It's the most requested aesthetic treatment in the world. It's been around for decades. And yet it remains one of the most misunderstood, most feared — and most spectacularly misused — procedures in medicine. Let's talk about it honestly.

I've been injecting anti-wrinkle treatments for over twenty years. In that time I've seen extraordinary results — and I've seen the kind of results that follow someone around for months, frozen into an expression that doesn't quite belong to them. The difference between those two outcomes isn't the product. It's the person holding the syringe.

What anti-wrinkle treatment actually does

Botulinum toxin — the active ingredient in anti-wrinkle treatments — works by temporarily blocking the signal between a nerve and a muscle. When that muscle can't contract with full force, the overlying skin relaxes. Lines soften. The face rests into a more composed, refreshed expression. It doesn't fill anything, plump anything, or change the structure of your face. It simply — and elegantly — reduces the muscular activity that causes certain lines to form.

The science is well-established. Botulinum toxin has been used in medicine since the 1970s, initially for neurological conditions, and in aesthetics since the late 1980s. The licensed products available in the UK have extensive safety data behind them. Used correctly, within appropriate dose ranges, by a qualified prescriber — it is one of the safest treatments in aesthetic medicine.

Why the frozen look happens — and how to avoid it

The "frozen" look that people fear isn't an inevitable side effect of anti-wrinkle treatment. It's the result of too much product, placed in the wrong areas, by someone without sufficient anatomical knowledge. The face is extraordinarily complex — every patient has different muscle anatomy, different depths, different movement patterns. What works beautifully for one person can look completely wrong on another.

In my clinic, I always start conservatively. I would rather see a patient back in two weeks for a small top-up than over-treat on the first visit. I spend time watching how someone moves their face — how they smile, frown, raise their eyebrows — before I consider picking up a syringe. That assessment is as important as anything that happens after it.

What you should expect

A good anti-wrinkle treatment should be almost undetectable by anyone who doesn't know you very well. You should look rested, refreshed, quietly composed. Your expressions should remain entirely natural — you should still be able to frown, raise an eyebrow, smile fully. Movement is what makes a face human. The goal is to soften it, never to eliminate it.

Results typically begin to show within three to five days and are fully visible at two weeks. Duration varies — most patients find their results last three to four months, though with regular treatment over time, many find they need less product less frequently as the muscles gradually reduce their activity.

Is it right for you?

Anti-wrinkle treatment works best on dynamic lines — the lines caused by repeated muscle movement, like frown lines between the brows, forehead lines, and crow's feet. For static lines (lines visible even at rest), or for loss of volume and structure, other treatments may be more appropriate — or complementary approaches may be needed. This is exactly why a proper consultation matters so much. The treatment should follow the assessment, not the other way around.

If you've been curious about anti-wrinkle treatment — or if you've had it before and weren't entirely happy with the result — I'd encourage you to come and talk. Twenty years of experience means I've seen almost everything, and I'm always honest about whether something is right for a particular person.

The difference between a great filler result and a bad one isn't visible in the product — it's visible in the face. One looks like the person, only better. The other looks like something was done. Lee explains why that distinction is everything.

Facial ageing is not simply about lines. It's about loss. Loss of volume in the cheeks, the temples, the lips. Loss of definition along the jawline. Loss of the structural scaffolding that gives a young face its lift and its light. Dermal fillers, used thoughtfully, can restore what's been lost — quietly, naturally, and without anyone quite being able to put their finger on why you look so well.

What fillers are — and what they aren't

The fillers I use at the clinic are based on hyaluronic acid — a substance that occurs naturally in the body, particularly in the skin and connective tissue. It has an extraordinary capacity to attract and retain water, which is what gives it its volumising and hydrating properties. When injected into specific areas of the face, it restores fullness, lifts contour, and hydrates the overlying skin from within.

Crucially, hyaluronic acid fillers are fully reversible. If a result isn't quite right — or if a client simply changes their mind — the product can be dissolved with an enzyme called hyaluronidase. This safety net is one of the reasons I'm comfortable recommending these treatments: nothing is permanent, and every outcome can be adjusted.

Where fillers work — and where they don't

Fillers work brilliantly for volume restoration — replacing the fat pads that naturally diminish with age, lifting the mid-face, defining the jawline, softening the nasolabial folds. They work beautifully for lip enhancement when done with restraint and an understanding of proportion. They can transform the under-eye area — one of the most delicate and technically demanding sites to treat, but one of the most rewarding when done well.

