Placentas, needles and threads: non-invasive surgery just got gory

It’s worth pausing here to note that we have all come across that person — the one who has gone a little too far with the dermal fillers, or whose face is set in telltale immobility. Non-surgical procedures are becoming so prevalent (‘growth in the sector reflects increasing cultural acceptance of cosmetic procedures, particularly among young people,’ noted a government report last year) that it’s not a question of ‘Has she or hasn’t she?’ these days, rather ‘Has it been done well or badly?’ In other words, we’re living in Terry Gilliam’s Brazil. Control and delicacy are key in the administration of these powerful new remedies, and Dr Sebagh is known for his artistry.

In his Paris clinic (he divides his time between Paris and London) an embroidered cushion stitched by a grateful customer reads ‘Jean-Louis — Docteur, Sculpteur, Magicien, Genie, Merci.’ Another demure little sampler says: ‘I heart Botox.’ He has treated stars including Cindy Crawford, with whom he developed an own-brand range of topical creams; he refused to treat a pregnant Kim Kardashian. He explained to me why he believes dissolvable thread (from £1,200 with Dr Sebagh at The French Cosmetic Medical Company) is the future of anti-ageing.

‘Surgery is really obsolete now that I can use the thread to give a tailor-made result. I can use it to lift the eyebrows, lift the forehead, correct asymmetry, or fight gravity. I can give you a Nefertiti lift on your neck and jawline, consisting of roughly half an inch on each side to reposition or prevent jowls. I have used Silhouette Soft thread on ten women today, starting in the morning with a queen of one of the Middle Eastern countries…’

The thread, made of polylactic acid (a term that, with his thick French accent, we had some fun deciphering over the phone), is drawn through the skin after injections of local anaesthetic. The procedure takes no more than 30 minutes. ‘We are very aware, when we develop our treatments, first that this needs to be delivered by a major professional,’ he says, ‘and secondly, that it needs to be a lunchtime treatment. You have to be able to walk away quickly, without bruising. Lots of women are hiding this, keeping it secret from their husbands, their neighbours, their friends...’

No matter how much of a breeze this sounds, it is a serious undertaking. When I watched a film of it being performed (by another practitioner, completely unrelated to Dr Sebagh) on YouTube, I was nearly sick. It showed a woman, who appeared physically near-perfect, having dots painted on her face, which a spookily smooth-faced male doctor of absolutely indeterminate age joined together, penetrating the skin using a long, jabbing piece of wire. The Silhouette Soft manufacturer’s oily tagline is: ‘Connect the dots. Reconnect your life.’

‘My concern with this treatment becoming widespread,’ commented Dr Ayham Al-Ayoubi of the London Medical and Aesthetic Clinic, based at 1 Harley Street, ‘is that only experienced facial plastic surgeons must undertake this. It should not ever be presented to the public as non-invasive. People will get into trouble if they do this in the wrong environment. It must be carried out in an operating theatre, in a sterile environment, with equipment to deal with consequences such as bleeding, infection, seroma [build-up of fluid] or allergic reaction. There needs to be a full support team. Technically this is very fiddly and if the wire isn’t applied correctly, it can cause significant facial asymmetry, especially over time.’

Dr Al-Ayoubi is a pioneer in laser surgery, both in his private clinic and with the NHS; he has recently lectured on cosmetic procedures at Queen Mary’s Hospital. ‘My new philosophy,’ he told me, ‘is that facial plastic surgery is 5D — it has five dimensions. Not only is the face a 3D structure, but it is also mobile. When you introduce thread or gel into a lady’s mouth, for example, this is a dynamic structure — this lady will eat, drink, possibly kiss. And the fifth dimension is: how will this change over time? Over three, four years?’

These are clearly issues to consider during what should be a long consultation process before starting surgery. Sir Bruce Keogh’s report for the government last year recommended that practitioners also perform a psychological assessment to pick up under-lying conditions such as body dysmorphia, a mental illness that can lead to people believing they need unnecessary surgery. A psychiatric assessment tool for all practitioners is currently being created at the Centre for Appearance Research at the University of West England. According to the report, ‘those who undergo cosmetic intervention are statistically more likely to… have been subject to domestic abuse or bullying, or be on medication for sleep disorders and anxiety. Those seeking treatments are also statistically much more likely to have mental health issues.’

Lying to one’s friends and spouse about treatments is also endemic. Botox is often the last taboo within a marriage. He declares her perfect; she knows better. He makes an off-hand remark about old women getting Botox; she thinks: if only you knew…

My novel Viper Wine, based on a true story and set in the 17th century, reveals a marriage full of love and secrets. Painting with lead foundation damaged women’s complexions, and at the grand old age of 32, Venetia Digby, a famous beauty, was in crisis about her looks. Her husband, Sir Kenelm Digby, brought her snails from the Continent known for their complexion-curing properties (the same breed of snail is still found around their former home in Buckinghamshire today), but for reasons of pride and power, Venetia preferred to seek out a personal apothecary whose services she could control — until she became addicted to his potent brew, viper wine, made of baked snakes, progesterone-rich pregnant mares’ urine, and opium.