I had timed my intervention perfectly. A day and a half before the Habitat for Humanity 35th anniversary ball, I scheduled a HIFU (high-intensity focused ultrasound) session at a Makati clinic to lift my sagging cheeks and tuck in the jowls that had obscured my chin and jawline.
I thought it would be a quick fix as I settled into the reclining chair. After enduring the very intimate chatter of my two clinic technicians (e.g. asking how many of my children I had birthed myself as a gauge of whether I could handle the pain of the HIFU treatment), their manager entered and piped in with her questions about my life.
Offhand, she asked, “You aren’t high blood, are you?” I told her I was, and she instantly stopped the ladies from doing further prep work on my skin. At this stage, the exfoliation had already been done and the pain-numbing cream had been slathered all over my face and neck. They called for someone to take my blood pressure and it was indeed high at 148/90.
She recommended we shift gears to a natural botox mask, which didn’t involve any machines. The manager went on to say that, sometimes, cancer survivors would come in to have treatments, too, but she wouldn’t allow it because it was too risky. When I informed her that it had been four years since my breast cancer surgery, she recoiled in shock. Given the sorry state I was in, they would only ever allow the most superficial interventions for me.
When women reach their mid-50s, it is more than just wisdom we have accumulated. We have clogged arteries, stress, and sleep issues that raise our blood pressure. Our metabolism has slowed down, resulting in pouches of fat appearing in unexpected places. Skin elasticity has disappeared and in its place, we have laugh lines, frown lines, and all sorts of visible discolorations ranging from tiny freckles, age spots, to huge swatches called melasma that even get darker with time.
Don’t get me wrong. I certainly appreciate this high regard for my health and I commend the manager for not going for the easy buck. But the irony of it all sinks in. When women reach their mid-50s, it is more than just wisdom we have accumulated. We have clogged arteries, stress, and sleep issues that raise our blood pressure. Our metabolism has slowed down, resulting in pouches of fat appearing in unexpected places. Skin elasticity has disappeared and in its place, we have laugh lines, frown lines, and all sorts of visible discolorations ranging from tiny freckles, age spots, to huge swatches called melasma that even get darker with time. Pardon my French but it is a total sX@t show.
The only advantage of being older is that we have more funds for repair work at our disposal than when we were young sprites. This is key since skin care maintenance for even the non-vain can cost a king’s ransom.
However, the sad reality for many women over 50 is that because of our somewhat weathered physical condition, the range of interventions open to us is more limited. For example, because I have metal fixater screws in my ankle resulting from an unfortunate skating accident 20 years ago, any treatment with the use of an RF (radiofrequency) machine can’t be allowed. For Ultherapy and other slimming treatments involving RF machines, for instance, doctors recommend that patients with metal implants get clearance from the machine manufacturer first. A lot of the safety considerations depend on the distance between the implant and the area being treated, so things need to be discussed thoroughly.
While technically, the clinics should require patients to first fill up medical questionnaires, the sad reality is we cannot expect everyone in the clinic to be as thorough and as knowledgeable of the risks involved. I recommend patients who are about to begin a new treatment to first disclose all sorts of medical conditions and medications being taken to the clinic manager or a medical doctor.
The UK website Professional Beauty Direct advises salon owners who buy its products to be mindful of contraindications that could make certain treatments inadvisable. The contraindications are as expected, viral infections such as colds, coughs, conjunctivitis, lice infestation, and open wounds that should be given time to heal. Likewise, patients with a history of cancer may be immuno-compromised and more likely to catch an infection.
“Other contraindications include pregnancy, back problems, broken bones, varicose veins, tooth abscesses, bleeding to the face, recent hemorrhage, claustrophobia, recent head or neck injury, fever, and other infectious diseases such as AIDS,” the website advises.
I’ve come to realize, however, that the medical profession has some leeway for exceptions. My dermatologist, Dra. Reena Corona of La Nouvelle Image Skin & Plastic Surgery Clinic, said she personally would consider hypertension and diabetes mellitus as relative contraindications, not absolute ones. “If the blood pressure or blood sugar is controlled with medication, and the patient is stable, there is no problem,” she assured me.
That said, she would avoid botulinum toxin injections for frown lines, forehead lines, and crow’s feet if the patient has a history of allergic reaction to a toxin or albumin protein, or perhaps an infection at the proposed injection sites. Botox is also contraindicated in a person with pre-existing neurological motor disorders like myasthenia gravis, amyotrophic lateral sclerosis, and other myopathies or neuropathies.
Dr. Corona said she also avoids injecting patients who have blood disorders or are on blood-thinning medications since they may cause excessive bruising. Women who are taking certain medications known to affect the botulinum toxin like aminoglycosides or hydroxychloroquine are also advised to skip it. Botox is also best not done in women who are psychologically unstable, especially those with body dysmorphic disorder, Dr. Corona says.
Even services as commonplace as laser treatments for hair removal or IPL for pigmentation, redness, spider veins, or permanent hair reduction are not for everyone. On the banned list are patients who have a recent tan or burn, those who have had herpes, or those with bleeding disorders.
“Neither do we do patients with epilepsy or seizure disorders since the flashes of light can trigger a seizure,” Dr. Corona said. Any photosensitive disorder like lupus is also a contraindication.
Given my experience with the aborted HIFU, I recommend patients who are about to begin a new treatment to first disclose all sorts of medical conditions and medications being taken to the clinic manager or a medical doctor. While technically, the clinics should require patients to first fill up medical questionnaires, the sad reality is we cannot expect everyone in the clinic to be as thorough and as knowledgeable of the risks involved. Google has made it easier to do some background research on possible health risks of various treatments or medications, so the onus is on us customers, most especially the ones with diagnosed conditions, to discover for ourselves the real price of cosmetic or beauty treatments.