Where fillers don't work — and where I'll always say so — is when skin quality or laxity is the underlying issue. Putting volume into skin that needs tightening or resurfacing rarely gives a satisfying result. This is why a comprehensive assessment matters so much. The right treatment in the wrong place helps nobody.

The question of how much

Less is almost always more. I build results incrementally — a subtle improvement that can be built upon is infinitely preferable to an overcorrection that needs managing. New clients are always treated conservatively on their first visit. Trust is built over time, and so are the best aesthetic results.

The aim is always to enhance the features someone already has — not to impose a different face onto them. The most beautiful results I've achieved in twenty years of practice have been the ones where the client looks exactly like themselves, only with the volume, definition and vitality of a younger version. That's the benchmark I hold every treatment to.

There are treatments that improve how your skin looks. And then there is BBL — a treatment with clinical evidence showing it can actually change how your skin ages at a genetic level. That is not a marketing claim. It is peer-reviewed science. And it is extraordinary.

BroadBand Light therapy has been around for years, but the HEROic platform represents a significant leap forward. HERO stands for High Energy Rapid Output — and the technology delivers exactly that. Greater energy, faster treatment times, and outstanding patient comfort, all without compromising on results. It's the reason BBL HEROic has become one of the treatments I'm most enthusiastic about at the clinic.

The science that changes everything

Stanford University researchers studying the Forever Young BBL protocol made a remarkable discovery. Patients who received regular BBL treatments didn't just look younger — their skin's genetic expression patterns began to resemble those of younger skin. The genes associated with ageing were being downregulated. The genes associated with healthy, youthful skin were being upregulated. The skin was, in a measurable biological sense, getting younger.

This is what separates BBL from most other light-based treatments. It isn't simply treating what's visible on the surface — it's communicating with the skin at a cellular level, triggering a regenerative response that compounds over time with repeated treatments.

What BBL HEROic treats

In practical terms, BBL HEROic is exceptional for pigmentation — sun spots, age spots, uneven tone — as well as redness, broken capillaries, rosacea, and the general loss of clarity that comes with years of UV exposure and environmental stress. It works across all of these simultaneously, which is part of what makes it so efficient.

The HEROic platform's higher energy output means treatments are faster and can cover larger areas in a single session. The integrated cooling technology keeps the skin surface comfortable throughout, making the experience significantly more tolerable than older BBL platforms while delivering superior clinical results.

Who is it for?

BBL HEROic is suitable for a wide range of skin types and concerns, and it works beautifully as both a corrective treatment — addressing specific pigment or vascular concerns — and as a maintenance protocol, keeping skin in the best possible condition year on year. I recommend it to clients across a wide age range, from those in their thirties wanting to maintain what they have, to those in their fifties and sixties looking to significantly improve skin quality.

A thorough skin assessment is always the starting point. During a consultation, I'll assess your skin tone, your specific concerns, and your lifestyle — including sun exposure habits — to establish the most appropriate BBL protocol for you.

Most laser treatments ask something of you. A week of redness. Days of peeling. A period of hiding. MOXI asks almost nothing — and in return delivers the kind of skin improvement that used to require a much bigger commitment. It has quietly become one of my most recommended treatments.

MOXI is a non-ablative fractional laser — which means it works by creating thousands of microscopic treatment zones within the skin, triggering a healing response that generates new collagen and improves skin texture, without removing the surface layer of skin entirely. The result is meaningful improvement with a recovery time that, for most people, amounts to a day or two of mild pinkness.

What MOXI addresses

MOXI works beautifully for pigmentation — early sun spots, uneven tone, the general dulling that comes with time and UV exposure. It improves skin texture, reduces pore appearance, and stimulates collagen production that continues to deliver results for months after each treatment. It's particularly effective for the kind of early-to-mid-stage skin changes that haven't yet reached the point where more aggressive interventions are needed.

This makes it an ideal maintenance treatment — the kind of thing I recommend clients build into their routine two to four times a year, keeping their skin consistently ahead of the ageing curve rather than playing catch-up. Prevention, in aesthetics as in medicine, is far easier than correction.

MOXI and BBL together

One of the most effective protocols at the clinic combines MOXI with BBL in a single treatment session — known as the MOXI BBL combination. BBL addresses pigment and vascular concerns at the surface level while MOXI works deeper in the skin to stimulate collagen and improve texture. Together they address the full spectrum of skin quality concerns, and the combined results consistently exceed what either treatment achieves alone.

For clients who want to make meaningful improvements to their skin quality without significant downtime or recovery, this combination is among the most powerful tools available in non-surgical aesthetics today.

Who is MOXI for?

