Dr. Jean-Marc Peres, cosmetic and plastic surgeon

What are the main factors that influence the appearance of our skin over time?

Dr. Jean-Marc Peres: There is, of course, a genetic factor that we cannot fight. However, it is beneficial to slow down the effects of time on skin aging. First of all, it is very easy to do so by avoiding well-known external factors—sun exposure, tobacco, pollution, stress—and by committing to a healthy lifestyle (notably through exercise and diet).

Furthermore, by fighting against the decrease in hormonal secretions from age 40 onward, particularly through the management of menopause in women, but also through the monitoring of thyroid hormones, DHEA, and testosterone.

How long does a Botox treatment generally last, and are the results permanent or temporary?

Dr. Jean-Marc Peres: The effect of Botox is temporary. The injection is most often repeated after six months. Botulinum toxin reduces the muscle contractions that cause wrinkles.

What is the difference between Botox and hyaluronic acid?

Dr. Jean-Marc Peres: Botulinum toxin reduces the muscle contractions that cause wrinkles; it is primarily used on the forehead and specifically to combat wrinkles between the eyebrows, with a preventive aspect regarding the formation of these wrinkles in younger patients.

The mechanism of action for hyaluronic acid is completely different from Botox. When used in injections, it is the gold-standard product for filling in deeper wrinkles or for volumetric rejuvenation. It is mainly used around the mouth, but also on the face in general.

Are there any alternatives to Botox?

Dr. Jean-Marc Peres: There is no alternative to Botox for the forehead. Botox, used in France since 2003 for aesthetic purposes, has made it possible to considerably reduce surgeries in this area, which used to be very aggressive.

Are there any alternatives to a facelift?

Dr. Jean-Marc Peres: There is no alternative to a facelift when there is significant sagging of the facial skin. However, in my opinion, the recommendation for a facelift should remain exceptional before the age of 50. Before this period, the most important thing remains maintaining the skin by avoiding tobacco and sun (returning to the first question) and hydrating it regularly. Of course, regular aesthetic medical treatments (peels, mesofilling) are a significant plus. Beautiful skin is an undeniable advantage for the surgeon, and therefore for the patient, in optimizing the result of a facelift when the time comes.

New medical methods (radiofrequency, HIFU ultrasound) are used for moderate skin sagging, with results that I find inconsistent; they can in no way be considered an alternative to a facelift. I do not use tension threads because they have many drawbacks, and even complications, that I do not encounter with surgical facelifts.

In cases of significant skin sagging, a surgical facelift remains the fundamental technique for facial rejuvenation, all the more so because today we can guarantee a very natural result thanks to an adapted technique, while recovery after the operation is increasingly rapid.

At what age do you recommend injections?

Dr. Jean-Marc Peres: There is no specific age to recommend, because wrinkles and expectations are completely different from one patient to another. I would clarify, however, that it is not at all necessary to undergo injections before the age of 25.

Are there any wrinkles that should be kept?

Dr. Jean-Marc Peres: Personally, wrinkles do not bother me, especially certain expression lines that I find attractive. Furthermore, I believe that one should avoid a lack of expression on the forehead after a Botox injection by reducing, but not preventing, the contraction of certain muscles. On the other hand, the sagging of facial skin that appears with age can never be considered aesthetic.

What do you think of Kobido?

Dr. Jean-Marc Peres: Massages and facial treatments, especially when performed by qualified practitioners using quality cosmetics, can only be recommended in the fight against the natural aging of the face.

What advice would you give to someone considering their first Botox treatment?

Dr. Jean-Marc Peres: I believe patients first need an information consultation on all existing procedures in medicine or surgery before making any decision. Next, patients should explain to the doctor what their expectations are.

If Botox can address them, we explain the product's mode of action, particularly the balance mechanism between the depressor and elevator muscles of the eyebrow, which can be adjusted according to the patient's wishes.

Before any injection, we ensure that the patient is not taking blood-thinning medication, and we simply recommend avoiding intensive physical activity in the hours following the injection.

Which creams do you recommend to protect the skin after an aesthetic medical procedure?

Dr. Jean-Marc Peres: After a non-abrasive medical aesthetic treatment or surgery, we advise patients not to change their usual skincare protocol for a few days, in order to avoid an allergic reaction, which is always possible with a new cream.

After an abrasive, deep treatment (laser or deep peel), we recommend a soothing repair cream for the first few days, then the Alaena repair cream after a week.

What is your Alaena ritual?

Dr. Jean-Marc Peres: I use the Body & Hair Cleansing Gel in the shower daily, then I apply the Moisturizing Cream for Combination Skin to my face afterward. I regularly engage in outdoor sports, so I always take the time to apply the Tinted Mineral Sunscreen SPF50 to protect my skin.