Dr Vali is the antithesis of those Instagram doctors you see. You know the ones, whose time-lapse videos starring influencers appear to give instantly transformative results, making everyone want to get in on the – seemingly easy breezy – action. Busting dark under-eye circles, creating social media-sensation lips… all with the flick of a needle, et voilà.
Well, it doesn’t work like that, says the diminutive cosmetic dermatologist and founder of LMS Wellness, whose YSL Tributes give her an extra five inches, but it’s her knock-out charisma that makes her seem six foot tall.
BUSTING THE INSTA MYTH
Board-certified twice, at Kings College London and UCLA, Dr Vali travels the world treating an invitation-only client base of royalty, supermodels and CEOs when they can’t make it to the LMS Wellness base in London’s Chelsea (a Dubai outpost is due this year). Operating from a starting point of ethical obligation, she says, “I’m medically responsible to do the right thing for you.” Which means that if a young girl comes in pointing at her phone and asking to have her lips plumped à la an Insta-star, Dr Vali’s initial response is, more often than not, no.
“You will have young clients coming in saying, ‘I want these lips’. I’m like, ‘Really? But you don’t even look like Emily Ratajkowski. You have acne or rosacea or big hollows under your eyes or pores. Who’s looking at your lips?’ I re-educate them and send them back home,” she explains.
“That’s what I don’t like about the social media movement,” Dr Vali adds, “Putting pictures up of your lips getting injected – it’s not a beauty treatment, it’s a medical procedure. They do not show you the complications. People come in and say, ‘She didn’t get any bruising when she had her lips done.’ I reiterate, ‘They didn’t show you that.’”
While procedures such as fillers and Botox may be marketed as casual ‘lunch-time tweaks’, when administered irresponsibly, poor results, “Can affect someone’s psychology so quickly,” says Dr Vali, whose four degrees and three postgraduate qualifications are testament to the medical skill behind her practice. “Even if people think it’s fluffy medicine, it’s medicine. You have to treat it like that.”
Social media has unquestionably had an enormous impact on aesthetic medicine, and not necessarily for the good, Dr Vali says. “I think social media can be detrimental to a person who doesn’t know themselves very well. It can make you seek out doctors much more quickly than you should do at a certain age.” The confidence-shattering effects of scrolling through endless perfection and the supposed quick fixes that achieve it can be dangerous for women, both physically and psychologically. “Instagram has been great for my world, not so much for the consumer,” Dr Vali warns, adding, “You’re not the same person as the people on Instagram.”
YOUR FACE FIRST
Before she will even consider administering an injectable, all of her patients are subjected to a full examination of face, skin, hair and body – and she doesn’t pull any punches. Using gaze analysis, which reveals that people make snap decisions on age and attractiveness by looking first at your eyes, then teeth, followed by where the light hits your cheekbones, jawline definition and finally your nose and cupid’s bow, Dr Vali identifies your best and worst features and your ‘selfie side’, or from which angle you are most photogenic in profile. Her process is then to correct weaknesses and draw attention to star features, bringing symmetry to your face by treating it as a whole, rather than addressing features in isolation.
It’s a couture approach based on your individuality rather than recreating a cookie-cutter vision of beauty. “Don’t you think everyone looks the same?” she asks, adding, “If you look at Bollywood stars now they’re looking very Lebanese.” At the extreme, this homogeneity can veer to the puffer-face look of overly-filled lips and cheeks that Dr Vali – not one to mince her words – refers to as “inflatable chipmunks”.
“I do not blame the consumer, I blame social media pressures, lifestyle pressures and the doctors who are not educating themselves or the consumer properly,” she says. Much of her initial work is dissolving previously poorly administered filler before restarting her patient on a bespoke treatment plan. “When a patient comes in and says, ‘Wallahi, I did not ask for this,’” indicating oversized cheeks, Dr Vali gets it.
