Consultation-led aesthetic medicine · Brighton & Hove · By appointmentConsultation-led · Brighton & HoveConsultation-ledBrighton & Hove
Treatments & concerns

Start with what you’ve noticed.

A face changes in two broad ways: in its structure — support, volume, tissue position and movement — and in the quality of its skin. The two are treated differently, and telling them apart is most of the clinical work.

Below are both routes, and every treatment offered here — organised by what it actually addresses rather than by what sells.

WHAT ARE YOU NOTICING?
Start from the observation

One appearance, several possible drivers.

A line made by movement, a shadow caused by lost support and a change in the surface of the skin may sit only millimetres apart. They are not the same problem. This page organises treatment by what has changed, so you can understand the possibilities without diagnosing yourself from a menu.

A shadow, a line, a hollow or an apparent sag can arise from true volume deficiency, from tissue position and support, from movement, from pigment, from visible vessels, from thin or crepey skin, from fluid — or from the light you happen to be standing in. Each of these regularly imitates the others.

That is the whole reason a consultation exists. It is not a formality before a procedure and not a sales step: it is the point at which the actual driver is separated from the ones that resemble it. Choosing the treatment before that is settled is how competent procedures produce disappointing results.

Below are six appearances patients describe most often, then a longer list in the same voice. The labels name candidate drivers, never a diagnosis, and nothing here is a recommendation for you.

“I look tired.”

VolumeSupport & positionPigmentVesselsSkin qualityFluid

Possible contributors include under-eye hollowing, pigmentation, visible vessels, thin or crepey skin, fluid retention, brow position and midface support. No single treatment addresses all of them.

Commonly mistaken fora simple volume deficiency. A shadow is not proof that something is missing — and photography or overhead light exaggerates all of these.

“My jawline has disappeared.”

Bone & proportionSupport & positionMuscle bulkLaxity

Possible contributors include chin projection, skeletal shape, changing facial support, muscle bulk, skin laxity and submental tissue. Adding structure helps only when a structural deficit is genuinely part of the picture.

Commonly mistaken fora filler problem. Where laxity or muscle bulk is the driver, adding structure can make heaviness worse.

“This fold has become deeper.”

Support & positionMovementSkin qualityBone & proportion

A fold may reflect anatomy, movement, skin change or loss of support elsewhere. Placing product directly into the fold is not automatically the most balanced answer.

Commonly mistaken fora problem located in the fold itself. Often the fold is the symptom and the cause sits higher in the face.

“My forehead lines bother me.”

MovementSupport & positionSkin quality

Forehead movement may be creating the line, helping to lift the brow, or doing both. Treatment planning must consider the eye area and brow position rather than the line alone.

Commonly mistaken fora line to be erased. The same muscle may be holding the brow up, so removing its activity can produce heaviness.

“My skin looks dull.”

Skin qualityPigmentInflammationLight

“Glow” is influenced by surface smoothness, hydration, pigment distribution, inflammation and the way light reflects from the outermost layers of skin.

Commonly mistaken fordehydration alone. Dehydration describes reduced water content; dryness relates to lipids and barrier function, and neither is automatically an injectable problem.

“I have marks left after acne.”

PigmentInflammationScarring

Post-acne redness or pigment can remain after inflammation without a permanent change in contour. Atrophic scarring is a structural depression in the skin.

Commonly mistaken forscarring. They often require different treatment strategies, and treating one as the other is a common reason results disappoint.

In your own words

Other things patients say.

You do not need to decide what any of it “needs”. The useful information is what you see, when it appears and what you would like to preserve.

  • “My brows or eyelids feel heavier.”

    Possible driversforehead activity, brow position, upper-eyelid skin, support beneath the brow

  • “My frown remains when my face is still.”

    Possible driversestablished folding, skin change, support

  • “I have lines at the corners of my eyes.”

    Possible driversmovement, skin thickness, accumulated sun damage

  • “My under-eyes look hollow or shadowed.”

    Possible drivershollowing, pigment, vessels, thin skin, fluid

  • “My cheeks have lost support.”

    Possible driversdeep and superficial fat compartments, ligamentous support, bone

  • “My face looks less balanced in profile.”

    Possible driverschin projection, cheek support, proportion between features

  • “My face looks less symmetrical than it did.”

    Possible driversnatural asymmetry, muscle strength, previous treatment, dental change, nerve function

  • “My jaw feels tense, or looks squarer.”

    Possible driversmasseter activity, clenching and grinding, dental and sleep factors

  • “My skin feels dehydrated and shows fine lines.”

    Possible driverswater content, barrier function, surface texture

  • “I have uneven tone, sun spots or melasma.”

    Possible driverssun exposure, genetics, hormones, inflammation — several distinct pigment conditions

  • “I have redness, flushing or visible vessels.”

    Possible driversvascular, inflammatory or barrier-related causes

  • “My pores look larger, or my texture is rough.”

    Possible driverscongestion, surface change, photoageing

  • “I have indented acne scarring.”

