What solutions exist to enhance my appearance while remaining natural?

Improving your lifestyle by stopping smoking and using sunscreen are the first steps to take to enhance your appearance. Genetic predispositions do indeed exist, but studies carried out on twins have made clear the impact of smoking and the sun on aging.
Solar exposure favors the apparition of wrinkles, spots and solar elastosis, wrinkled skin, while smoking can cause the occurrence of wrinkles, malar edema due to a reduction of lymphatic drainage and cause a dull complexion with dilated pores.
Some food supplements containing hyaluronic acid and antioxidants can help improve the quality of your skin.
Please do not hesitate to ask for advice. Doctor Natalie Rajaonarivelo will meet you and establish a precise diagnosis of the different solutions available such as botulinum toxin, hyaluronic acid, surgery,etc. to enhance your appearance while remaining natural.

Wrinkles appeared for some time


Over time, the skin damages and wrinkles appear, earlier or later, depending on the individual. Different treatments can be considered depending on the origin of the wrinkles. Indeed, some dynamic wrinkles are due to the contraction of some muscles of the face and lead to expression lines such as crow’s-feet, forehead lines, and frown lines. Botulinum toxin is an adapted solution to treat those wrinkles by relaxing the muscles.
On the other hand, some wrinkles can be due to a loss of dehydration and of the volumes of the face. Those lines should be treated with hyaluronic acid, a product enabling rehydration and possibly a gain of volume.
The fine lines can be treated with peels or laser treatments.

I’m afraid of Botox

Patients are often afraid of being “frozen” with botulinum toxin injections. The mode of action of botulinum toxin is to relax some muscles too contracted such as corrugator muscles (frown lines), orbicularis muscle ( crow’s feet ). If, in the United States, treatment with botulinum toxin is considered successful when the face is frozen, in France, by contrast, the expectation is a natural result. The goal is to prevent a permanent contraction of muscles but to allow mobility and expressiveness. So, the treatment, if performed correctly, will give a glow to the face and reduce the “tired look” of the eyes while maintaining facial expressions in response to emotions.

My eye area looks tired because of my under-eye bags and circles

Over time, bags and dark circles may appear under the eyes and give you a constant tired look even if you are not tired. This defect can be treated with aesthetic medicine procedures carried out in the office or surgical procedures performed in the clinic. Hyaluronic acid injections or lipofilling can be considered to treat the hollow effect appearing with age. On the other hand, under-eye bags require a surgical treatment without scars. It is generally preferable to start with the hollow under-eye treatment, because this treatment will significantly help reduce the bags. Tinted under-eye areas can be corrected with light de-pigmenting peels.

My eyelids are heavy

Over time, the upper eyelids may become saggy and give a sad and tired look. The eye area can be opened with aesthetic medicine treatments such as botulinum toxin or Ulthera laser sessions, but a surgical procedure is required when the excess of skin is too prominent. Blepharoplasty is currently the preferred treatment on men and women above 40 years old.

I am not comfortable with the lower part of my face

Over time, tissues tend to become saggy and to create unsightly jowls. Moreover, sometimes we can observe a lack of definition of the angle of the neck. The skin of this area can be stretched and fat excess may become visible. The oval of the face and the angle of the neck can be reshaped with medical -injections, threads, or surgical treatments.
Bitterness folds may appear on both sides of the chin and of the mouth. Aesthetic medicine procedures such as combining hyaluronic acid and botulinum toxin, or sometimes thread-lift, will tend to correct these folds.

My lips are too thin. I would like them to be pulpier, sexier

Lips play an important aesthetic role in the harmony of face. Solutions exist to enhance their shape. Hyaluronic acid injections will help rehydrate them without increasing their volume, but it can also increase their volume while preserving or modifying their initial shape, depending of the product used. For a painless treatment, a local anesthesia is systematically performed before the injections are administered..

I always had a complex about my nose but I am afraid to change

Patients considering a rhinoplasty mostly fear their appearance after the surgery. Doctor Natalie Rajaonarivelo is committed to respecting each patient’s identity and face morphology. She attaches particular importance to the natural aspect of the result. For this reason, a rhinoplasty requires 2 to 3 hours and each step is defined on a case by case basis, according to each face and each nose, contrary to the standardized rhinoplasties which give the same aspect to each treated nose. She aims to obtain a final result that integrates harmoniously with the individual’s face while respecting its identity and erasing the unsightly defects.

