Case Study Results: Neck Trainer to Eliminate Sagging


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One of my most “difficult” case studies so far. Having enrolled 8 participants to trial the Paul Younane Portable Neckline Slimmer, only three finished the four-week long case study.

The gadget either did not appeal or one of the participants experienced issues with her neck and shoulders. However – those that did finish felt that using the trainer made a difference (this was also my experience with other clients) and I would like to thank them for endurance. 


Manufacturer Claims 

  • Features: Matched with three different strength springs, it can produce different massage effect.
  • Benefits: It can eliminate excess fat in jaw, and help you shape a perfect face type. It can eliminate the double thin and make you thin more beautiful. Compliance is key. 

Participants’ comments:

On the technique (following the instructions)

  • I liked that it only took 3 minutes. I didn’t like that it did feel like hard work and towards the end would ache a bit. I preferred the first exercise to the second.
  • I liked that it was easy, no noise.
  • Easy and quick. Wasn’t sure I was doing it right.


  • It took me about 4 minutes. It seemed really quick to me and could easily be slotted in on most days.
  • Five-six minutes. Length was fine.
  • Fine – very quick



How did your face feel after the exercise?

  • I did feel as though the lower half of the face had been exercised. I felt more aware of the muscles in my face and particularly around the jaw. The second exercise caused an ache in the back of my throat although this stopped once I stopped the exercise.
  • I didn’t feel any particular sensation, there was no discomfort, my face didn’t feel tight. However, I believe I could see a difference and when I felt my chin and cheeks they felt firmer.
  • Ache under the chin like the muscle had been exercised.


  • Anyone wanting to tone up their neck and jaw line.
  • Anyway who wants to improve the shape of their face/chin.
  • Women of a certain age with a sagging chin!







Participants’ Final Comments

  • I think I will continue it for a bit longer to see if i get a better result. It feels like it is doing something even if I don’t have anything to show for it yet.
  • It’s quick, it’s easy, it’s inexpensive and it works.
  • Difficult to take a picture at exactly the same angle but I genuinely think there is a difference!

In Summary

If there are no health issues and you enjoy more vigorous exercise, I feel it is worthwhile investing in the trainer. The neck tissue ages fast and we don’t pay enough attention to the skin on the neck when applying skincare. The trainer aims to alleviate sagging of the area by bringing in blood flow and stimulating the defining muscles. Daily compliance is essential.

INCI: Traditional Brightening Actives


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Lightening & Brightening products & treatments should take into consideration that the skin is challenged by transition from cold outdoor to warm indoor temperatures in January. 

The range of brightening skincare products is overwhelming and reading the INCI lists essential. Traditional plant extract combinations have a renaissance in natural skincare – they target all aspects of skin repair such as dull appearance, sub-clinical inflammation aggravated by weather changes, patches of redness and oiliness at the same time, overall uneven skin tone.

It is the combination of actives contained in the plant extracts as well as the levels of the extract used that deliver clinical results. Some of the plant staples to look for in your products are listed below:

For Extra Hydration 

  • Lupin – for skin hydration and improved barrier function
  • Lady’s Smock – rich in amino acids and helps skin recovery (re-epithelialisation)

Anti-inflammatory Actives

  • Borage – anti-inflammatory, capillary dilating compounds incl. gamma-LA
  • Centella asiatica – alleviates fragility of capillaries and facilitates re-epithelialisation


  • Shiitake mushroom (contains kojic acid) – prevents melanin formation and collagen breakdown, astringent
  • Mulberry root – brightening, tyrosinase inhibitor reduces melanin synthesis
  • Grape (contains resveratrol) – strong antioxidant, prevents melanin formation and transfer
  • Licorice root – brightening, tyrosinase inhibitor reduces melanin synthesis – also anti-oxidant, anti-inflammatory, antimicrobial (contains saponins, flavonoids) and also alleviates skin sagging

Happy INCI list reading – and feel free to share your comments!

New Anti-Ageing Technology: Micro-needling Patch Available for the First Time in Yorkshire


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SUMMARY: Micro-needling is an anti-ageing treatment that helps improve the appearance of fine lines and wrinkles. But current devices have a number of limitations including pain, erythema (redness) and bleeding. Radara® is an innovative pain free micro-needling therapy to temporarily improve crow’s feet lines and an alternative to Botox.

Continue reading

Skincare Products & Shelf-life


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Shelf life is the length of time that a commodity may be stored without becoming unfit for use, consumption, or sale.

