Dubai: One of the great aspects of living in the UAE is easy access to beauty treatments. Many women in the country have an “eyebrow lady”, or a “facial girl” but to some, the most important of all is their botox provider.
Botox is an anti-ageing beauty treatment in which the facial muscles are paralysed by a toxin called botox. It involves injecting tiny amounts of Botulinum Toxin (Bo - Tox) into the depressor muscles of the face to erase wrinkles around the eyes, the forehead and around the mouth.
Clinics in the UAE have been offering botox for over two decades, claiming it is the ultimate in economical and non-invasive facelift technique.
The bi-annual botox upkeep isn’t something that many expat women (and men) indulge in back home. But here in the UAE, it is discussed so openly, that most people will share their botox stories openly at the dining table.
“Please let me tell you about my botox doctor,” my girlfriend quietly said to me over lunch the other day as I was interviewing her for this piece. “He is amazing. He did my forehead and his prices are great too.” She is 29. “I know I'm young, I just started noticing lines on my forehead that I wanted to nip in the bud before they got deeper.”
Botox and aesthetic medical clinics line the streets of Al Wasl Road and Jumeirah Beach Road. “They don’t even try to hide it,” she said to me. “It’s very openly discussed here, which honestly I love.”
In Canada on the other hand, Botox clinics are a little more low key and less frequently driven past. Over there, Botox is typically sold by the number of injectable units.“When I lived in Toronto, I would spend $12 per unit of botox,” said Jessica, a Communications professional living in the UAE. “I would typically need about 20 units for my forehead, 30 units for my crow’s feet and around 4 units for my lip lines. This all adds up to around $600.”
Jessica moved to Dubai two years ago and has been going to a clinic where she benefits from discounts and special deals as she is a regular customer. “My botox woman gives me a special price. I get my whole face done for Dh900 and she is someone I trust.” Jessica is 32 and started botox when she was 29.
Nadine, a long-time Dubai resident, who recently moved to Dublin, Ireland for work, spoke to Gulf News about the shift in perception of botox and beauty salons in the Middle East vs. in the West. “It genuinely surprises many people that I have a monthly budget for my botox, waxing and nail upkeep. They think I am high-maintenance and on many occasions, they tell me that I am “too fancy” for our Friday night pub meetups.”
Nadine was raised with the mentality that going to the salon, getting facials and having botox done is a necessity, not a luxury. Nadine is 31 and started Botox when she was 28.
Not all women are big supporters of botox. Iman, who is in her 50s is against injecting foreign substances into your body. “What’s the problem with just accepting the lines on your face? The problem with botox for me is that once you start, you really need to keep going. I just find it too much work on top of already being a woman and dealing with enough.”
Mariam, another woman against botox explains that she doesn’t mind a few lines on her face. “I just turned 30 and I feel I have more important things to worry about than my face having a line or two on it. It is an expensive procedure and requires constant maintenance. I am against botox.”
The procedure, which takes less than 10 minutes and can remove lines for up to six months, is safe and relatively pain-free, with no downtime, but should only be carried out by a qualified doctor.
The experts weigh in
Botox has been used for aesthetic purposes for decades, but questions — and misinformation — surrounding the popular injectable neurotoxin still abound. How much should it cost? Should you be getting it in your 20s? We ask leading doctors about the most pressing queries people have about Botox...
Gulf News Spoke to Dr Natalia Spierings, a consultant dermatologist, Mohs micrographic and dermatological surgeon and educator who shuttles between the UK and UAE and Dr Maryam Zamani, an oculoplastic surgeon and aesthetic doctor based in London and the founder of global skincare brand MZ Skin.
What’s the average price of getting Botox in Dubai?
Dr Natalia Spierings: There are two ways to price Botox — by area or by unit. I prefer the ‘by unit’ pricing as it is more transparent and allows the patient to understand exactly what they are paying for. In most practices the per unit price is Dh40 per unit for Allergan Botox.
Are there red flags people should watch out for when it comes to pricing and finding a doctor?