“Some fillers change with time. That’s why you need to know about products. When you ask them what was used, they’re like, ‘I don’t know.’ It’s your face. How do you not know? You know the latest collection in Chanel but you don’t know what’s in your face?” she asks incredulously. By customising treatment using a wide variety of fillers – including Juvaderm, Restylane, Teosyal, Sculptra and Radiesse – to suit a patient’s skin type and facial structure, Dr Vali can more accurately predict outcome in the short- and long-term. “We never inject underneath the skin, we inject on the bone,” she says. This gives a micro-contouring effect to cheekbones, under-eye hollows and jawline without adding volume; every millimetre is planned. “So, no one knows you’ve had anything done. But you look fresh. That’s the important thing.” While it takes two-to-three syringes per cheek for the ubiquitous inflated look, Dr Vali uses only one. “We go deep, we never volumise, we look at how it integrates with the tissue,” she says. She also points out that, contrary to what Instagram would have you believe, a dermal filler containing hyaluronic acid takes seven-to-10 days to settle, with the final result in four-to-six weeks.
In tandem, Dr Vali and her brother Dr Enayat may prescribe a thread lift, where dissolvable barbed threads are inserted into the face using a needle and positioned to lift jowls, folds and down-turned mouths. Where fat pads have dropped with age, the threads can be used to gently hoist them up, pulling shadowy hollows taut without adding volume.
This bespoke approach puts the consumer, not the manufacturer of the filler or thread, first. Which is why Dr Vali will not promote any specific product or technique. “As a doctor, you should not be speaking on behalf of any brand. You should be speaking on behalf of the consumer,” she says, adding, “Have autonomy and act in the patient’s best interest.”
Dr Vali wears: Bespoke tailoring. Model wears: Dress, Dhs6,353, Elisabetta Franchi
MAKE-UP FREE IN THREE MONTHS
Despite how much you might plead for a J Lo jawline, before Dr Vali will consider sculpting your face with dermal filler, threads or Botox, her primary goal is to optimise your skin – the body’s largest organ. After all, if your skin is weak or damaged it won’t provide the structure to support fillers. And while Botox might offer a quick fix, lax skin will never look tight or fresh. “The muscle is paralysed but the skin is still loose,” she points out. Take twin sisters, she says, one who uses Botox to give her an outer-edge eyebrow lift, and one who doesn’t. Over the long term, the Botox user will end up with a droopier brow as other muscles overcompensate. Instead, by tightening the skin on a cellular level,
Dr Vali can achieve a freshened look, without the long-term downsides of relying on injectables. Therefore, her first priority is always your skin, devising a bespoke programme of prescription-grade medical facials and a skincare regimen of secret potions and products incorporating prescription-grade vitamin A derivatives, designed to stimulate fibroblast activity in the medical layer of the skin, which produces collagen, elastin and hyaluronic acid to tighten and eliminate flaws from the inside out.
“If you convert the skin cell, suddenly my 35-year-old skin looks like a 25-year-old. I obtain tightening,
my pigmentation evens out, you can see I have no pores,” says Dr Vali. It’s true, she has the flawless skin of someone well over a decade younger. “Make-up free skin is actually easy to get, it’s just cosmetic companies have made you think it’s impossible. If I tighten you, if I take out the pores, if I get rid of the acne, even out your pigmentation, what do you need? There’s no more foundation, no more contouring. A little bit of blusher, mascara and lip gloss and you’re out.” Handy if you’re a CEO, a mother of many, or indeed both, as many of her patients are.
An element of patience is required, as it takes skin cells six-to-eight weeks to change behavioural patterns. “Every skin condition has an underlying inflammation to it. For me to override the inflammation, I have to cause inflammation,” she explains. “So, prescription-grade retinol causes an inflammatory process of redness, dryness and peeling, it causes your skin cells to turnover and start working again. It’s an irritant and that’s why most people don’t like using it. But if you can just get through that phase, you become tolerant.” In other words, it’ll take six weeks for the compliments to come in, but it will be worth it when they do. In comparison to physicians who use machines such as lasers to resurface the skin, “Our approach takes longer,” explains Dr Enayat, “but the products we use go down to the reticular dermis – the medical layer of the skin,” whereas lasers do not stimulate evenly, which may damage this key layer, and the long-term effects of their use are not known.