Having just finished a column on preservatives in skincare for the Cosmetics&Toiletries, in January I encourage my clients to inspect the shelf-life – expiry date and period after opening – of their skincare products. 

Preservatives are necessary. They prevent irritation or infection and inhibit the growth of fungi and bacteria in skincare products. In some cases they can cause allergic reaction, in my clinical experience particularly the Methylisothiazolinone (MI). Overall, the use of parabens has decreased significantly. Phenoxyethanol is now the most commonly used preservative. Green, sustainable preservative technologies are great but often not as effective and expensive.

Inspect all your skincare products in your bathroom cabinet and look at the following:

  • Period after opening – prevents the contamination and changes after the product has been opened
  • Expiry date – guarantees physico-chemical stability of the unopened product


Follow good practice and always store skincare away from light and heat. Dark glass packaging is protective. If possible, buy skincare in airless pumps and tubes to limit exposure to air leading to oxidization.

The luxury night and eye creams are often an exception and using a spatula or an application wand is recommended – though it rarely happens in real life.

More in my next Cosmetics&Toiletries column, to be published soon..



Best Bargain for New Year Radiance 2016


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Join the FaceWorkshops Club to discover skincare bargains and the science behind the products. 

Among one of the TKMaxx bargains is Prevage, the idebenone-based skincare line by Elizabeth Arden. Shop now, the stocks are running low. 


THE PREVAGE RANGE – serums to alleviate lacklustre, dull skin

Idebenone, a synthetic antioxidant based on the natural antioxidant ubiquinone, also called coenzyme Q10, but has a smaller molecule. Both antioxidants have been suggested as topical ingredients to protect skin from oxidative damage caused by UV light or pollution.

The claims about the powerful efficacy are based on a study comparing the effectiveness of idebenone to 5 other antioxidants (ubiquinone, kinetic, alpha lipoic acid, l-ascorbic acid and dL-tocopherol), where is was found to outperform the others in its antioxidant capacity. There are other studies showing the molecule to be less effective than other antioxidants, however, my clinical experience is good – the range is effective enough to deliver short-term anti-ageing benefits. 


Anti-Ageing Intensive Repair Daily Serum (dropper)
£165 (previously £220)/30ml

Anti-Ageing Daily Serum (pump)
RRP £165/50ml – but £49.99 for starter pack at TKMaxx

RATING: Both products deliver good results.

  • 30 ml dropper serum –  deeper regeneration
  • 50 ml pump serum – more surface acting
  • The intensive serum is an all rounder – more firming and regenerating. There is less of it (30 vs. 50 ml) and it is more liquid – requires working into your skin. If happy to work with the dropper and invest the money, buy the intensive serum but it is slightly runny and cumbersome. 
  • Idebenone seems to be in a lower concentration in the dropper than in the pump product but the intensive serum has additional beneficial ingredients.
  • The TKMaxx offering is a great bargain and a taster prior to making the full investment. 

Happy Shopping!

Botox Alternatives in Vogue


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Early in the 2016, I will be trialing an exciting new evidence-based therapy that is an alternative to Botox and fillers. My rationale for introducing an alternative to injectable treatments is discussed below. Happy Reading!

The January 2016 issue of the Vogue talks about something I come across in the clinic – clients complaining of having an “angry looking face”. The author Kelly Gilbert seeks an antidote for her advancing “resting angry face” and I will add scientific rationale to the insights she quotes.

People notice minor irritations accumulating on their faces; re-telling a different story than they feel was their life story. However, a story rather than “no story” – by Botox and fillers – written in the face is always preferable.

“People’s faces do not reflect how they feel, they feel positive and energetic but their expressions don’t reflect this..”

  • Dr Murad links “cultural stress” as contributing to furrows. His patients are tired, stressed and unhappy due to digital dependency – and he provides an App for them to develop a more positive outlook.

It is often our European expressiveness – as opposed to e.g. the Japanese lack of facial expression – and bad facial mimic habits (frowning when conveying a position of authority, pursing lips when trying to concentrate) that are to blame for premature lines and wrinkles. Paralysing facial muscles is only a short-term solution and coming off-trend.

The remedies offered in the article are Selfridges-based FaceGym (a take-home version of FaceGym is a part of my facial yoga tuition), facial acupuncture or Botox administered to the decompressor muscle underneath the lower lip (recommended by Dr Prenna-Jones).

Professional treatments can make a significant difference if carried out regularly but it is the at-home facial yoga and massage that can be done daily (and is free of charge) that can tip the balance favourably. We all want to look enthusiastic and full of energy.