Dr Natalia Spierings: Yes. Online deals are always a bad idea! There is a black market for Botox and if it looks too cheap then it probably is. 100 units of Botox sold at cost is about Dh1,000 from the manufacturer (we are talking Allergan brand Botox — there are different brands that have different price points but they are all roughly the same). Also people should avoid going to someone’s house or hotel room for Botox treatment — not only is this illegal in Dubai but it is also unsafe. Though rare, it is possible to have an allergic reaction to Botox and if you are not in a medical facility this could prove fatal, especially if what is being injected into you is perhaps not pure Botox because it was bought on the black market.
When looking for a practitioner, experience and aesthetic sensibility are both very important. Though injecting Botox may appear easy, it actually requires a good amount of knowledge of facial anatomy and movement and also listening to what your patient wants; this takes time and usually requires a decent consultation before any needles are brought out.
Getting Botox done well and having it work for you is a journey you take with your doctor — so it is important to find someone you trust and feel comfortable with. Less is more when it comes to Botox as well — more can always be added but you can’t take it away once it has been injected! The way most doctors are trained to do Botox is incorrect — for example the idea that you can lift an eyebrow with Botox is incorrect (it doesn’t lift, it relaxes muscles which is the opposite of lifting and if you do try to achieve a lift for example on the outside eyebrow area then you are going to cause some funny wrinkles to form whenever you lift your eyebrow).
Dr Maryam Zamani: If something is too good to be true, it may be. If the price seems too inexpensive then ask questions — what product is being used, is this person fully qualified. Stay away from practitioners who come to you. It may seem that aesthetics is as easy as getting your nails done, but there are real and serious potential complications. It is difficult to manage potential complications if you do not have access to certain products or help.
Is there a right age a person should start getting Botox?
Dr Natalia Spierings: No. I always advise patients to start doing Botox when they start to notice they are developing static lines — lines that are present even when the face is ‘at rest’ or not making any expressions (like frowning or smiling). It is definitely preventative but starting when you have no lines at all is probably a waste of time and money.
Dr Maryam Zamani: Botox is FDA-approved and available for patients 18 and older. I say that the correct age is when one is bothered more days than not from whatever their issue may be. If you use neuromodulators to treat hyperhidrosis, it may be as young as 14 (with parental permission), or if you suffer from migraines, perhaps in your 20s. If a gummy smile is making you self-conscious, perhaps it is 18. There is no right or wrong age. It depends on what the reason for the neuromodulator and how much the issue bothers the patient. Generally, for lines and wrinkles, I recommend treatment when you start to see a static line without movement. I do not recommend neuromodulators for prevention before an actual line is present.
What are some of the risks involved when getting Botox?
Dr Natalia Spierings: Bruising (temporary) and asymmetry or too much/too little movement. There are no really long-term risks though some patients can have an anaphylactic reaction the first or second time they have it if they are allergic (though this is extremely rare). If Botox is done incorrectly, it can usually be corrected.
Dr Maryam Zamani: As with any in-clinic procedure, there are some risks and finding a reputable board-certified consultant doctor or surgeon with experience is essential. Common short-term risks may include bruising, transient swelling, headaches, redness or swelling at the site of injection. Other potential complications include muscle weakness, heavy brows, or asymmetry of treatment. These can sometimes be rectified with a top up. Difficulty swallowing, paralysis and allergic reactions are uncommon but documented potential risks from neurotoxin injections. The overall risk of neurotoxin is minimal.
What are the benefits of Botox?
Dr Natalia Spierings: The main benefit is prevention — prevention of deep static lines around the frown area, the forehead and around the eyes. With consistent use, mild static lines will be ‘ironed out’ and new ones should not develop. I recommend getting treated every four months (for most patients — so three times a year) to maintain the effect and keep the wrinkles away. It can also be used to treat a gummy smile.
Dr Maryam Zamani: As well as being an effective anti-wrinkle treatment, Botulinum toxin is a licensed and FDA approved treatment for chronic migraines and has also been shown to be effective in multiple different headache types as well (think tension-type, cluster headaches).
- Botulinum toxin can be used to treat hyperhidrosis (excessive sweating) on the forehead, in the axilla, the hands or feet.
- Bruxism or teeth grinding
- Can be used to debulk the massetters and make the face more narrow
- Gummy smile
- To help those suffering from blepharospasm
- Treat platysmal bands in the neck
- Elevate the tip of the nose
- Give the lips a lip flip
- Diminish wrinkling or orange peel effect in the chin
- Diminish marionette lines
- To help facial asymmetry
What is the difference between Botox and filler?