    Possible driversstructural loss within the skin, not surface marking

  • “My skin feels less firm, or crepey.”

    Possible driverscollagen and elastin change, photoageing, early laxity

  • “My hair is thinning or shedding.”

    Possible driverspatterned loss, medical, hormonal and nutritional factors

  • “I have a lump, tag or mark I want checked.”

    Possible driverscommon benign lesions — anything uncertain is referred, not removed

  • “I want help with weight or my general health.”

    Possible driversage, medication, life events, sleep, activity and medical factors

If several of these sound like you, that is the usual picture rather than the exception — most faces present a combination, and the order of work matters as much as the choice of treatment.

By concern

Two guides, because they are two different problems.

Structure, support and movement are read as one system: bone, soft-tissue support, tissue position, volume and the muscles that move the face. Skin quality is read separately: the surface itself, its texture, hydration, pigment, scarring and resilience. A treatment that restores support does not resurface skin, and one that improves skin quality does not restore support. Each guide below is written to be read on its own.

Route one

Face & Structure

Shape, proportion, skeletal and soft-tissue support, volume, tissue position and facial movement.

The guide covers the five layers of the face and how each one changes, how the assessment is performed at rest and in movement, which treatment families follow from which finding, and where treatment is not the right answer.

Route two

Skin Quality

The surface itself: texture, hydration, pigment, scars, fine lines, barrier and resilience.

The guide covers barrier and hydration, pigment, inflammation, collagen and surface texture as separate processes, what influences skin over time, which method reaches which depth, and why one treatment can disappoint.

Route three

Not sure — and that is entirely normal

You do not need to diagnose the layer yourself. Bring what you have noticed; the assessment establishes what is creating it.

Many concerns involve both structure and skin, and the useful question is which part matters most and what should be addressed first — or whether anything should be treated at all.

The decision point

The assessment is the instrument. The treatment is only the consequence.

Your face is considered at rest and during expression, from the front, oblique view and profile — because a face can look balanced in a photograph and behave differently when it moves. What is separated:

  • which layer is producing the change — movement, support, volume, skin, or a combination;
  • which part of it is realistically modifiable, and which part is not;
  • whether another route addresses the cause more directly;
  • whether the result you have in mind can be achieved responsibly;
  • whether doing less, or nothing, is the better decision.

A consultation may conclude that no treatment is appropriate. That is a legitimate outcome, and sometimes the most useful one.

All treatments

Everything offered here, and what each one is for.

Fourteen treatments and services, grouped by what they address. Each card states what the treatment is for and where its limits are; each guide goes considerably further, including the evidence and the risks.

Prices are deliberately not shown beside treatments, because a fee tells you nothing about whether something is right for you. The complete fee list is on one page.

Movement and expression

Movement and expression

Anti-Wrinkle and Expression Lines & Facial Movement Consultation

For concerns such as forehead, frown and eye lines; a brow that feels heavier; a strong resting frown; jaw tension; or changes associated with repeated facial movement.

The first distinction is between a dynamic line, visible when the muscle contracts, and a static line that remains when the face is still. They may need different expectations and, sometimes, more than one approach.

Some treatment options in this area are prescription-only. They are considered only after an individual clinical assessment and are not suitable for everyone.

People often describe… a frown that stays when the face is still, forehead lines on raising the brows, lines at the corners of the eyes when smiling, or a jaw that always looks tense.

What it does not address: volume loss, skin texture, pigment or laxity. A line already established at rest may soften without disappearing.

Structure, volume and proportion

Structure, volume and proportion

Hyaluronic-acid dermal fillers

For selected concerns involving lost support, hollowing, projection or proportion — including cheeks, temples, chin, jawline, lips and carefully selected under-eye concerns.

Filler adds or restores structure. It does not improve the surface quality of the skin and is not a substitute for surgery where laxity is the principal issue.

People often describe… a cheek that has flattened, a hollow temple, a chin or jawline without definition, or lips that have lost their shape.

What it does not address: how the face moves, and it does not improve texture, pigment or redness.

Collagen biostimulators

For gradual support where the objective is improved tissue quality and firmness rather than an immediate change in shape. Different materials behave differently; product, placement and course are chosen according to the tissue and the intended effect.

People often describe… tissue that feels less firm than it did, or a gradual loss of quality rather than one hollow area.

What it does not address: immediate projection or precise shaping. Depending on the material and the objective it may serve tissue support or skin quality, so the intended role is defined before anything is chosen.

Absorbable PDO barbed threads

For modest support of selected, genuinely mobile tissue descent. Results and longevity vary and the evidence is limited; it is rarely the first route and is not a substitute for surgery where laxity is greater. The guide explains what it can and cannot do, the risks and the alternatives.

People often describe… tissue that seems to have dropped a little, or a jawline that looks softer by the end of the day.

What it does not address: volume loss, skin quality or established laxity, and it does not replace surgery.

