

Most of us associate having an IV with being in a hospital but, for me, it’s the opposite. I look forward to the rest! It takes a couple of hours for the effects to kick in and then I have energy, joie de vivre, mental clarity and even sleep better."

A N D

ULL OF E N E RGY

FSO WHAT EXACTLY ARE THESE WONDER DRIPS?

Says Dr Aamer Khan: Originally developed for cancer patients and used to treat premature babies and the malnourished, Intravenous (IV) Therapy or Intravenous Micronu trient Therapy (IVMT), is a treat ment method that uses nutrients such as vitamins ad minerals and administers these directly into the bloodstream typically through a vein in the arm.

The infusion I use for Beverley - an energy boosting cocktail cocktail containing glutathione, B12 and vitamin C to help repair, boost energy levels and increase the body’s metabolism – is mixed with a saline solution and slowly fed into the blood stream though an IV drip.

Vitamin drip can be more effective than taking vitamins orally as the body’s natural absorption process can render up to 85% of that vitamin useless.

When you receive an “IV” Vitamin drip the nutrients enter your bloodstream immediately to help the body to begin healing itself. You also get much higher concentrations of nutrients delivered directly to your body’s cells. Intravenous

DR AAMER SAYS: 80 per cent of skin ageing is caused by the sun’s UV rays due to collagen loss. Research also shows that prolonged sun exposure can cause collagen to break down at a higher and faster rate. It does this by penetrating the middle layer of the skin (dermis), causing the abnormal build-up of elastin. Enzymes are then produced which inadvertently break down collagen. Silhouette Soft will not only tighten loose and sagging skin but also boost new supplies of collagen. The 30-minute lunchtime procedure is carried out using local anaesthetic. Sutures, made from polylactic acid, are introduced into the skin through miniscule needle holes around the hairline so small they're not visible after the healing process. The sutures naturally dissolve over time, boosting the body's produc tion of collagen. Results are immediate but peak after around three months when new collagen has formed. From £999.

HARLEY STREET PRESCRIPTIONS

LESLEY SAYS: Two skincare ingredients are key to boosting collagen - retinol and vitamin C. Regular use results in smoother, brighter skin. Use vitamin C in the morning and retinol at night - I like La Roche-Posay Pure Vitamin C 10 Serum, £45 and Olay Regenerist Retinol 24 MAX Night Serum, £44, an investment but lasts months. The usual suspects - cigarettes and alcoholcan also cause collagen to break down, but you can tailor your lifestyle to naturally boost collagen from the inside out. Exercise, especially resistance training, has been found to boost collagen levels through growth hormone and fibroblast activity. Cortisol levels can contribute to decreased collagen stability, so try and keep your stress levels and sleep quality in check. Food like quinoa, salmon, beans, lentils, nuts, leafy greens, berries and citrus fruit will all help stimulate your skin’s collagen synthesis. Revive Collagen Tropical Flavoured Drink Supplement, £39.99, is worth trying; research shows taking 10,000mg hydrolysed collagen daily for 8-10 weeks helps to increase skin density and hydration. To prevent further loss, wear a minimum of SPF30 daily.

Years of sunbathing has left me with sagging skin, lines and wrinkles. A friend says it's collagen loss. Is there a way to reverse the damage and restore collagen?

Dr Aamer Khan and Lesley Reynolds from the Harley Street Skin Clinic share their advice on your biggest beauty dilemmas

La Roche-Posay Pure Vitamin C 10 Serum, £45

Olay Regenerist Retinol 24 MAX Night Serum, £44

80% of skin ageing is caused by the sun's UV rays

DR AAMER SAYS: Acne scars are caused by inflammation and damage to the hair follicle and its associated oil-producing gland. Deep-pitted scars can be treated with hyaluronic acid dermal fillers or injections using your own fat, which will even out and smooth indents. Results are immediate and can last for nine months to two years. Expect to pay from £350 for dermal filler treatment and up to £3000 for fat transfer. A course of chemical peels will even out skin tone. The concentration, type of peel and how many depends on the severity of scarring. The treatment can take up to 30 minutes and the peeling process usually lasts between three to five days after treatment. Depending on the level of peel you're getting, you may feel stinging or burning for up to 20 minutes. Expect to pay anywhere from £80- £1200 per peel.

LESLEY SAYS: Maintaining a good cleansing routine is key to keeping skin in check. Use a cleanser containing salicylic acid and works deep inside pores to dissolve oil and dead cells. Try La RochePosay Effaclar Micro-Peeling Purifying Gel Wash, £20. One of the most effective skincare ingredients is a green tea extract, also known as EGCG. Research has shown that this powerful antioxidant works at a cellular level to dramatically improve the appearance of scars. Try Science of Skin Rescue No. One, £18.99. Adding a retinoid at night will also encourage cell turnover for a more even skintone. Try BeautyLab Retinol Serum, £25. Food also plays a big part in the health of your skin so watch your diet. Seasonal fruits, vegetables and water are all ideal for flushing toxins from your skin. It’s also worth trying a zinc supplement, which can reduce inflammation and generate cell growth, helping scars to heal. But they can have side effects, so ask your health practitioner first.

Past acne breakouts have left me with scarring on my cheeks. Can I make it less visible?

LA ROCHE-POSAY EFFACLAR MICRO-PEELING PURIFYING GEL WASH, £20

SCIENCE OF SKIN RESCUE NO. ONE, £18.99

BEAUTYLAB RETINOL SERUM, £25

WARNING. READERS SHOULD TAKE THE ADVICE OF THEIR DOCTOR BEFORE ACCEPTING ANY ADIVCE GIVEN IN THIS COLUMN. GOT A QUESTION?