  • FaceGym offer a new frown treatment with a focus on “the fed up look” ie. drooping corners of the mouth and forehead muscles that permanently contract. The protocol is based around lifting and stretching the muscles using finger work and machines (their Pure Lift device is a rather expensive (£349) electrical stimulation wand.
  • Traditional Chinese Medicine practitioners in London attempt to replicate the back-from-holiday look when jaw relaxes, the cheeks lift and forehead releases all tension. The relaxation of facial muscles improves blood flow (and energy flow) – the 3rd eye chakra being identified as the liver point which holds anger and stagnating energy (it sits between the eyebrows). Facial acupuncture can reset tense muscles.

I agree that there is a need for muscle movement in the face. Freezing muscles hinders the microcirculation and lymph flow. Repetitive Botox can lead to puffy eyes and lack-lustre skin.

Is Botox falling out of favour? I hope so. It has long been the go-to treatment for eradicating expression lines.

But it is important to look after the whole face – not just select areas. If rejuvenating only one part of the face, discrepancies between the zones will shift other peoples’ readings of declining facial attractiveness to “looking strange”.

I advocate effective natural treatments that help the body harness its own repair. Needle-rolling facials that activate collagen response when combined with topical active products might have fantastic results but only if the products are correct for skin type. As with any minor-invasive therapy, repetitive skin injury might bring on more pigmentation.

Facial Yoga delivers results in four weeks time. The new therapy I will be adding to my portfolio in 2016 seems to offer good results without any side-effects. 



Acne: Future Directions for Research


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These are the top 10 most important questions for new research in acne. Most of the answers are up to the pharmaceutical industry – but some can be addressed by adequate skincare and lifestyle changes. 

4. The best way of preventing acne?
6. Which lifestyle factors affect acne susceptibility or acne severity the most and could diet be one of them?
7. The best way of managing acne in mature women who may/may not have underlying hormonal abnormalities
8. The best topical product for treating acne (medical and skincare)

The topical and preventative solutions I am interested in are linked to skincare and treatments – sebum and comedone removal, active ingredients and defect skin barrier recovery..

  • The increasing important role of skincare ie. cleansing washes in sebum removal and light, non-occlusive, non-comedogenic moisturisers to protect the defect skin barrier in acne has been discussed recently. Acne-targetting or preventing serums and moisturisers with active ingredients need to target the multi-factorial nature of acne.
  • The treatment of macrocomedones is important as well as understanding of hormonal involvement in pre-menstrual acne flares. Hyfrecation, manual extraction or chemical manipulation of the intra-follicular environment have been investigated recently.

scan for Katerina

(BDNG, Vol.14, Nr.3, 2015)

The Internal Route: Diet, in my clinical practice, seems to play a significant role. My recommendations are in line with my review and recent theories.  Supplementation is also important and I will be working on expanding my empirical evidence with case studies in 2016.

More reading about my work  Tackling Female Adult Acne

Reference for Acne PSP







Higher BMI Health & Facial Ageing


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Medical students are taught that half of the facts they learn are not true – we just don’t know which half. Some of our most widely believed medical facts are based on almost no evidence at all.

Is being slightly overweight (with BMI 25 – 30) healthier?

  • Health weight range is not based on solid evidence (e.g. a significant study undertaken on many thousands of people or several such studies) with clearly defined basic categories i.e. BMI greater than 30 [Body mass Index; the ratio of body weight to the square of body height (kg/m2)]. Meta-analysis, is usually the holy grain of medical research, to provide the definitive answer to a scientific question.
  • When the WHO (World Health Organisation) experts gathered to define obesity, BMI 30 has been chosen arbitrarily. Yet, obesity in middle age can reduce the risk of a person developing dementia later in life; to be overweight may well be healthier than to have normal weight. People who are considered overweight, with BMI 25 – 30, live longer. If methods of defining cut-off points in healthcare are largely arbitrary, it come as no surprise when the health definitions do not stand up to scrutiny.*

In the ageing face, intuitively extra weight seems to add plumpness to the facial structures temporarily but research shows that thicker subcutaneous fat layer is significantly linked to reduced dermal elasticity and increased sagging severity at the lower cheek in Japanese population [Ezure T, Amano S, 2010].

Clinically, I see yo-yo diets and rapid weight loss exacerbating ageing concerns more than higher BMI.

