‘She’s going to have good arms!’ I was ten years old and standing in my parents’ bathroom when I heard my mother say this.
She was in bed, making her morning round of phone calls to her friends. I don’t know who she was imparting this vital information to, but in the world in which I grew up – as the child of rather glamorous parents, who liked to entertain friends at our house in south-west London – this boast was akin to my mother saying, ‘She’s going to be a brain surgeon!’
Physical appearance took precedence over any other conceivable achievement.
My arms are now 62 years old and suffering the normal skin laxity that comes with age. But also, like so many others, I have been taking the ‘miracle’ weight-loss drug Ozempic. The consequence of dropping two dress sizes in pretty short order can be clearly seen in the batwings – I hate that word – hanging from my upper arms.
Indeed, that’s not the only part of my body to suffer: my skin is looser everywhere, but especially on my inner thighs, face and neck. When I bend over, my inner thighs remind me of ruched curtains.
It was in December 2022 that I started taking Ozempic, injecting the ‘pen’ into my stomach once a week as instructed, and increasing the dose very slowly, from 0.25mg to 1mg, over several months.
These were the early days of people taking the treatment and my friends gave me a hard time.
‘What about the side-effects?’ they’d preach. What if I was to get thyroid cancer? (Animal studies have shown a connection between semaglutide, the active ingredient in Ozempic, and thyroid tumours.) What if I got hit by a bus? I thought.
I’ve never regretted the tweakments I’ve had: I don’t think they make me look ridiculous and I understand that others might prefer to leave well alone.
These things are not for everyone. And I have always been impulsive and tend to rush headlong into things.
As Editor at Large for Vogue for 26 years, I also lived in a world that valued beauty almost as much as my mother did. I was lucky in that I had access to the latest treatments, including a tummy tuck in my 40s to correct the kangaroo pouch gained through stretched skin on my lower abdomen after having two babies.
When I left Vogue and headed into new waters at the age of 52, I treated myself to a lower face and neck lift, getting a very big discount because I wrote about it.
The procedure still did not come cheap, but it gave me a huge confidence boost.
But I have always struggled with my weight. My family has a genetic predisposition to be fat and for much of my life I have been a yo-yo dieter, moving up and down dress sizes.
I never weigh myself, but at my largest I was a size 14/16 and at my slimmest – and that was rare – I could be a size 10.
When I started to take Ozempic it was life-changing. It silenced the ‘food noise’ in my head, meaning I no longer thought about food constantly, the way I used to.
I was never obese, but it helped me lose the excess weight that had accumulated round the time of the menopause, establishing itself around my thighs, back, arms and legs. Thanks to Ozempic, that incipient middle-age spread is no more.
And, in my seventh decade, I am fitter than I have ever been.
If you drop weight quickly on Ozempic, as I did, you can burn muscle as well as fat, so I created a rigorous exercise regime of weight training, swimming and Pilates to stop that happening. The mental benefits alone have been amazing. I am full of energy and zip. And yet…
Although I couldn’t be more thrilled about the lost pounds and the two dress sizes, I have been left with a horrid laxity of skin where the weight has gone.
On top of that, there is a marked difference in texture. My skin looks like scrunched up crepe paper – the fat combined with the youth that kept it smooth has gone.
So, September last year saw me in the elegant, South Kensington clinic of renowned plastic surgeon Patrick Mallucci, who practices bespoke surgical and non-surgical treatments for precisely my kind of problem.
As I held out my arms in the crucifixion pose, he cast his skilful eye over my puckered and pleated bits. I was embarrassed, but he made it easy and not shaming at all while, with a blue marker pen, he drew lines along my underarm skin and my inner thighs to show me where he felt he could make improvements.
Mr Mallucci told me he was seeing a marked increase in people looking for skin tightening treatments, precisely because of the new weight-loss drugs, while explaining everything available on the market. There’s ‘a whole spectrum of skin tightening approaches,’ he said.
At the bottom end lie the basic, over-the-counter treatments which are just trying to improve the overall quality of the skin, such as Environ Derma-Lac Lotion (£44.95). Combined with its Vitamin A, C & E Body Oil (£48, both from theskingym.co.uk), they are known as ‘retinol for the body’.
Then there are injectables – dermal fillers and Botox – which are great for perking things up.
Moving up the ladder, you can try non-invasive energy devices, such as radio frequency treatments that heat below the surface of the skin to try to stimulate collagen production: ‘Nice and easy, minimal downtime,’ I was told.
Last, come invasive energy devices – machines and gadgets like Morpheus8 and Genius – which use microneedling to deliver energy a bit deeper into the skin, resulting in more significant tightening.
Over the years, writing about beauty and tweakments, I have tried many of these. But I know that skin laxity is a tough nut to crack and I didn’t think any of them would solve my post-Ozempic problems.
