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Guest editorial by Dr. S. Nedic for Prime magazine (Europe)

Guest editorial by Dr. S. Nedic for Prime magazine (Europe)




IN THE PAST COUPLE OF YEARS SOUTH AFRICA HAS EVOLVED INTO ONE OF THE BIGGEST emerging markets in aesthetic and anti-ageing medicine. As exotic as Africa sounds, beauty and medicine have always been a part of African history. Just a few undisputable facts: in 1967 the first human-to-human heart transplant was performed in Cape Town; and the world’s oldest art object, a necklace, was found in a South African cave, suggesting infatuation of beauty in native populations. The multi-national milieu of South Africa is often described as a ‘rainbow nation’ with specific ethnic backgrounds, cultural characteristics, social norms, lifestyle habits, and their interpretation of beauty coming together to form a huge challenge for an aesthetic and anti-ageing physician.

The South-African black majority (79.5%) has a substantial number of inhabitants engaged in a new socio-economic life in a politically changed country with status and wealth dictating their appearance. Many of these inhabitants are demanding aesthetic procedures for beautification, following celebrity looks which do not necessarily retain their ethnic features (narrowing of the nose and nostrils, mid-cheek enhancement, and decreasing overactive Procerus muscle activity). The additional challenge presented to aesthetic physicians, like myself, arises from the lack of case studies and live demonstrations on black patients in international congresses and seminars, as well as peer-reviewed articles. This leaves physicians to draw conclusions from mostly Caucasian cases and from their own patients. I have witnessed, in the past 5 years, the pendulum shift from wealthy white patients with a more conservative approach towards facial aesthetics, to wealthy black patients who are more open towards innovative treatments for beautification.

Facial rejuvenation in people of native African descent is an additional challenge since the majority of patients don’t have visible wrinkles, but rather skin laxity and hyperpigmentation. This makes the variety of radiofrequency devices, infrared tailored light and superficial chemical peels the cornerstones of treatment. The limited use of laser devices and intense-pulsed light on Fitzpatrick skin type VI for resurfacing, hyperpigmentation, stretch marks, and acne can potentially have a huge negative impact on the income of the aesthetic practice, as they opt for more suitable but usually less income-generating devices like LED phototherapy.

Urbanisation, Westernisation, and fast socio-economic growth in the black population has not changed their perception of beauty and the attractiveness of a woman’s body. Curvaceous women with a low waist-to-hip ratio and a particularly large buttocks area are still considered to be the most attractive. The bigger the buttocks, the more respect they gain from men — is the usual explanation from an African woman who is happy to use any of the available body procedures in the aesthetic market for abdominal localised adiposity or cellulite, as long as the buttocks remains big. In fact, the demand for body procedures is considerably higher than in previous years following the trends from the international market.

Understanding expeditious changes in the local market, recent trends in aesthetics, and the demand for a new profile of the patient in South Africa is imperative for the aesthetic physician trying to juggle between the patent’s expectations and their own sense of beauty and artistic vision using the most innovative procedures.