MOXI is suitable for most skin types and is safe year-round with appropriate sun protection. It works well for clients in their thirties and above who are beginning to notice the early signs of sun damage and ageing, and it works equally well as part of an ongoing maintenance programme for those who want to preserve excellent skin long term. As always, a proper consultation is the starting point — I'll assess your skin, discuss your goals, and recommend the most appropriate treatment schedule for you.

It isn't a filler. It isn't a booster. It's something categorically different — a next-generation collagen biostimulator built on a technology that's taken years to develop and is unlike anything else currently available in aesthetic medicine. Lee introduces Juläine of Sweden, and explains why she's excited about it.

The landscape of injectable aesthetics has been relatively stable for some years. Hyaluronic acid fillers, botulinum toxin, and a handful of established biostimulators have dominated the field. Juläine of Sweden — developed by Nordberg Medical using their proprietary LASYNPRO™ microsphere technology — represents something genuinely new in that landscape, and the results are giving practitioners and patients good reason to pay attention.

The science behind LASYNPRO™

Juläine is based on Poly-L-Lactic Acid (PLLA) — the same foundational ingredient as Sculptra, which has an established track record as a collagen stimulator. But what distinguishes Juläine is the LASYNPRO™ microsphere technology — Lactic Acid Induced Synthesis of Collagen Protein — which represents a significantly more sophisticated approach to how the PLLA is formulated and delivered.

The lactic acid released as the PLLA microspheres are gradually absorbed by the body acts as a signalling molecule — instructing the body to synthesise new collagen. This isn't a passive process. It's an active, ongoing conversation between the product and your own biology, producing new collagen that is genuinely your own, building gradually over weeks and months, and lasting well beyond the product's absorption.

What makes it different

Clinicians using Juläine have consistently reported something that sets it apart from other biostimulators — an immediate skin glow effect visible right from the first treatment. This isn't the gradual reveal of collagen stimulation that takes weeks to emerge. It's an immediate improvement in skin luminosity and quality that patients notice as soon as the product is injected. The longer-term collagen stimulation then builds upon this foundation over the following weeks and months.

The product is also noted for its ease of injection and its smooth integration into the skin — both important practical considerations for the treating clinician, and factors that contribute directly to patient comfort and result consistency.

Is Juläine right for you?

Juläine is particularly suited to patients who want to address volume loss and skin laxity in a way that produces natural-looking, gradual results — rather than the immediate but more visible change associated with hyaluronic acid fillers. It's an excellent option for those who have been considering Sculptra, and who want to explore the latest advances in PLLA-based biostimulation. As always, a thorough consultation is the essential first step.

No needles. No numbing. No downtime. Just deep, structural tightening that works at a tissue level most treatments can't reach. XERF is the world's first multifrequency monopolar radiofrequency treatment — and it's changing what's possible without surgery.

Skin laxity is one of the most challenging aspects of facial ageing to address non-surgically. Volume loss can be replaced with fillers. Pigmentation and texture can be improved with lasers. But the loosening of the underlying structural tissue — the descent of the SMAS, the softening of the fascial layers that give the face its lift — has historically required surgery to address meaningfully. XERF is one of the most significant steps forward in changing that.

The technology behind XERF

XERF uses multifrequency monopolar radiofrequency — combining both 6.78 MHz and 2 MHz frequencies — to deliver energy at multiple depths simultaneously. This is the world's first treatment capable of doing this, and the clinical significance is considerable. By combining frequencies, XERF can target the shallow, middle, and deep layers of the skin in a single treatment, reaching all the way to the SMAS — the Superficial Musculoaponeurotic System — the foundational tissue layer that surgeons address during facelift procedures.

The system's Wave Fit™ pulse technology and Advanced Integrated Cryogen Delivery cooling work together to control energy delivery while maintaining surface comfort — achieving what Cynosure calls a Never-Numb™ treatment. No topical anaesthetic is required. Most patients describe the experience as warm and comfortable throughout.

What the clinical evidence shows

In-vivo studies using ultrasound-guided fibre-optic imaging have measured internal skin temperatures of 50°C, 60°C, and 70°C during XERF treatment — the temperatures at which meaningful collagen remodelling occurs. Subsequent histological analysis has confirmed increased thickening and tightening of collagen bundles at multiple tissue depths, along with an observable upward pull in the fascia. This isn't theoretical. It's measurable structural change, demonstrated in peer-reviewed research.

The personalisation built into the XERF system is another significant advantage. Accurate Impedance Feedback provides real-time analysis of each patient's skin, allowing the treatment to be calibrated precisely to their individual tissue characteristics. Three depth settings and ten intensity levels mean no two treatments are identical — because no two patients are.

