Gentle aesthetics are replacing the knife

The Citizen

08-05-2025

It is about balance, precision, less about surgery and more about a gentle approach.
Aesthetic medicine is no longer about dramatic transformations. It is about refinement, sculpting, shaping and enhancing what already exists, carefully. It is about balance, precision, less about surgery and more about a gentle approach than just cutting someone to size.
After all, the face is a three-dimensional structure in motion, said aesthetics practitioner and Mall of Africa beauty squad influencer Dr Karishma Ramdev.
'Aesthetics is not just about changing faces,' she said. 'It is about understanding ageing, bone loss, collagen depletion and how to work with what people already have to enhance rather than alter.'
'No longer is it just about looking good in pictures,' she said. 'It is about feeling good in your own skin.'
Slow ageing without looking like someone else
'People are becoming more aware and accepting of aesthetic treatments,' she said. 'They are looking for ways to slow down ageing while still looking like themselves.'
Aesthetic medicine offers non-invasive or sometimes minimally invasive alternatives to plastic surgery. It is becoming more popular due to its shorter recovery times, lower risks and personalised treatments.
Unlike plastic surgery, which requires specialist surgeons and involves more extensive procedures, aesthetic medicine can be performed by trained physicians and general practitioners in South Africa.
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In previous years, aesthetic medicine gave us stiff upper lips and expressionless foreheads. No wrinkles, but no character either. But things have changed, said Ramdev.
In recent years, there has been a move away from exaggerated fillers and frozen expressions toward more subtle enhancements that preserve youthfulness without obvious intervention.
'People aren't asking to look different,' she said. And that, she believes, is where true aesthetic skill lies. It's not in altering, but in restoring, rebalancing and preventing.
'It's not just about wrinkles'
'It isn't just about wrinkles and fine lines,' she said. 'We treat skin laxity, acne scars, stretch marks and even conditions like varicose veins.'
Techniques may range from injectable treatments like botulinum toxin (Botox) and hyaluronic acid fillers to more advanced procedures such as chemical peels, thread lifts and energy-based therapies like ultrasound and laser treatments.
Body sculpting has also gained traction, offering non-surgical ways to contour and define areas of the body that resist diet and exercise.
'Botox isn't about freezing the face,' she said. 'It is about softening movement before wrinkles become permanent.'
Collagen-stimulating treatments are gaining momentum too, it's a way to counteract the natural depletion of collagen that begins as early as 25.
'We aren't just filling lines anymore,' she said. 'We are rebuilding the foundations of the face in a way that looks effortless.'
Despite its growing popularity, aesthetic medicine remains one of the most misunderstood industries, said Ramdev.
'There is a huge difference between well-done work and overdone work,' she said. 'The problem is people only notice the bad work.'
Her goal has always been to change that perception through education. 'I spend just as much time explaining procedures as I do performing them,' she said. 'When patients understand what we are doing and why, they make better decisions about their own faces.'
Men are sneaking into consults
Women have long led the charge in aesthetic medicine, but the tide is turning, and men are now sneaking into consults, often as a plus one with their partners at first.
'A decade ago, men barely spoke about aesthetics,' she said. 'Now they come in knowing exactly what they want. These can be preventative treatments, sharper jawlines, and subtle refinements that don't scream that they have had work done.'
Male aesthetics is moving into the mainstream, reshaping traditional ideas of masculinity in a post-metrosexual, more free society. 'Men are finally allowed to invest in their appearance without it being taboo,' she said. 'And they love the results.'
While male patients seek definition and structure, women continue to prioritise volume and skin health. 'Women know what works,' she said. 'They have been exposed to aesthetics far longer and are comfortable making tweaks to preserve their features rather than overhaul them.'
Preventative treatments are also becoming the norm. 'The younger generation isn't waiting until things start sagging or creasing,' she said. 'They are stopping it before it happens.'
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