Texture, pigment and resurfacing

Texture, pigment and resurfacing

Chemical peels

From superficial cosmetic acids to selected TCA protocols. The relevant question is not simply which acid is used, but how deeply the treatment is intended to act and whether the skin is suitable for that degree of injury and recovery.

People often describe… rough or congested texture, dullness, uneven tone, or marks left behind after breakouts.

What it does not address: lost support or volume, and deeper protocols are unsuitable for some skin types and situations.

Conventional microneedling

Mechanical collagen-induction treatment for selected texture concerns, with its clearest role in atrophic acne scarring. It is performed as conventional microneedling at odNOVA; radiofrequency microneedling is not offered.

People often describe… indented acne scars, uneven texture, or pores that look larger than they did.

What it does not address: lifting, volume or pigment reliably. Change develops over a course rather than in one session.

Skin quality and regenerative support

Skin quality and regenerative support

Skin boosters

Micro-injected hyaluronic-acid treatments intended to support hydration and selected measures of skin quality without creating facial structure or projection.

People often describe… skin that feels dehydrated by the afternoon, dullness, fine surface lines, or makeup that no longer sits well.

What it does not address: facial structure or projection, and it does not correct pigment or scarring.

Polynucleotides

Injectable preparations used for selected skin-quality concerns, including delicate periorbital skin. The evidence is developing, so the guide separates plausible biological mechanisms and early clinical findings from stronger conclusions.

People often describe… thin, crepey skin around the eyes, or skin that looks tired rather than hollow.

What it does not address: hollows or lost support. The evidence is still developing and the guide separates mechanism from proven benefit.

PRP and PRF for skin

Autologous preparations made from a sample of your own blood. They are used as regenerative support for selected texture and skin-quality concerns; response varies because the treatment depends partly on individual biology and preparation method.

People often describe… skin quality that has changed overall, early crepiness, or texture that is no longer smooth.

What it does not address: volume or tissue position, and response varies with individual biology and preparation method.

Energy-based treatment

Energy-based treatment

High-intensity focused ultrasound

HIFU places focused ultrasound energy at planned tissue depths. It may offer a gradual, modest improvement in selected cases of mild laxity. It does not reproduce a surgical facelift and is not a solution for every heavier lower face.

People often describe… mild slackness along the jaw or neck, or a lower face that feels less firm than before.

What it does not address: pigment, redness or rough texture, and it does not restore lost volume.

Hair, lesions and medical support

Hair, lesions and medical support

PRP for hair loss

Hair shedding and thinning have several possible causes. PRP may have a role in selected non-scarring hair-loss patterns, often as one part of a wider plan rather than a replacement for diagnosis or established medical options.

People often describe… more hair in the brush, a parting that has widened, or thinning at the crown or temples.

What it does not address: the cause of hair loss. It does not replace diagnosis or established medical options.

Benign skin lesion assessment and removal

Assessment of selected skin tags, seborrhoeic keratoses, milia, cherry angiomas and other lesions that appear clinically benign and fall within the clinic’s scope. Anything uncertain, atypical or unsuitable for cosmetic removal is referred through an appropriate medical pathway.

At odNOVA, lesion removal is performed with Plasma Pen when clinically appropriate. Cryotherapy is not offered.

People often describe… a skin tag catching on clothing, a raised rough patch, small firm white bumps, or a small red dot that has appeared.

What it does not address: diagnostic assessment of anything uncertain. Atypical or changing lesions are referred through a medical pathway rather than removed.

Medical weight management

A prescriber-led programme that begins with eligibility, medical history and the wider factors affecting weight. Where prescription treatment is appropriate, it forms part of a monitored clinical plan rather than a product purchase.

People often describe… weight that has changed with age, medication or life events, or previous attempts that have not held.

What it does not address: a product purchase, and it is not suitable for everyone. Eligibility and history come first.

Clinical services

Phlebotomy, prescribing support and related clinical appointments delivered within Piotr’s professional scope.

People often describe… a blood test you have been asked to arrange, or a prescribing question that falls within Piotr’s scope.

What it does not address: specialist or GP care, and it does not replace your own medical team.

Honest limits

What none of this can do.

The same limits apply across every treatment above, and they are worth reading before choosing anything:

  • Nothing here stops ageing, and nothing here replaces daily photoprotection, sleep and general health.
  • A treatment that restores support does not resurface skin. A treatment that improves skin quality does not restore support.
  • Where the principal issue is genuine laxity, no injectable or energy treatment reproduces surgery.
  • The strength of evidence differs considerably between treatments. Each guide says plainly where the evidence is limited.
  • Some concerns belong in a medical pathway first — a changing or atypical lesion, uncontrolled inflammation, or a diagnosis that is not yet clear.
  • No treatment is a legitimate outcome of a consultation, and sometimes it is the right one.
Before you choose

Bring the concern. The treatment can wait.

You do not need to decide which page describes you perfectly. The consultation connects what you see with the anatomy, skin and medical context behind it — then establishes whether treatment is worthwhile at all.