Dr Natalia Spierings: Botox is a neurotoxin that relaxes muscles and smooths out lines, preventing them from forming. Filler literally ‘fills’ — so it creates volume where it is lacking, like in the lips and the tear trough (the hollow under the eye). Botox is great for virtually everyone as they get older and is extremely effective at preventing the development of lines on the forehead, the glabella and around the eyes.
Filler is not for everyone — it needs to be used cautiously in order to enhance appearance without over filling or causing facial structure to change in an unnatural way. Also, filler has more associated risks such as infection, thrombotic events, skin necrosis and irregularities in the skin (like funny lumps and bumps). Filler also tends to move with time, which can cause problems.
I would suggest that most people should start with Botox as anti-aging and prevention and very few people actually require any filler until perhaps they are older. The two places I use filler the most are for thinning ageing lips (especially the top lip) and for tear trough problems (which can make people look older and more tired as they get older). I very rarely inject filler into younger people (like in their 20s) as generally they don’t need it unless they have a facial structure.
Dr Maryam Zamani: Botulinum toxin is a series of injections used to help temporarily paralyse muscles that are responsible for creating dynamic lines. Neurotoxin generally lasts between 3-5 months. Fillers are a group of varying substances including hyaluronic acid, PLLA, Calcium hydroxyapatite that function to fill or volumise areas. These products can be used to create volume, lift or contour and can last anywhere from 3-24 months depending on the exact substance that is used.
Remember: It is imperative to find doctors with proper credentials that can fully understand a patient's wishes and expectations while also communicating what is achievable. Do your homework and find reputable individuals. Recommendations are a perfect way to start. It is important for patients to be well educated about any procedure they wish to undertake to understand potential risks and what can be achieved. My practice is built on the ethos that less is more, so generally my patients come for the fresh look rather than a done look but there are many others that are happy to do whatever the patient desires, even if it is not in their best interest. Finding a doctor that is similar to your aesthetic is important.
10 most popular cosmetic procedures for men: From Botox to liposuction
Botox for the forehead to look less stressed
Botox to rejuvenate frown lines
Eye rejuvenation to look less tired and fresher
Jawline and chin enhancement to looking more masculine
High definition liposuction to have a defined and masculine body
Genital plastic surgery
Laser hair removal — alternative to traditional methods like shaving or waxing
Kybella to lessen the look of a double chin
Dermal fillers can help men have a smoother, fuller appearance.
In the world of beauty, cosmetic procedures and surgery, women have always made up the biggest chunk of customers.
However, more men than ever are interested in taking care of their looks and they don’t care about stigma surrounding masculinity and beauty.
A report from the American Society of Plastic Surgeons showed that more than 1.3 million cosmetic procedures were performed on men in 2019 in the US — 211,000 being surgical. According to the report, the most common surgical procedures include nose reshaping, eyelid surgery and liposuction.
“Besides the obvious reason of men wanting to improve their appearance, some men are going for plastic surgery procedures to look younger so that they can compete with their fellow friends,” said Nayri Estepanian, a beauty aesthetic adviser. “As time goes on, it is also becoming more socially acceptable for men to admit they want to look better and to do something about it.”
Estepanian, who launched nayrittastalk.com, a platform that links people to doctors and products, adds: “Most women have always cared about how they look but today with social media men are keen to look better.”
The adviser talks to Gulf News about the most popular procedures and her take on plastic surgery trends...
What kind of backgrounds do men seeking procedures come from usually?
If we talk about the men in the Arab region, many do go for surgeries yet discretely due to cultural restrictions. Young men in their teens and 20s seek rhinoplasty to reduce a nasal hump or wide nostrils, and chin implants for a stronger, more masculine profile.
Men in their 30s and 40s ask for rhinoplasty as well, and neck liposuction or neck lifts and reduction of excess eyelid fat. For men in their 50, 60s and up, they usually need a more extensive face lift with eyelid surgery and they go for common procedures that improve the appearance of their body, as opposed to the face.
What advice do you have for men seeking cosmetic procedures?