One thing I did know was that I didn’t want to have full-on surgery. A brachioplasty (arm lift) involves a two-hour operation and an overnight stay in hospital and, although it removes all the excess skin, it leaves you with a scar from armpit to elbow.
But there was a new way, Mr Mallucci told me, something called Renuvion. ‘Now, this is an exciting treatment,’ he said. ‘It’s more invasive than a tweakment – you are put under sedation – but it is much less dramatic than going under the knife.’
He pointed at my various body parts as I stood in front of him in my bra and knickers – never my favourite thing – assuring me I was a perfect candidate for the treatment as I hadn’t lost massive amounts of weight, but did need something more effective than a body cream.
Renuvion could be used to treat loose skin on various body areas, including the arms, abdomen, legs, and knees, Mr Mallucci said, ‘anywhere the skin is lax, even the face and neck.
The idea is you can get some decent tightening without all the scarring and downtime of surgery.’
It sounded perfect for me. But without getting rid of excess skin, would it really work?
The science sounded impressive: a wand would be inserted through small incisions in the skin to apply radio-frequency heat and cooling helium plasma to the target area, causing the sub-dermal collagen tissue to contract and boost collagen production. This should create an instant firming effect.
It’s not a treatment to try if you are looking for a quick fix. The results are gradual, improving over three to six months as the collagen remodels. Touch-up treatments may be needed every two to three years to maintain the look.
And it’s certainly not cheap: the total cost for my arms and inner thighs, including surgeon’s fee, operating theatre (in Mr Mallucci’s practice, not a hospital) anaesthetics, dressing appointments, pre-op blood test and garments, comes to a steep £9,700. (Full disclosure: as a journalist I didn’t pay.)
The sedation and the techniques involved make it significantly more expensive than most other tightening treatments available.
And yet it did not feel like a major procedure. I was sedated for less than an hour, and after a half hour in the recovery room, my husband came to collect me. I left wearing a rather chic, shrug-type jacket which helped compress my arms, plus compression stockings on my legs.
The incisions were tiny, only about a centimetre long. There was no pain, other than a sort of fizzing feeling of sensitivity in my arms.
It wasn’t unpleasant but I am still aware of it from time to time three months on.
Mr Mallucci says it is a sign that the collagen is being stimulated.
So did it work? I started to notice a difference in the texture of my skin within about six weeks. It looked smoother, less like crepe paper and more hydrated – and it has continued to improve over time.
It would be a lie to say that my batwings have gone but they are certainly easier to live with.
My body was not the only thing to shrink: I also developed what is commonly known as ‘Ozempic face’ – the gaunt, hollow-eyed look you can get when you lose weight quickly in midlife.
Oculoplastic surgeon and facial aesthetics doctor Maryam Zamani suggested that hydration and volume-boosting were needed.
I had lost some of the volume around the eyelid and cheek junction, she said, creating hollows that made my eyes look tired.
Due to the general loss of volume on my face, the crow’s feet and lines in between the brows had become more prominent.
The good news is that it was all very easy to treat.
Zamani injected a small amount of Azzalure (similar to botox) – 40 units into the glabella (the skin between the eyebrows above the nose) and 25 units around the eyes to soften the crow’s feet – at a cost of £400. She then added small amounts of different types of hyaluronic acid filler in the tear trough area below the eyelids and the cheek area, as well as a few drops around the marionettes (the lines that run down from the mouth to the jawline). Altogether the filler cost £2,375.
Hyaluronic acid is a naturally occurring substance that is already found in your skin and helps to keep it plump and hydrated.
These fillers are typically soft and gel-like, and last between six to 12 months before the body gradually absorbs the particles.
After this plumping and hydrating procedure, I came out looking like a refreshed version of myself and not a plumped-up doll.
I know it looked natural because my husband didn’t notice!
If this all sounds very vain, well, maybe it is. But the truth is that since I started taking Ozempic my self-esteem has improved because I feel and look better. I have energy, and my mental wellbeing is in good shape. I know that skin tightening is not the be-all and end-all, just the icing on the cake, but it’s the kind of cake I enjoy.
I have just been back to have a check-up with Mr Mallucci. We are both thrilled with the results.
The skin on my arms and thighs is much smoother, plumped but not in a swollen way – smooth and even.
Combined with the tone I have developed from exercise, I think the difference in both my arms and legs is visible.
Is all this worth the five-figure price tag? Would I go out in a sleeveless dress? No, but that’s just me. If I had arms like Nicole Kidman I might, but I’m not there yet!
I do think that, unlike so many of the expensive options out there that promise much but rarely deliver really good results, Renuvion has fulfilled its promise and that, within the realms of realistic expectations, I am happy.
I also like to think my mother would agree if she saw those arms of mine today.