In terms of the skin barrier function that often translates to dry, flaky skin, redness & sensitivity, the “tight winter skin feel” – we have mixed & inconclusive results of tree small studies carried out at the forearm – not the face.

  • Loffler et al (2002) studied the relationship between BMI and the physiological function of the skin, showing that higher BMI lead to higher Trans-epidermal Water Loss (TEWL) and less functional skin barrier.
  • Puch et al (2008) found that normal weight participants (BMI < 25) responded better to supplementation than overweight participants (BMI >25). In the obese, skin barrier was weaker and skin colour increased in redness. 
  • In contrast, Guida et al (2010) observed reduced TEWL rate indicating better skin barrier in the obese compared to normal weight participants (BMI 18.5-24.0 kg/m2).

More research is needed to clarify how BMI impacts on the ageing female face. The patterns of different skin parameters require detailed mapping; there seem to be minor changes of TEWL but e.g. a clear increase in skin surface pH during the course of life [Trojahn et al (2015)]. More about facial maps in my next blog..

*Sunday Times 12th April 2015, Sorry, Madam, You really must eat more cakes by GP Malcolm Kendrick. Based on extracts from his book Doctoring Data: How to sort out medical advice from medical nonsense.


Choices in Anti-Ageing: The Botox & Fillers Alternative


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A good analogy for the holistic approach I advocate for the face – personalised skincare routine, professional treatments and at-home facial exercise – is exercising the body. 
faceworkshops massage and accupressure
If we want to tone up and achieve a better silhouette, we have a choice of a) an instant tummy tuck or b) to engage in a bespoke exercise regime. The later requires more effort and personal commitment, and the results are delivered slowly in comparison to the former. I have been witness to the adverse side effects of Botox, fillers and facial fat transfer making me firmly believe that the holistic approach is a health-affirming, if longer-term path, to inner beauty.
  • When looking at the psychology of appearance, I refer to Dr Eileen Bradbury who said that undergoing cosmetic procedures often exposes us to a judgement of being vain; we receive little sympathy from our peers. Yet, we all strive to look attractive and struggle with ageing (see my survey).
  • Attractiveness is important in all walks of life – symmetry and evenness of facial skin and features signal our health. Yet, we often don’t see each other in movement, or when smiling, only static in the mirror. There is something disturbing about asymmetry – and as we age these asymmetries become more exaggerated. For example, sleeping on one side can contribute to more lines and a slightly ‘squashed’ appearance.
  • Aspirations to look “young again” and procedures that promise that seem to be within our reach. We feel that we want to be untouched by age. In a competitive situation, we want to provide “no information” about our inner feelings to the world. We want to hide the story we carry in our faces – our joy and sadness – not to be vulnerable. We strive to look alive & natural in order to be competitive and hope our looks will help us to deal with life challenges.
  • The power of expectations? Dr Bradbury says that women judge each other instantly on weight; a very contradictory topic in ageing when we want plumper faces yet slimmer bodies. Being able to afford to do “anti-ageing” is also an economic statement, opening us to risk and great vulnerability if the procedures go wrong. If a procedure does not deliver the expected results, women feel their sexuality and “their feminine power” has been diminished. People are often unaware of the risk when signing a consent form prior to a procedure – there is a “natural high” derived from expectations which can blind us to the risks. They often don’t have realistic expectations and six months after the procedure, they feel similar to how they did before. (Among people opting for cosmetic surgery, 19 % have pre-existing history of mental health issues versus 4 % in control group.)

Approaching life at a slower pace – relaxing, respecting and taking care of our face – represents a softer, yet better way forward. Injuring skin is a short-term quick fix and has trade-offs that we are yet to fully understand. Ageing is inevitable. Tools of mindfulness and engaging in the internal world of self – connecting with your body through skincare can be incredibly rewarding.


One-to-One Facial Yoga Tuition


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Christmas Vouchers: One-to-One Facial Yoga £40

Anti-ageing facial exercise. Firm & plumper cheeks; improved jawline definition; brighter eye region and reduced lip lines.


60 minutes of individual tuition. Personalised at-home routine (10 minutes). Follow-up session in 4 – 6 weeks. 

Limited availability. Please book by email on

A Client’s Testimonial


I’m very much enjoying the new routine. It’s great to know that I’m actually targeting the areas I need, rather than just doing a long, generic routine from a book, especially as I was unsure if what I had been doing was effective or not. I think this is why it’s so useful to have a one-to-one session. It’s easy to do the five days out of seven, as the routine is very short and is handy to do straight after cleansing at night. RS, Manchester, November 2015

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