My advice for men is to know how to take care of their skin at a young age; you can see the differences at an older age.
How much is too much when it comes to cosmetic procedures?
Personally, I think doing a lot will make the person look older… and I do advise people to go for surgeries if they really need it or they need to fix certain areas.
So what do doctors in Dubai have to say about current trends for men?
Gulf News speaks to Dr Jaffer Khan, founder and plastic surgeon at The Nova Clinic and Aesthetics International, Dr Jamil Al Jamali, consultant plastic surgery and expert in aesthetic dermatology at Medcare and Dr Umesh Nihalani, specialist dermatologist at Dubai London Clinic.
When did you start seeing a rise in men seeking cosmetic procedures?
Dr Jaffer Khan: In my opinion, I think this is something that has been around for many years and perhaps we are seeing more people now because of social media influence and even a lot of the wives are bringing their husbands in for treatments. However, I don’t think that this is something that is only a recent phenomenon.
Dr Jamil Al Jamali: In the last 10 years there has been an increase in cosmetic surgery. High definition liposuction has become very popular to give the body a cleared sculptured view of six pack. For older men most common procedures are brow lift, face lift which has become very popular especially for men over 50 years.
Dr Umesh Nihalani: To be honest, it is not really a new thing. For around six to seven years, I have seen a rise in male patients seeking cosmetic procedures. I think the popularity has increased through various beard shapes which are trending. Men started getting laser hair removal done to avoid frequent visits to the barber. Due to this, they contact experts for cosmetic procedures.
What kind of backgrounds do these men come from?
Dr Jaffer Khan: Generally, men seeking cosmetic surgery are those from more affluent backgrounds and one of the most common procedures is hair transplant. After this, rhinoplasties, liposuctions and gynecomastia or reduction of the male chest are very common procedures for men to do.
Age ranges are anywhere from 25 up until 50 years of age and sometimes older, but this would be the average. I think more and more it is the younger generation of men who are more informed due to the social media platforms, which could be a good or bad thing depending on how you look at it.
Dr Jamil Al Jamali: I usually see business men, actors, people who are in front of the camera and need to look good. Age wise it is young men until 50-60 years old.
Dr Umesh Nihalani: I think men from all backgrounds are conscious about their looks and appearance. Especially men working in the hospitality and fitness industry. More men seek treatments in their 40s, but we definitely see younger male patients such as weightlifters and teachers who get dynamic [wrinkle] lines in their early ages. Recently, I have also seen young boys are very much conscious about their acne.
Do you think there is a stigma around men seeking cosmetic procedures?
Dr Jaffer Khan: I don’t think there has ever been a stigma. Perhaps men have simply just not been as aware as the women of what is available and at times are busy and have other priorities rather than aesthetic enhancements. With equality, there should be no stigma for men and it should be much the same as it is for females.
Dr Jamil Al Jamali: No, I don’t think there is any more stigma around men seeking such procedures.
Dr Umesh Nihalani: Not really, as cosmetic surgery has become a fashion and many well-known men do these procedures to look and feel better. Men want to improve their appearance and increase their self-esteem.
In your opinion, what are the top procedures that are popular for men?
Dr Jaffer Khan: Nowadays, more and more men are opting for non-surgical treatments such as Botox and fillers. However, another procedure which men are often interested in is eyelids surgery particularly for fat pads on the lower eyelids and excess upper eyelids skin.
What advice do you have for people seeking cosmetic/surgical procedures?
Dr Jaffer Khan: My advice would be that if something bothers you and it is affordable, safe, and you have understood the risks, and you feel that this particular aesthetic enhancement would give you an increased self-esteem... then I see no reason why not to do it. In this case, you should actually have a few consultations with people who you feel comfortable with and then make your choice as an informed decision.
Dr Jamil Al Jamali: Education is very important. All men should read about plastic surgery procedures to know what is the latest used machines etc. Also, they must understand that need for such surgeries are more appearance related and not medical.
Dr Umesh Nihalani: Here I want to send the message that aesthetic treatments for men and women are completely different. Planning cosmetic dermatological procedures is a multilevel approach. Experts will plan at which level of your skin, the treatment is targeted. There are many tailored treatments that can give men a good masculine look and enhance their features. It is well established that men and women have different requirements to enhance the youthful look. Mild to moderate changes in the technique can address the purpose.
