The Silhouette Thread Lift: Changing faces?

It has always been my mission to stay on top of new developments in the cosmetic industry, whilst at the same time using my experience, common sense, and judgement to make an assessment on whether these would benefit my patients.  The Silhouette Thread Lift is a procedure that I have been keeping a professional eye on  for well over a year  now.

The Silhouette Soft, in particular, looks appealing as it tightens sagging skin whilst simultaneously increasing the production of collagen. The appropriately trained practitioner lifts lax skin in the desired facial regions using sutures containing polylactic acid, a fully absorbable ingredient that has been used in medical procedures for years.

What’s more, unlike previous thread lifts, there are no incisions and the sutures are dissolving. Instead, a fine needle is inserted about 3-5mm under the skin and progressed along the direction of lift that is desired. Usually two threads are placed on each side to achieve the desired lift in any given region. How many threads in total are used will depend on the extent of the lift desired.  These Silhouette Soft threads are then held in place by virtue of multiple absorbable cones positioned in opposing directions within the thread  thereby “snagging” itself  and holding the surrounding tissues. The doctor then compresses the tissue by pulling up on the sutures to create the desired lifting effect. Whilst this is the primary mechanism in which the Silhouette Soft thread lift works, there is also a biostimulation effect from the polylactic acid material of the threads, causing the body’s own collagen to build up gradually around the thread itself. The whole procedure takes around 30 minutes and the lift results are immediate.

Silhouette Sift Before & After

A photo from Silhouette Soft illustrating the lifting effects of the thread lift.

How long do the results last? This of course will vary with individuals, however in general it may last 12-18 months although there will be patients who will fall outside of these time frames, on both sides, depending on the quality and elasticity of their tissues.

Dr Costas Papageorgiou, our oculofacial surgeon and medical associate, has completed the required course at the Silhouette Beauty laboratory and is confident this is a viable option for select patients in their 30’s to 40’s who are experiencing some early sagging and perhaps are not surgical candidates but want to address some cheek or early jawline laxity.

Those who read my blogs will notice I completely dismissed the one stitch face lift in 2013. I want to clarify that that particular procedure is different and does require incisions, uses permanent threads rather than absorbable ones and was often performed by doctors who were not neccessarily trained in facial aesthetics.  As a surgeon, I am not satisfied that the relative invasiveness that is needed with the one stitch face lift on balance weighed up against the relative short duration of time the results last  are in the patients interest and I still stand by that. I think that if one is going to offer a shorter duration of effect from any particular treatment, and  provided of course the patient understands this, then at least at the very minimum is should absolutely be minimally invasive with no scars at all.

Moreover I also want to make clear that I firmly believe that a full face lift is still the gold standard in cases of more advanced ageing and is also the most consistent, reliable and longest-lasting option for suitable candidates.  However,  I do appreciate and am aware that there are some patients out there who are not quite “ripe” for a surgical procedure but nonetheless desire some immediate “tightening” in a much less invasive way, and are prepared to accept a shorter duration of effect. In these instances  feel that the Silhouette Thread Lift, which is FDA approved for the US market and CE marked for the European market, could provide such a solution.

The most important key to the success of this treatment will always be to ensure that patients understand and manage their expectations accordingly to avoid misunderstandings and disappointments. From our point of view we will do our utmost to ensure the appropriate information is therefore conveyed.

Call our London clinic 0207 432 8728 or Karidis Medispa on 0151 709 8593 for more information.

How not to get old – Surgical and Non-Surgical Q&A with Mr Karidis

If only the fountain of eternal youth was bottled and evenly distributed to the population. Alas, it is but a myth.

However, modern technology and advances in science and medicine has allowed us to delay the appearance of ageing and that is exactly what the new Channel 4 series, How Not To Get Old, focuses on.

As one of the Cosmetic Surgeons to be featured in the programme, I thought it would be a good time to write a blog about the common questions posed during a consultation, both for surgical and non-surgical procedures.

How not to get old

The new Channel 4 series examines surgical and non-surgical ways to stay young

How much does diet and exercise actually contribute to staying young? Isn’t it more to do with genetics?

Eating healthy food and exercising regularly reaps so many rewards not just on a physical level but also emotionally and psychologically. Of course certain things can be ‘blamed’ on genetics but there is a lot to be said for the effect that extrinsic factors have on the skin and overall ageing process. It is well known that certain vitamin and mineral intake improve the quality and complexion of the skin including the widely publicised effect of vitamin C improving the look of fine lines, texture of the skin and to some extent improving pigmentation of the skin. A good diet, plenty of hydration along with regular exercise improves circulation and the delivery system of those vital nutrients and oxygen to the skin leaving you more fresh faced and glowing.