Who is XERF for?

XERF is ideal for patients experiencing skin laxity — particularly along the jawline, the neck, and the lower face — who want to address the structural cause rather than simply treating the surface. It works particularly well for those in their forties, fifties and sixties who are noticing the early to moderate signs of tissue descent, and who want a non-surgical option with genuine clinical evidence behind it. A consultation with Lee will establish whether XERF is appropriate for your specific concerns, and how it might fit into a broader treatment plan.

It doesn't fill. It doesn't freeze. It doesn't change the shape of your face or alter your expressions. What Profhilo does is something more fundamental — it restores the skin's capacity to be healthy. And that, in twenty years of practice, is one of the most exciting things I've been able to offer.

Profhilo arrived in the UK aesthetics market and quietly changed the conversation about what injectable treatment could achieve. Before Profhilo, injectables were largely about adding something — volume, smoothness, lift. Profhilo introduced a different idea: what if we could use an injectable to restore the skin's own mechanisms for looking good? What if we could treat skin quality itself, rather than its symptoms?

What makes Profhilo different

Profhilo is a highly purified hyaluronic acid — but unlike dermal fillers, it isn't cross-linked (chemically modified to hold its shape). Instead, it's formulated to flow through the skin tissue, spreading from just five injection points on each side of the face to hydrate a wide area. As it moves through the tissue, it stimulates four different types of collagen and elastin — the structural proteins that keep skin firm, supple and resilient.

The result is skin that is genuinely better — more hydrated, more elastic, smoother in texture, and more luminous. Clients often describe it as their skin looking like it did ten years ago. Not plumped. Not stretched. Just healthier, more vital, more alive.

The treatment experience

Profhilo is injected at five specific anatomical points on each side of the face — a protocol known as the BAP (Bio Aesthetic Points) technique — chosen to maximise the spread of product through the tissue. The product itself has a distinctive feel as it's injected — slightly thicker than a filler but with the capacity to spread and integrate that fillers don't have. Small bumps appear at the injection sites and typically settle within a few hours.

The initial course consists of two treatments, four weeks apart. Results begin to become visible from around four weeks and are optimal at around two months after the second treatment. Maintenance treatments every six months keep the skin in consistently excellent condition. Many of my longest-standing clients consider Profhilo the cornerstone of their skin health regime.

Profhilo and other treatments

Profhilo works beautifully alongside other treatments — it doesn't interfere with fillers or anti-wrinkle treatment, and it enhances the results of energy-based treatments by improving skin quality before or after. In The Garrett Curve, Profhilo often forms a foundational layer of the treatment plan — the base upon which everything else is built. Better skin quality makes every other treatment work better. That's the logic, and in practice it consistently holds true.

If you've been curious about Profhilo — or if you've heard about it from a friend and wondered whether it's right for you — a consultation is the only honest place to start. Your skin is unique, and the right treatment plan should reflect that.

There is a quiet frustration I encounter in almost every consultation. A patient — often highly intelligent, often successful, often spending considerable sums on skincare — sits across from me and describes their routine. Cleanse. Tone. Moisturise. SPF. Perhaps a serum. Perhaps a vitamin C. Perhaps something that promised to turn back time.

And yet here they are.

The problem is rarely effort. The problem is almost always understanding. Because the skincare industry has spent decades selling the promise of transformation whilst largely delivering hydration. And hydration, though valuable, is not the same as skin health.

After twenty years in medical aesthetics, I want to explain the difference — and the science that separates a product that truly performs from one that simply feels nice.

"The skincare industry has spent decades selling the promise of transformation whilst largely delivering hydration."

The Skin Is a Living Organ — Not a Surface

Most people approach skincare the way they approach polishing furniture. Apply product to surface. Buff. Admire result. Repeat.

But skin is not a surface. It is a complex, living organ comprising multiple layers — each with distinct functions, distinct cell populations, and distinct needs. The epidermis, the outermost layer, acts as a barrier. Beneath it, the dermis contains collagen, elastin, fibroblasts, and the structural architecture that determines how your skin looks and behaves. Deeper still, the subcutaneous layer provides volume and support.

A moisturiser, however luxurious, sits on the epidermis. It hydrates. It soothes. It protects the barrier. It does not reach the dermis. It does not stimulate fibroblasts. It does not rebuild collagen or accelerate cellular renewal. It never will — because it was not designed to.

This is not a criticism of moisturisers. Barrier support is genuinely important, and a good SPF is arguably the single most valuable skincare product you can use. But if you are hoping that a cream — however expensive — will reverse pigmentation, stimulate collagen, or meaningfully address the signs of ageing, you are asking a product to do something it is biologically incapable of doing.

