The best aesthetic treatments… from a pro

Dr Nerina Wilkinson has been in the field of plastic and cosmetic surgery for over 25 years. She speaks to Ingrid Wood about the advancements she has seen and what the best procedures are right now.

By Ingrid Wood

A world renowned plastic surgeon specialising in facial and breast augmentation surgery and owner of Dr Nerina Wilkinson + Associates, a private medical aesthetics clinic in the V&A Waterfront in Cape Town, Dr Wilkinson’s philosophy is centred on the physical and emotional wellbeing of her patients and embracing the diversity of beauty.

“True beauty embraces authenticity. It’s not about creating a cookie-cutter look but rather about celebrating each patient’s unique features and character,” she says. “Physical beauty is also closely tied to a healthy appearance and should therefore involve procedures that promote well-being and self-esteem rather than simply pursuing unrealistic ideals.”

Dr Nerina Wilkinson

Which non-surgical procedures have the most impact?

“Facial fillers placed on the bone to lift sagging tissue can yield significant impact. This approach, often referred to as structural or volumising fillers, involves injecting hyaluronic acid-based dermal fillers deep on the bone structure to provide support, contour and ‘naturally’ lift sagging facial tissue for a refreshed appearance. It also improves skin quality due to the bio stimulatory effects of hyaluronic acid in the filler. The long-lasting results and versatility of this approach make it a popular choice among my patients seeking a non-surgical solution.

“Radiofrequency (RF) micro-needling, such as Morpheus8, is good for tackling wrinkles and scars. These treatments leverage controlled heat, precisely applied, to tap into the skin’s innate healing mechanisms. The real magic lies in their ability to stimulate collagen production – a crucial protein for skin strength and elasticity – for lasting improvements in skin texture and appearance. While immediate results are noticeable, the full benefits of collagen activation and tightening may take a few months to fully manifest.”

What are the most impressive advancements you have seen?

“Breast augmentation surgery has seen remarkable advancements in ultimate results. We have moved away from large round unnatural breast augmentations to naturally looking and feeling breasts. The ergonomic cohesive silicone gel implants surgeons use today provide a more natural look and feel. Additionally, hybrid breast augmentation procedures (which include the introduction of fat grafting techniques in combination with traditional smaller breast implants) has offered patients more customisation options and more natural-looking outcomes.

“There was a period when facial fillers were used excessively, leading to an overdone, unnatural appearance (also known as “pillow face”). This trend has shifted towards more subtle results that enhance natural beauty rather than change the appearance completely. The advancement in anatomical studies, precise facial ultrasound imaging, the understanding of the placement of fillers deep on the bone, as well as improved injectable gel/ filler technology has also resulted in the ability to achieve extensive lifting and optimal functioning of deep facial muscles. Facial fillers today can result in improved facial contours, structure and an overall natural lift.

“New skin biostimulation ‘prejuvenation’. The advanced trend of regenerative medicine-which leverages the body’s inherent regenerative potential – has taken centre stage. It encompasses the innovative use of stem cells, fat grafting and lately also skin biostimulators. Stem cell therapies, including adipose (fat)-derived stem cells, have shown remarkable promise in enhancing fat grafting procedures, ensuring longer-lasting and more predictable outcomes, while skin biostimulators harness the body’s natural mechanisms to stimulate collagen production, providing a non-surgical avenue for addressing volume loss, skin laxity and wrinkles.”

There is no one-size-fits-all, explains Dr Wilkinson. “Every patient is unique, and I tailor treatment plans to their individual needs and desires. My goal is to empower patients to make choices that enhance their confidence and well-being and not only their appearance. I want them to feel in control of their journey to self-improvement.”

Lids, hair, lipo? In the next article with Dr Wilkinson, we find out what men want and what women want…

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