Award-winning , Dr Sophie Shotter is the beauty editor's favourite skin doctor. Most famous for her natural-looking injectables, seeking out and offering the best tech treatments and working with clinically-proven, specifically selected skincare brands, Sophie is the doctor to have in your little black book. Sophie is also on the BCAM board, a charity actively pushing for better regulation. Sophie is the founder of the Illuminate Skin Clinic in Kent (she also practices in London) is a fan of the subtle transformative powers of Botox and fillers, but believes that before you even consider injectables, looking after your skin is a must
“I always take an inside-out approach to skin health - you can’t add one great product to your routine and hope it fixes everything if you’re practising bad habits elsewhere in your lifestyle. It’s all about combining supplementation, nutrition, exercise and, of course, great clinically evidenced products and treatments," she says.
Which treatments would she trust with her own face and body for natural effective results? From a breast lift to fat freezing, laser and ultrasound, here’s what Dr Shotter swears by.
The skin I’m in
“I’ve looked after my skin from a young age, so, fortunately, it still looks pretty good. My main concern is ageing; I want to preserve as much collagen as I can. I have a few slightly looser pores around my T-zone which weren’t there 10 years ago, and some fine lines around my eyes. I don’t mind a few fine lines creeping in as I age, but I want to help my skin stay firm and tight. I also have a big bust, and so am conscious of lines appearing on my décolletage. I am trying to be proactive and remember to apply my skincare my products right the way down my chest. Pollution is also an issue as I spend a lot of time in London I’ve been having ‘tweakments’ since I was 30, and how I’ve addressed my face has changed over the years. It started out with just a little Botox and then around age 33, I added fillers."
My skincare regime
"I thoroughly cleanse my skin morning and night to lift off any pollution that is sitting on my skin from a day in London. I also take a great antioxidant supplement called Pro Luminous by Zenii £45 . It is great for protecting my skin from oxidative stress due to pollution, and also for helping minimise damage from glycation. I had some DNA testing done, which told me that I’m moderately prone to ageing as a result of sugar (glycation).
The non-surgical treatments that work for me
I try to stimulate my collagen production using different techniques that treatments all work in slightly different ways and so it’s a multi-pronged attack.
* Radiofrequency: "I have Venus Viva nanofractional resurfacing every three months, for skin texture. It keeps my pores nice and tight and my fibroblasts stimulated. It’s not painful – we apply numbing cream. You’re quite red afterwards, which goes down over the first 24 hours. The skin can feel and look a little dry for a week.
* AHA peels: "I have regular SkinBetter Science AlphaRet Peels - these have no downtime but contain powerful AHAs and retinoids to help keep my skin healthy. I sometimes combine these with a Hydrafacial."
* Ultrasound. "I had Ultherapy, a skin tightening treatment which heats the skin using ultrasound on my neck 18 months ago, and am due to have it again. This works at a deeper level than radiofrequency and is the only non-invasive way to target the SMAS, which is the layer a surgeon manipulates during a facelift
* Fat freezing. "CoolMini by CoolSculpting helped refine my jawline. I had it six months ago and it worked quickly on me. I didn’t have a big double chin, but it’s definitely refined the angle of my neck very nicely."
* Sofwave: "This is a new generation Ultrasound treatment which uses parallel beam technology to lift and tighten the skin. I’m in love with it!"
The injectables I rate
* Botox: "I started having Botox at 30 initially in my frown lines and to address crows’ feet. I now have it every three to four months on my face and neck. I have a gummy smile and it can be used to relax the muscle that pulls up the upper lip (it just drops the upper lip by a couple of millimetres). My masseter (jaw) muscles used to be bulky and make my jaw look square, so I have Botox there too. In my chin, it relaxes the upwards pull of the mentalis muscle, which can happen with age and causes the crease beneath our lower lip.
* Fillers: Five years ago I started having fillers in my cheeks to support my tear trough. I had a very early loss of volume under the eyes, which I wanted to address preventatively. I now also have fillers in my cheeks, chin, lips, and nose.
"My chin has been a concern for several years as it’s naturally slightly receded, and so will make me prone to heavy marionette lines in the future. I’ve had filler in my chin to project my chin forwards slightly and give me a stronger jawline. This will support my face and help minimise any sagging and marionette lines. It puts tension into my facial tissues rather than just trying to keep everything tight from the cheekbone area, which can result in looking over-filled.