I’m in my 50′s and my skin is sagging and looking a bit droopy. Should I try your non-surgical treatment Ultherapy or would I be better suited for a face lift?

Ultherapy can improve the texture of the skin in any age-group, however it does have its limitations! Typically, the less severe the sagging is the higher likelihood a non surgical procedure will benefit you .  This is because if sagging is quite advanced then you are probably a better candidate for surgery. We see fantastic results in people in their 30’s, 40’s and beyond with the Ultherapy, providing the skin is of good quality. However, it is usually recommended that a consultation in which both non-surgical and surgical options are discussed in order to best suit your individual needs and expectations.

Is there a treatment that can get rid of my fine lines around my eyes?

Treatments for fine lines are aplenty ranging from wrinkle-relaxing injections, to accent radio frequency, to Palomar fractional laser to Oxygen Infusion and more. A complimentary consultation with one of the nurses can determine which would be best for your skin and budget.

What is the ‘best age’ to have a face lift?

We usually see people in their 40′s upwards for face lifts. Obviously you need to have a reasonable degree of sag present which needs to be corrected and for some people it does begin early, say early forties. I guess it would depend on your philosophy, however many people prefer to have correction of any sagging before it becomes too apparent. This is because the effects of your cosmetic surgery will not be as obvious as it would be if you wait until the sagging is well advanced. Furthermore from a surgeon’s point of view it is usually better for us to work on tissue which still retains some elasticity and therefore is better to work with.

I’ve looked after my face over the years but every time I look down at my hands, I’m reminded of my true age! What can be done about ageing hands?

We have a developed a fantastic 3-part system for this problematic area. Our non-surgical Ultimate Hand Lift combines Laser / IPL with a chemical based peel and dermal fillers in order to give the result of smoother, younger looking hands. If one is also troubled with prominent hand veins, the surgical route may be recommended. We work closely with a vein surgeon who can effectively deal with those too. We’ve had many happy clients in both cases.

The skin above my knee is becoming saggy. Is there a non-surgical treatment to give it a lift?

This is traditionally a difficult area to deal with. However Accent radio frequency can be used to lift and tighten the skin – usually this is achieved over a course of around six treatments ensuring you have the best possible results. We are considering the use of Ultherapy being used for sagging skin around the knees, although it is still in the trial stages.  Nonetheless there is no treatment that will completely eliminate sagging in this difficult region and the aim is simply to improve it.

I’m in my 20′s, should I consider using Botox now or should I wait until the lines are more prominent?

Collagen production usually starts to slow down in your late 20s, after this time fine lines and wrinkles may become more apparent and visible and could benefit from wrinkle-relaxing treatments like Botulinum Toxin Type A (commonly referred to as Botox). We wouldn’t advise this injectable to anyone who just ‘wanted’ it. It is a prescription drug and we have a responsibility to our clients to only use it if they need it, so a consultation will definitely be required. As to whether to use it as prevention rather than cure – I am of the belief that you can prevent deeper, more refined lines by targeting it earlier but again, it depends on the individual.

I have always wanted more defined, slightly larger lips but am worried that I would be left with a ‘trout pout’ as seen in some magazines!

Magazines don’t really do our industry justice sometimes! We champion the natural look giving a boost in volume without overdoing it. ‘Less is more’.  Nowadays, with the use of hylauronic acid based dermal fillers, a very natural long-lasting result can be achieved and we can say goodbye to the days of the trout pout!


If you have a question now or during the How Not To Get Old series, please tweet @MrAlexKaridis using the #AskKaridis or email and my team of highly skilled aesthetic nurses will respond to you!


Has Catherine Zeta-Jones had a brow lift?

I must say I struggled to recognise Hollywood actress Catherine Zeta-Jones in her latest role alongside Gerard Butler in Playing for Keeps. I feel she has significantly changed her look through what appears to be a Brow Lift.

Of course I’m not saying that she looks awful or terrible in anyway, it’s just not the CZJ we are used to.  You see the Catherine we remember always had a full upper eyelid and slightly low set brow. This can give a very sultry and appealing look when a woman is young and a feature I think the Welsh star used to her advantage early on in her acting career. However, as one grows older the skin quality in the upper eyelid starts to thin and lose some of its elasticity, resulting in some sagging, which droops onto the upper eyelashes giving rise to a sleepy or tired look.