NO QUICK FIX
Just as regenerating skin takes time, so that traditional quick fix of liposuction is inadvisable in the long run, says Dr Vali, who prefers
a combination of methods to target stubborn fat cells internally and externally. “Liposuction works, it takes 100 per cent of the fat cells away. However, with no lifestyle changes, and as hormones change with age, the other fat cells around the body become hungrier and larger and that’s why you have those women walking around with big waists and big hips. Their stomach is completely flat but they’re wide, their silhouette has been distorted,” she explains, “It’s reactive fat gain, in areas where they never had fat previously.” It’s a problem prevalent in the Gulf where, Dr Vali says, “Everyone wants a quick fix in this region, no one wants to exercise.” So, instead of lipo – “Because in two years’ time you come back and your stomach is still flat but your waist is wider, you have back fat, your hips have gotten bigger” – LMS focuses on deep fat loss, achieved by “speeding up your metabolism, changing your hormonal profile and getting your body to work as a fuel for you.” On top of that, superficial fat is worked on externally by sculpting the silhouette selectively. “Because we’re only taking away 30-40 per cent of your fat cells and the fat cells are still there, changes in weight will not result in distortion of your refined silhouette,” Dr Vali says.
BYE BYE BRAIN FOG
In parallel with the work Dr Vali and her team do addressing face, skin, hair and body concerns, they also run a sophisticated wellness programme led by Dr Enayat. Unlike traditional medicine, which aims to resolve a specific symptom in isolation, Dr Enayat creates a personalised approach, designed to bio-hack your way out of brain fog, loss of energy, depleted libido, poor concentration, bloating and volatile emotions.
“What you’ll find is female CEOs quit when they hit 45 because they have brain fog, they’re exhausted, their adrenals have gone down,” explains Dr Vali. With the right hormonal supplements, gut healing and nutrition, “they get their edge back.” Like everything offered by LMS – which is geared to the world’s top one per cent – supplements are prescription-grade and designed to harmonise everything from your adrenals to your thyroid. Rather than generic food intolerance tests or blood work, it’s a nuanced approach marrying medicine with evidence-based science. “Within four weeks you feel better,” Dr Vali says.
Ultimately, she is far more interested in making people feel better than simply looking good on Instagram. If a client comes in asking for enhanced cheekbones and she’s in her mid-30s and single, Dr Vali will tell her to freeze her eggs before embarking on cosmetic treatments. “Go take care of yourself first before you waste money on me,” she says. “At the end of the day you’re going to get to 39 and be depressed and then you’ll think, ‘If I fix my nose I’ll get a man.’ That’s not how it works. So we really like the wellness route,” she smiles.
GOOD WORK TRAVELS
Unlike the overly-worked aesthetic peddled on social media, good work speaks for itself. And the best work is undetectable. “The supermodels, the Victoria’s Secret Angels, they’re not natural,” Dr Vali confides. “Hollywood actresses, even the ones you think, ‘No, she hasn’t…’ Everyone has had refinement work. It’s just that some do it well and the doctors that do it well, you don’t hear of.” She hopes that by educating women (and men) in a more holistic, individual approach to beauty and wellness, attitudes that have resulted in the chipmunk look will change. And customers are evolving, she says. “They would rather understand wellness, health and vitality than spend money on a bag. They’re like, ‘I’d rather have thicker hair, or clear skin than buy the latest outfit.’ My consumer has changed. I come before fashion, I come before fine jewellery, I come before a fast car and before the yacht, because I’m sitting there saying I’m going to fix you on the outside and the inside.” It’s a big claim for a small woman, but what Dr Vali lacks in stature she makes up for in empathy, vision and experience. As she says, “We’re creating elegance. If you want elegance, come to me. If you want high street, go everywhere else.”
From the March issue of Harper's Bazaar Arabia