A patient came in last year asking about HIFU — High Intensity Focused Ultrasound. She’d seen it advertised everywhere, read the marketing language, and arrived with what I’d describe as cautious optimism. She was fifty-one. Her concern was jowling and neck laxity. She’d had one session at another clinic eighteen months earlier, seen almost no change, and wanted to know whether she had done something wrong or whether the treatment […]

There’s a particular look I can spot from across a waiting room. I’m not proud of that — it means it’s visible from that distance. Cheeks that sit slightly too high, slightly too round, with a quality of fullness that doesn’t move with the rest of the face. The nasolabial folds paradoxically more visible, not less. The whole mid-face looking somehow compressed, like a fruit that has been slightly overripe. […]

She apologised for looking tired. That was the first thing she said when she sat down. She’d had a full eight hours, she told me, and still — she gestured at her face. The circles had been there for years, but they seemed darker lately, more sunken. She was forty-three. I told her what I tell almost every patient who comes in describing this: dark circles are almost never about […]