"I’ve also had Volite, a very soft filler, which acts a little like an injectable moisturiser."
* Profhilo: "For the last five years, I’ve had Profhilo , a heat-stabilised hyaluronic acid in my face, neck and décolletage. We inject it in specific spots from where it spreads out, stimulating your own fibroblast cells. We do two sessions one month apart, and the result is firmer more hydrated skin. It’s as though your skin looks filtered.
"If I had to choose Botox or fillers, I’d choose fillers. The change is immediate and really noticeable. It allows me to address the changes in my facial structure, plus the hyaluronic acid in filler does provide some collagen stimulation in its own right, and draws moisture to the treated areas – so your skin looks better anyway. You can’t lose with carefully done filler.
"I have a trusted colleague assess my face, and together we work on what we both see. It’s impossible to see your own face in three dimensions, so objectivity is important."
Under the knife…
"Six years ago, I lost a lot of weight, four-and-a-half stone, which left me with excess skin on my breasts. I had a breast lift (mastopexy). I'm still am really happy with the result and will consider repeating the procedure when I need to. Last year I also had a correction of flat nipples - they weren’t inverted but were flat, and it bothered me. It’s an easy procedure under local anaesthetic."
"I’ve had some CoolSculpting on my stomach, which works by freezing fat cells to around -11C, permanently killing around 25 per cent of the fat cells in a given area. These are permanently gone, so it’s great for treating stubborn pockets of fat. I had a pretty flat stomach anyway but hated the fact that I had quite a bit of grabbable fat on my upper stomach. I felt like I could see/feel this particularly when I sat down wearing something with a waistband. I’m much more confident about it now. I’d love some more to work on my arms - they’ve always felt big and I often struggle with the sleeve size in jackets and blouses, but it’s hard to find time to get on the treatment couch myself.”
"I’m really excited to try Uvence. This is a procedure which involves localised liposuction to remove some fat. This is then processed in a laboratory to create a standardised injectable fat product which is just for you. This can be injected into the skin of the face and other areas for impressive and lasting skin rejuvenation."
Treatments I’d really love to try…
“Venus Legacy radiofrequency on my legs to tighten up the skin. It feels a bit like a hot stone massage and it’s also great for cellulite. The need for weekly appointments over eight to ten weeks, isn’t doable for me at the moment, unfortunately. I’m interested in the new CoolTone by CoolSculpting, which launches in the UK in 2020. It’s a muscle stimulating device which will cause some fat loss as well as stimulating muscle definition and development.”
What would I'd ever go near...
“I would never touch any form of permanent filler or threads. Anything that is put in my face should be dissolvable in case there were ever any problems.”
The treatments that give biggest bang for your buck
“For me the treatment that gives the biggest bang for your buck is fillers - my patients have real wow results, as I am literally sculpting their face. It’s where medicine meets art. But that does come with a caveat. I don’t feel there’s any point in investing in injectable treatments if you’re not looking after your skin too. Good products and in-clinic treatments give a smooth, even canvas. I firmly believe injectable results look better and last longer if a patient is also taking care of their skin.”
The lifestyle habits that support my skin
Not smoking and avoiding the sun. I wear a Heliocare SPF 50 every day, including on the cloudiest winter days. Unless you need to use a torch because it’s so dark outside, you should use an SPF of at least 30. I’ve never smoked and my skin is grateful for it. When I see young patients with premature lines and wrinkles, they’re almost all smokers. Smokers are also more prone to breakouts and tend to have more lacklustre skin tone. I would encourage them to stop smoking, introduce alpha-hydroxy acids to their skin, consider Profhilo or Volite to improve their radiance inside out, and put them on a retinol if their skin will tolerate it. I would also put them on Zenii Pro Luminous and Pro Collagen powder to improve their fibroblast activity, and help them to mop up more free radicals from the damage their smoking does to their skin.
Exercise is great for mind, body and skin. It’s one of the best stress relievers for me, and also increases blood flow to the skin so that skin is healthier and looks more radiant. I used to do a lot of HIIT trainin g which I loved, but found that with my busy schedule it was just too much stress for my adrenals and I ended up burnt out. So now I focus on more LIIS (low-intensity steady state) training, with HIIT sessions when my body tells me I have energy to spare.
Find Dr Sophie Shotter at Illuminate Skin Clinic in Kent and 10 Harley Street in London.