My advice for everyone who is undergoing any similar treatments is that smoking reduces the effect of all these procedures. So please quit smoking for long, youthful looks. Second is drinking plenty of water, which we usually neglect in our busy lives. Consult your nearest expert for daily care regimes, which are equally important to complement cosmetic procedures.
In your opinion, what are the top procedures that are popular with men?
Dr Jamil Al Jamali: Male breast reduction surgery (when there is enlargement of the male breast gland, athletes who take hormones, those who are overweight). Most men are embarrassed about their breasts, they don’t go to the beach, pool etc.
Another type of surgery is high definition liposuction, which is also called body sculpturing using the most recent vaser liposuction techniques, which can give the body a very nice appearance especially around the trunk and breast area. This procedure has become very popular during the last five years.
Dr Umesh Nihalani: In my practice I see beard shaping as one of the most common procedures with men. Laser beard shaping reduces your visits to the barber shop, and it maintains a well-groomed beard shape. However, it only works on dark hair. So please get it done before your hair turns white.
Other procedures like Botox and fillers are getting popular in men as well.
Hair restoration is also a trend. A good hair transplant can give one a good boost in confidence levels. But in the near future many alternative, less invasive hair restoration treatments are expected.
Even other procedures, like chemical peels and lasers for general rejuvenation are in demand as well. We have seen male patients asking for regular facials too.
Why do we feel pressured to look a certain way?
Gulf News speaks to Sneha John, a Clinical Psychologist at Camali Clinic who gives us a little bit of insight as to why people have a desire to look better.
A person’s self-confidence will have a huge impact on their productivity, self-efficacy, and overall happiness. Taking the extra time to ensure that a person looks and feels their best, involves an internal perspective.
The internal goes hand in hand with the external. From an internal perspective, looking good simply means feeling confident and comfortable in one’s own skin. Societal trends around looking young and not embracing the process of ageing as a natural part of life, puts across the message that a woman should not age
Appearance related pressure is real and wide-spread in today’s age. It is linked to a host of different factors such as low-self esteem, anxiety, being self-critical and dissatisfied with life in general.
Alternative anti-ageing things to do for younger skin
After years of interviewing doctors and speaking to skin care experts, many have given me tips on how to maintain young skin. There are certain things you have to do in order to keep your skin clean, and moisturised as well as adding certain ingredients to it, in order to keep it plump and bouncy.
Step 1: Cleanser
This is a fancy way of saying wash your face. Don’t wash with soap though, you aren’t 12 years old. Get yourself a cleanser that works best for your skin, whether it’s one for oily, dry or combination skin.
To add a little extra umph to my cleaning I use a silicone face brush that vibrates to bring all the dirt out from under my skin. when washing my skin. It has changed the way my face felt after washing.
I use a cream cleanser with active ingredients like hyaluronic acids.
Step 2: Toner
Toner should usually be the first thing you use on your cleansed skin. Alcohol free ones are best. Apply the toner with cotton rounds and take it down to your neck and chest. If your toner has active ingredients like Alpha hydroxy acids or Beta Hydroxy acids, then you are doing the right thing. BHA toners actually go into your pores and clear them out, giving you the impression of tighter pores and a more clear face.
Step 3: Serum
I love to use either a Niacinamide or a Retinol serum. Serums are the second lightest liquid you apply on your skin after toner. Serums do the brunt of the work on your skin. Retinol specifically handles the anti-aging work. Retinol is magic. It reduces fine lines and wrinkles by increasing the production of collagen. It also stimulates the production of new blood vessels in the skin, which improves skin color.
Niacinamide is great for texture. It plays an important role in keeping your skin healthy. For this reason, it’s a popular additive in the cosmetic and skincare industry. When applied topically or taken orally as a supplement, niacinamide has been shown to have anti-inflammatory effects on the skin. It has been used to treat skin conditions like acne and rosacea,
Step 4: Eye cream
Although some aestheticians say that it isn’t really necessary, I noticed that it has made a difference with the lines under my eyes. Apply the eye cream with your ring finger and put any of the leftovers on your lips.
Step 5: Moisturizer
One of the final steps and the thickest cream to seal everything in. Apply all over your face and neck.