Catherine Zeta-Jones with her sultry eyes in 2007

Catherine Zeta-Jones with her sultry eyes in 2007

Catherine Zeta-Jones in Playing for Keeps

In the film ‘Playing For Keeps’, her brows look lifted

From a surgeon’s perspective, we have no way of changing the consistency of the skin to make it feel firmer, one alternative we use to counter this in the early stages is to recommend cosmetic surgery in the form of an upper eyelid or blepharoplasty procedure, something I believe the 43 year-old may have had a few years ago.

However, in someone like Catherine, who also possesses a slightly low set brow, the improvement in the upper eyelid region does not usually last long because the brow starts to weigh in and drop, giving rise to the same heavy look in the upper eyelid region that was originally corrected.

When this happens the best thing to do is to counter the sagging by lifting the eye brows. This works very well, and with today’s surgical techniques the cosmetic procedure is carried out through three small incisions within the hairline of the frontal scalp. The one caveat that one needs to accept is that although it will give you a brighter more open look to the eyes, it can also change your look somewhat as appears to be the case with Catherine Zeta-Jones.  That is why it’s very important for this to be done conservatively, by avoiding having the eyebrows pulled too high or pulling the medial or inner eyebrow part too high, otherwise you risk looking like a rabbit in the headlights!

Nonetheless I still think its important to note that even small lifts of the eyebrows can change your expression or look somewhat. That is something a patient will need to accept if it means looking brighter and less tired, so the trade off in many instances will still be worthwhile.

I’m sure we’ll get used to the new look of Michael Douglas’ glamorous wife, even if she did raise my eyebrows.

For more information on Brow Lifts, Face Lifts and other procedures please visit or call a member of the Karidis team on 0207 432 8727

The Ultimate Hand Lift

Long said to give a person’s age away, the latest body part to be given a ‘lift’ in order to turn back time is the hand. Often riddled with age spots, wrinkles and pigmentation due to over-exposure of the sun, our hands can look tired, sunken and leathery with age but the cosmetic industry has a solution!

Cosmetic surgery has shaved years off many faces around the world but hands are a much more complex matter. The ‘hand lift’ we offer at Karidis is not a surgical procedure however, in fact it is a combination of three non-surgical treatments put together to create the ultimate in skin renewal and rejuvenation and means there’s no downtime.

The Ultimate Hand Lift would smooth and plump the skin

At our London and Liverpool clinics our Ultimate Hand Lift includes a chemical peel, a hyaluronic acid-based filler injection and laser treatment, the combination of which will conceal prominent veins, plump up the skin and eradicate pigmentation such as liver spots and sun damage.

The chemical peel is applied to the top of the hand where sun exposure has taken its toll and where age spots seem to cluster! The peel will gradually lift the pigmented areas and can take more than one treatment to be fully effective. We then use a laser, either the V-Beam or Intense Pulsed Light Therapy (IPL), which helps to firm and tighten the skin, boost collagen and also reduces the appearance of any discolouration and fine lines. Finally we inject the liquid hyaluronic acid that hydrates and therefore plumps up the skin giving your hand a much more youthful, wrinkle free look!

We recommend three treatments of the combination, one every three weeks to give the pigmentation the chance to lift and the collagen to be stimulated.

As with most laser treatments, the Ultimate Hand Lift combination is not suited for people who are going on holiday shortly as the sun exposure will reverse the effects of the treatment, this can be avoided by wearing an SPF Factor of 50 or wearing sun protective (cotton) gloves.

We are offering the Ultimate Hand Lift for £250 per treatment, or a course of a three for £650, which includes a free pharmaceutical grade SPF cream of 50.

Please note these prices are based on the client requiring one syringe of hylaronic acid per treatment. Book a consultation today and get the young hands your young heart desires!

The Keogh Report on the Cosmetic Industry: My View

The NHS Medical Director, Sir Bruce Keogh, has submitted a report regarding cosmetic intervention, the content of which has sparked a media frenzy.

NHS Medical Director

The ‘Keogh Report’ contains guidelines that could have a big impact on Cosmetic Surgery in the UK.

Spurred on by the PIP breast implant scandal in 2011, Sir Keogh and a panel of industry professionals have created a 68-page document in which they have pulled the industry apart in order to rectify, regulate and reconstruct its existing flaws.

With quotes such as: “It is our view that dermal fillers are a crisis waiting to happen” in the report, it is easy to think the cosmetic industry is heading for trouble.

Well, in many ways, it is. It is in trouble because there isn’t always adequate protection or support for the patient and there is a host of unregulated, illegal products being used by people who are simply not qualified to administer it. This then often falls into the laps of the NHS, who are left to pick up the pieces.

If the Keogh Report regulations pass, Botox will be better controlled

If the Keogh Report regulations pass, Botox will be better controlled

The Keogh report proclaims that a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush. That simply has to change. One way is to classify fillers as a prescription-only medical device, a point made by the board.