What Skin Actually Needs

Genuine skin health requires intervention at a cellular level. Specifically, it requires four things.

Cellular renewal. The skin naturally sheds and regenerates, but this process slows significantly with age. By your forties, cellular turnover has roughly halved compared to your twenties. The result is dullness, uneven texture, and pigmentation that accumulates rather than resolves.

Collagen and elastin stimulation. From our mid-twenties, collagen production declines at approximately one percent per year. Elastin — responsible for skin's ability to spring back — degrades and is not efficiently replaced. No topical moisturiser reverses this. Ingredients that genuinely stimulate collagen synthesis — retinoids, growth factors, certain peptides — can make a meaningful difference, but only when formulated at therapeutic concentrations and delivered correctly.

Barrier integrity. A compromised skin barrier drives sensitivity, dehydration, and accelerated ageing. Supporting the barrier through ceramides, niacinamide, and appropriate lipid replenishment is genuinely valuable — but it is the foundation, not the intervention.

Pigmentation regulation. Melanin production is driven by UV exposure, inflammation, and hormonal factors. Addressing pigmentation requires ingredients that interrupt the melanin synthesis pathway — tyrosinase inhibitors, retinoids, kojic acid, azelaic acid — at concentrations that actually work.

The Brands I Trust — and Why

In over two decades of practice, I have seen an enormous number of skincare brands come and go. The four I return to consistently are not the ones with the most beautiful packaging or the most compelling advertising. They are the ones with the most rigorous science behind them.

ZO Skin Health

Founded by Dr Zein Obagi, ZO Skin Health was built on a philosophy I deeply respect: the skin should be treated, not simply maintained. ZO products work at the cellular level — stimulating renewal, addressing pigmentation, and building genuine resilience. The Retinol Skin Brightener range is exceptional, as is the broad approach to building a complete skin health programme rather than selling individual products in isolation. It is not a gentle range. It works because it challenges the skin to function better.

Alastin Skincare

Alastin's TriHex Technology is genuinely innovative — it works to clear damaged elastin and collagen whilst simultaneously stimulating the production of new, healthy structural proteins. This makes it particularly powerful used alongside in-clinic treatments such as BBL HEROic, MOXI, or resurfacing procedures, where the skin's natural repair mechanisms are already activated. The Regenerating Skin Nectar is one of the most clinically supported post-treatment products available. Alastin bridges the gap between clinic and home in a way very few brands genuinely achieve.

Obagi Medical

Obagi's Nu-Derm system remains one of the most evidence-based approaches to transforming chronically sun-damaged or pigmented skin. Built around prescription-strength hydroquinone and tretinoin in its classic formulation, it requires commitment — and proper clinical supervision — but the results it delivers over a twelve-week programme are unlike anything available over the counter. For patients dealing with significant photodamage, melasma, or persistent uneven tone, Obagi represents a serious intervention rather than a skincare routine.

Tebiskin

Less well-known than the others but no less impressive clinically, Tebiskin focuses on dermatological precision — formulations designed around specific skin conditions including rosacea, sensitivity, post-procedure recovery, and barrier repair. In my practice I find it particularly valuable for patients with reactive or compromised skin who need effective intervention without provocation. The science is meticulous and the results are consistent.

"The best skincare results I see are always the result of a combination approach — a properly prescribed home programme combined with in-clinic treatments that address what topicals cannot reach."

The Honest Truth About Results

None of these brands are inexpensive. None of them are available in a department store. And none of them will transform your skin overnight. What they will do — used consistently, in the right combination, at the right concentrations — is create a meaningful, measurable improvement in the health and appearance of your skin over weeks and months.

The honest truth is this: the best skincare results I see in patients are always the result of a combination approach. A properly prescribed home skincare programme — built around scientifically credible products — combined with in-clinic treatments that address what topicals cannot reach. MOXI to drive cellular renewal. BBL HEROic to address pigmentation and vascular irregularity. Profhilo or polynucleotides to restore hydration and stimulate collagen at a deeper level.

Skincare does not replace treatment. Treatment does not replace skincare. They work best together — and understanding that is the beginning of genuinely healthy skin.

Building Your Skin Health Programme

Every patient I see has different skin. Different history, different concerns, different tolerance, different lifestyle. This is why I do not recommend products off a shelf — I recommend them after a proper consultation, a thorough skin analysis, and an honest conversation about what you are trying to achieve and what you are realistically willing to commit to.

If you are ready to stop guessing and start genuinely investing in your skin health, I would welcome the conversation.