Step 6: Sunscreen
Nothing ages you faster than the UVA and UVB rays being emitted by the sun. When those UVA and UVB rays hit your skin cells, they cause wrinkling, spotting, and loss of elasticity as they burn through the integrity and biological makeup of the cell structure. Always wear sunscreen. No matter what.
Ageing is fine, but I don’t want to look older
Being young is great. There is no denying it. The energy, the metabolism and the smooth skin are all things we would never want to give up. So many older women that I come across, have told me stories about their ‘glory days’. How soft their skin was, how small their waist used to be, how they never had to colour their hair. It made me realise that I am in the glory days. I am currently living them right now. I needed to start taking advantage of the fact that this is my time to prevent the worst. So I went to see a cosmetic dermatologist, because I was curious about my skin. I wanted to know if I was doing a good job at keeping it healthy. I proudly informed the doctor that I stopped wearing make up for the last three years, that I drink more than two litres of water a day and that I moisturise religiously day in and day out. So much work! I was wondering if it paid off.
He takes a closer look at my face and informs me that at 30, I should have probably started botox two years ago. “Not because you have wrinkles, but because botox prevents wrinkles.” I wasn’t too surprised when I heard that. I know that most of Dubai’s ‘It Girls’ start getting botox injections in their late 20s every four months to prevent wrinkles and dull skin. I brushed his comment off as a sales mechanism. ‘Of course, he wants you to do botox.’ I told myself. These injections are at least Dh1,000 a session. The profits for him would be fruitful. I politely said my goodbyes and left.
Later that day, when I got home, I stood in my empty room and declared to myself that no one is going to inject muscle freezing, synthetic materials under my skin. I am young. I’m not even 30 for God’s sake! So I am definitely not ready for botox. At least not yet. Maybe one day I will need it. ‘Need’ ... what a funny word to use in this scenario. But yes. I’m in my 20s and I already have a ‘need’ to work on my face. I wonder when and why I started becoming so youth obsessed. To be very frank, I don’t mind getting older, I just mind looking older.
The media plays a big role in showing that there is a preference for younger people on the television screen. We are regularly being fed a steady and repetitive stream of images and messages that tell us to continuously strive for youth. Whenever we look at a screen, the models are young, their stomachs are flat and everything is stretchy with a dewy, healthy glow. And when they aren’t young, they look young. Media figures, who are more than 50 years old still have gorgeous skin, beautiful bodies and full hair. I mean just look at Elle MacPherson or Claudia Schiffer! They wear skinny jeans and cool sneakers. They look like they are in their 30s. That’s what I strive for. I don’t want to let my body call the shots, I want to be the one, who carefully delays looking my age for as long as I can. Because of my obsessive consumption of popular culture, I have already started my fight against time. Despite being self-righteous about invasive procedures against ageing, I still wanted to make sure that not a single wrinkle showed up on my face before I turn 40. I am going to fight the biological clock.
If I wanted to keep this face for as long as I can, I needed to start preventative measures as soon as possible. I decided that as a first step, I had to nourish my skin from the inside out. I started incorporating healthy food, full of good fats and greens into my diet. I also tried to decrease my sugar intake, which affects collagen elasticity in the skin. Moreover, I started a four-step skin routine in the morning and at night. Within just four weeks, my skin was clearer and smoother. Another thing I insisted on, was that I slept eight hours a night, every night. I also made sure I wore sunscreen whenever I stepped out of the house and that when I went to the beach that I had a large hat with me. I also never deliberately lied in the sun to tan. This was my own recipe to the concoction of my very own fountain of youth. Seems like a lot of work. But I am ready to work now, so I can reap the benefits later.
For now, I appreciate my face, my chin, my hair and my neck. I should be happy that one week of dieting makes a difference on the scale. Fast metabolisms are fun and I appreciate that they don’t last forever. I’m glad to see that I can get away with wearing funky clothes, and colourful make up. I know one day, it won’t be that easy.
I have done enough reading to know what’s coming up. I know skin loses elasticity, I know that hair becomes duller and greyer. Getting older, changes your youthful appearance and causes many women to work tirelessly to look young. I plan to be one of those women. I plan to protect myself for as long as I can.