I cannot tell you how relieved I am of the report’s findings and suggestions as I have encountered far too many unfortunate people who have come to me following botched surgery or unnecessary complications as a result of these so-called ‘Cosmetic Surgery Cowboys’.

We work to an incredibly high standard and ethos at Karidis, whereby our staff are fully qualified to carry out the treatments and where consent forms, cooling off periods, advice on alternative solutions and quality of care are the absolute norm.

With the cosmetic industry in the UK estimated to rise to £3.6 billion by 2015, the government must act quick to make sure the safety standards and common practice guidelines set out in the report are fully implemented to stop more people falling victim to pushy cosmetic sales people, irresponsible advertising, illegal wrinkle smoothing solutions and potentially life-threatening situations.

Only then will we be able to improve the industry as a whole, for both the patient and the professionals.

Follow the link below to read the full report:

The One Stitch Face Lift: Unravelled


In my experience, quick-fix procedures that sound too good to be true in the world of cosmetic surgery, often are and this can be said of the ‘One-Stitch Face Lift’.

The minor surgical procedure, also referred to as the Silhouette / Thread Lift, is performed under local anaesthetic and usually takes under an hour. Two incisions are made on each side of the hairline and a barbed thread is inserted by a long needle which then anchors itself in the tissue around the cheek. The thread is then pulled, creating the lift, and secured with a suture.

Mr Karidis gives his verdict.

Sounds quite straightforward doesn’t it? However, don’t forget,  this IS still an invasive procedure and as such isn’t always as straightforward as the title may suggest. The one stitch face lift can cause scarring from the incisions, there is still a period of downtime after the procedure and the results are only said to last up to 18- 24 months. Furthermore having performed similar thread lifts in the past myself, I also found problems with the “threads” extruding from the skin as well infections developing around the tracts of where the threads were inserted.

Moreover, as a cosmetic surgeon  one of my main concerns is that there is no longevity in the results and it feels like a false promise. The client will often pay a lot of money and not get the matching, long lasting results they deserve.

My advice is to have a consultation to determine whether you even need to go down the surgical route. If your situation is such that you do not have significant skin laxity or droop, then it could well be that Ultherapy would be a better option for you. Ulthera is a completely and truly non-invasive, non-surgical treatment which is both effective and simple to perform. It uses ultrasound to tighten, shrink and stimulate your skin’s natural ability to rejuvenate and rebuild the collagen. Furthermore it is only performed once and so no need for multiple sessions.

Alternatively of course, it may be advised that Ulthera wouldn’t be effective and the best solution to complaints of sagging skin and jowls would be best treated by a full or part-face lift. However if this is what you require, then you should not fear this but accept it. The truth is that, provided a face lift is performed by a suitably experienced surgeon, it should be able to turn the clock back effectively and give you many years of satisfaction. In these situations,  there is no point in offering a lesser or smaller procedure just to appease you or entice you into having surgery.

Ultimately, the saying is true: “You get what you put in” and if that is one stitch, you shouldn’t expect too much in return, so please do keep your options open and do what is best for your skin, your look and what you want to achieve.

Will you be a sucker for the Vampire Facelift?


American Reality TV star Kim Kardashian caused controversy  when she shared photos of herself undergoing a Vampire Facelift. The ominously titled procedure gained press attention earlier this year when it was included via gift certificate in Oscar nominees’ gift bags. As a result, I’ve been approached by numerous people over the past month all asking the very same question… What exactly is a Vampire Facelift?

The first thing to note is that the procedure is much less scary than the name suggests… The non-invasive procedure provides patients with fantastic results without the need of going under the knife. The 90-minute procedure begins with roughly two teaspoons of blood being drawn from the patient’s arm. This is then spun through a centrifuge for around 6 minutes, during which time the red and white blood cells separate. This process produces a plasma rich with platelets, or very small cells, which stimulate the growth of more cells.

Kim Kardashian - Vampire Facelift

The platelets are reinjected back into the face, neck and décolletage in areas viewed as ‘trouble spots’. These include the wrinkles under the eyes, the neck and the ‘tram lines’ that run from the nose down to the mouth. The platelets need to be injected back into the face within ten minutes of the blood sample being drawn; otherwise they coagulate and turn to jelly.

Platelet-rich Plasma Therapy, as it is commonly referred to amongst medical professionals, is one of the best and safest procedures for skin rejuvenation and boosts the creation of new blood cells and collagen without surgery.

Would you consider a Vampire Facelift? Tweet me @MrAlexKaridis

For more information on Platelet-rich Plasma Therapy and other treatments available at the clinic, please visit my website.