EMAIL Lesley@harleystreetskin.com

DR AAMER SAYS: Cellulite is bulging fat cells enveloped between layers of fibrous tissue and occurs when the underlying fat deposits begin to push through layers of collagen fibres. Onda Coolwaves is designed to zap fat, boost collagen and tighten loose skin at the same time. The procedure is non-invasive, quick and painless with no downtime. It uses a small hand piece that emits special ‘microwaves ‘ which target the fat cells and cellulite, while the heat produced tightens skin. Over the following weeks the treated fat is eliminated naturally by the lymphatic system. For best results a course of four treatments recommended, two weeks apart. From £1200 for 4 treatments.

LESLEY SAYS: Cellulite is more about the connective tissue under the skin, as well as lack of muscle tone. The stronger, more toned your muscles are, the better your body is at burning off excess fat. There’s no guarantee that losing fat helps. In fact, drastic weight loss can cause sagging skin, making the condition worse. That said, some foods contain ingredients thought to help decrease the dimpled appearance. Asparagus is said to help strengthen veins and capillaries, while oranges can improve circulation and strengthen capillaries. Pears helps reduce the effects of pollutants in the body, and pineapple has an anti-inflammatory action that can help fight fluid retention.

A body brush helps encourage lymphatic drainage. Use on dry skin sweeping up from the ankles to the tops of the thighs. After showering, apply Clarins Contour Treatment Oil, £44, whilst skin is still damp to help the elimination of toxins.

Although I exercise regularly, I just cannot shift my cellulite. What can I do to improve its appearance?

CLARINS CONTOUR TREATMENT OIL, £44

Dubbed Hollywood’s ultimate secret weapon, Lesley Reynolds reveals everything you need to know about the hottest cosmetic surgery trend

THE TRUTH ABOUT

Buccal removal fat

THANKS TO THE SOARING POPULARITY of the angular, sharp-cheeked look made famous by the likes of Bella Hadid and Chrissy Teigen, Buccal-fat-removal (pronounced ‘buckle’) has become the most talked-about cosmetic procedure in recent months. Described as 'permanent contour' it helps to enhance your cheekbones and sculpt your face, But the so –called ‘chubby cheeks’ surgery may not be suitable for everyone. Here’s what you need to know

WHAT IS BUCCAL FAT?

Buccal fat pads are the deposits of local fat, which sit on top of the buccinator muscle (the portion of the face between the bottom of the cheekbone and the corner of the mouth).

They’re responsible for the rounded soft jaw shape and serves as a cushion between two of the chewing muscles: the buccinator and masseter muscles.

SO WHY HAVE SURGERY AND WHAT’S INVOLVED?

Removing the buccal fat is purely cosmetic, resulting in a slimmer, more chiselled appearance to the face. It’s usually performed under local anaesthetic, sometimes with sedation, and removes some of the mid facial cheek fat either via small incisions inside the mouth, or it can also be carried out using a micro suction method through small incisions, the tissues are also heated with radio frequency to induce skin tightening. The procedure takes between 30 minutes to one hour and best results are usually seen around three to four weeks later once swelling has subsided. The procedure it costs around £2500

WHY IS IT SO POPULAR?

With nearly 300 million views of videos tagged ‘buccal fat’ on TikTok, social media is a large driver of its sudden popularity. Back in September 2021, Chrissy Teigen started the trend when shared that she had had buccal fat removal on her Instagram account. Now, it’s become a viral phenomenon to speculate which other celebrities may have had the procedure and more and more users are also documenting their own experience and results.

The obsession with creating a "narrower, slimmer silhouette" may also stem from "selfie culture," in which people are constantly staring at a distorted reflection of the way they look.

WHO IS IT SUITABLE FOR AND WHO SHOULD AVOID IT?

CAN BUCCAL FAT GROW BACK?

The short answer? No. Other than experiencing weight gain, which may alter a facial structure in other ways once buccal fat has been removed, it is permanent.

Whilst we all strive for a bit of youthful plumpness, too much fullness in the cheek area can leave the face looking puffy and hamster-like. In fact, many patients with “chubby cheeks” are simply born with excess facial fat in their face so the procedure can reduce the appearance of lower cheek fullness. The benefits include losing the baby-face’ look,” leaving a more defined structure. The other benefit is that there is no scar on the outside; the scar is inside the cheek so it is hidden from view. But anyone considering the surgery should be sure that any fullness in the cheek area is due to the buccal fat pads, and not the masseter muscles, which is when that muscle of the jaw increases in size often secondary to teeth grinding or jaw clenching. The only way of knowing is to be examined by an experienced doctor or surgeon. Another factor to remember is that as we age, we tend to lose midface volume anyway so if performed when too young the procedure may make you look too gaunt by the time you are in your 30s and 40s. Also, people with narrow faces and those who are above a certain age are usually not suitable.

DOES BUCCAL FAT REMOVAL MAKE YOU AGE FASTER?

Buccal fat removal isn't without controversy. Sceptics argue that removing that small piece of fat may contribute to a greater degree of facial sagging with age since buccal fat does help fill out areas of the face that can begin to look sunken with age. Also looking very hollow can actually make you look older which is why it is important to see an experienced doctor.

WHAT ARE THE DOWNSIDES?

There are of course risks to any procedure although buccal fat removal is a relatively safe procedure, in experienced hands. However, unlike lip or cheek fillers it is not reversible and results are permanent, meaning, it doesn’t ‘wear off’. You should be 100 per cent sure of your decision before undergoing the procedure. Complications can include prolonged swelling, bleeding, bruising, and infection and rarely but not unheard of, damage to the saliva duct if the incision is too high. It's also possible to end up with cheek asymmetry if more fat is removed on one side than the other, or if too much is removed resulting in a sunken look. It is vital to go to an experienced practitioner or surgeon.

Photos: Denis Gladkiy