A Spot Of Trouble

As people enter their forties it is often assumed that the bad skin that has plagued them since their teenage years will be long gone. Yet for many this is far from the case…

Thankfully there are multiple courses of treatment available to treat this painful, embarrassing and sometimes disfiguring condition. Everything from the contraceptive pill, to antibiotics and intense pulse light therapy have been proven as effective solutions to achieving a clearer complexion.

However, tackling the initial outbreak is often just the beginning of the battle, with some spots leaving scars that can take months, or even years to fade.

In addition to the face, acne outbreaks are also common on the chest and back, which can have a damaging effect on a person’s self esteem and even dictate what they choose to wear.

In extreme cases, acne can even leave permanent scars on the skin’s surfaces, and as celebrity sufferers Victoria Beckham, Katy Perry and Cameron Diaz can confirm – make up can only cover so much…




I receive a significant number of enquiries from women in their 30s, 40s and older, asking for solutions to eradicate their acne scars.  Here at the clinic, we offer a number of treatments aimed at improving the appearance of the skin, the treatment that I most often recommend for this type of scarring is Micro-Needling.

Medical Micro-Needling is a treatment that constitutes a form of Collagen Induction Therapy (CIT). It is also referred to as a non ablative skin treatment. This means that the deeper parts of the skin are treated without removing the top layer of skin. Its ability to improve skin colour and other skin texture changes means that is an effective solution for light scarring from acne and photodamage.

For more information of this procedure, please visit my website.

Do you suffer from adult acne? Tweet me @MrAlexKaridis

The ‘Thigh-Gap’ Trend

Thigh Gap  trend on the catwalk

The ‘thigh-gap’ first sparked controversy last month, when Twitter users admitted that they were prepared to stop eating in order to achieve the super-slim thighs of the models they saw on the catwalk’s at fashion week.

This trend had spread far and wide across the social landscape, with dedicated sites such as ‘Mind The Gap’ and Twitter account, @CarasThighGap, which cites model, Cara Delevigne.

The desire for such slim thighs is so strong, that some surgeons have  reported an increase in demand for thigh specific procedures.

While diet and exercise can help slim down and tone the area, there will always be stubborn pockets of fat that are resistant to diet and exercise alone; liposuction can help with this.

Inner thigh liposuction is a common area of concern among many women who visit my clinic looking to have the procedure. The treatment can significantly improve the silhouette of the thigh and sculpt problem areas. Following  the procedure, the patient will be able to instantly see and feel a difference.

During an initial consultation with your surgeon, you will be assessed on your suitability for the treatment and your expectation for the end result. Your surgeon will give you a realistic overview of the results you can achieve. It is important to remember that liposuction alone will not give long lasting results, a healthy diet and exercise routine are also needed to prolong the results..

If you would like any further information on the treatment, please don’t hesitate to contact me on Twitter @MrAlexKaridis or alternatively, call a member of my team on 0207 432 8727.


The Curse of the Hollywood Botox Binge

Are the starts of the silver screen overdoing Botox treatments? Despite not being nominated, Renee Zellweger managed to garner a large amount of attention at the 2013 Academy Awards due to her surprisingly youthful complexion.

The 43 year old’s face, and its lack of movement, caused something of a debate on Twitter during the ceremony, with many of the social media users speculating that she had resorted to cosmetic treatments to turn back the clock.

Renee Zellweger Botox

In my opinion, the smoothness of her complexion and omission of any wrinkles is unnatural for a woman of her age. From her appearance, I believe that she has undergone a non-surgical treatment such as Botox, though her lack of expression suggests that she may have been prescribed a little too much.

Of course Renee wouldn’t be the first Hollywood actress to resort to Botox as a means of competing with a more youthful Hollywood crowd; Jennifer Aniston, Nicole Kidman and Courtney Cox have all admitted to having Botox treatment in the past. There are undoubtedly many more who have not and will not admit to having the injectable treatment too, those who have ‘Baby Botox’ may escape the media’s attention for example by having subtle changes.

Botulinum toxin type A, commonly referred to as Botox, is a purified protein that works by relaxing the contracted muscles in the face that cause wrinkles, thus creating a more youthful look.

At my London and Liverpool clinics, we selectively address problem areas in order to achieve a natural, rejuvenated appearance for all of our clients. By adding smaller amounts of Botox, we can create a youthful look without restricting movements of the face, thus avoiding the frozen look. In Renee’s case, I would say that through seemingly overdoing her wrinkle-smoothing treatments, she has failed to achieve this effect.

What do you think of Renee’s new look? Tweet me @MrAlexKaridis

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