I have a complex about my breasts. They are too small

In France, breast augmentation is in increasing demand. This procedure can be carried out after adolescence. Most women who desire this procedure are between 20 and 40 years of age. Around 20, the growth of the breasts is over and some women consider their breasts too small. At around 40, women ask for advice after their pregnancies and breast feedings. There are two solutions to increase the volume of the breast: implants and lipofilling. In all cases, the treatment remains a surgical procedure. Breast augmentation with hyaluronic acid is strictly prohibited in France due to the risks linked with capsular contractures and the complexity of radiological monitoring.

I have a complex about my prominent breasts

Breast hypertrophy can be seriously debilitating from an aesthetic and/or functional point of view. Indeed, patients suffering from breast hypertrophy may have difficulties to find adequate clothing. Low cleavage clothing is sometimes avoided because patients do not want to expose their breasts. Breast hypertrophy makes the silhouette thicker by giving a heavier look. But beyond aesthetic concerns, the weight of the breasts may cause potentially disabling back pains, and the subsequent discomforts may limit physical activities.
A breast reduction surgery can be performed to correct the problem. The surgery can be done in the day care department, allowing the patient to leave the hospital the same day of the surgery. There is no minimum age for the surgery. Young girls with a real and disabling hypertrophy can benefit from the treatment.

My breast has lost volume since I was pregnant

Pregnancies and more specifically breastfeeding may cause a melting of the gland. The breast can also lose volume and sag more than it did before the pregnancy. A breast augmentation will help reshape the breasts. It may be associated with a breast ptosis in order to lift up sagging breasts. This procedure is called an implant-plasty.

Is there a link between breast implant and breast cancer?

With the benefit of research, we can state that having breast implants does not increase the risk of the occurrence of cancer.
The implants do not affect breast cancer screening, including mammography, but you need to inform the gynecologist and the radiologist who performs the examination.

Is pregnancy possible after a breast surgery?

It is strongly recommended to avoid pregnancies for 2 years following a breast surgery in order to avoid damaging the aesthetic result of the treatment.
In most cases, breastfeeding remains possible after the surgery, but there can be no assurance if a scar is situated in the area of the areola.

I have a complex about my saddlebags, I do not like my silhouette

In case of local areas of protruding fat, liposuction is a solution aiming at enhancing the silhouette. The procedure can be carried out on a very thin patient when some masses of fat do not disappear with weight loss. Liposuction aims at reshaping the silhouette by erasing the unsightly areas, not to help lose weight. A healthy lifestyle with a balanced diet and regular exercise is obviously essential to the success of a liposuction.

My stomach is not the same as some years ago, despite sports and a balanced diet

When a balanced diet and a regular exercise are insufficient to preserve the anatomy of the stomach area, a treatment can be considered according to the discomfort felt. When the skin is sagging, a laser treatment may be sufficient to enhance the appearance of the stomach area. Liposuction is the best solution for some localized areas of protruding fat. However, when there is a significant excess of skin, or numerous stretch-marks in the stomach area, abdominoplasty is the only procedure which will be effective. The abdominoplasty can be combined with a liposuction if a significant excess fat is present.

Excessive perspiration embarrasses me

Whether it affects the hands, causing sweaty hands, or the armpits, which cause clothing stains, excessive perspiration can be socially or personally disturbing. Botulinum toxin injections are considered to efficiently treat excessive sweating. Contrary to aesthetic treatments with botulinum toxin, this procedure only requires one session per year for a lasting result.

Should minors always be accompanied for the consults?

A minor does not need to be accompanied for a consultation.
However, aesthetic medicine and surgical procedures require parental permission and information.

Are surgeries covered by health insurance?

Aesthetic treatments, medical or surgical cannot be covered by health insurance under any circumstance..

Here is the list of procedures that are usually covered by insurance:

  • Breast reconstruction after cancer.
  • Breast reduction with more than 300 g removed from each breast.
  • Inverted nipples treatment.
  • Otoplasty on children.
  • Gynecomastia in cases of psychological or sexual impact.

A prior agreement procedure is required, which may be refused, for the following:

  • Breast deformities (Poland anomaly and tuberous breasts).
  • Abdominoplasty with a significant abdominal apron covering the pubis following surgical treatment of obesity (gastric ring or gastric bypass surgery).
  • Rhinoplasty after a trauma (broken nose demonstrated by x-rays or scanner).

What is the coverage by the health insurance?

When the surgery is covered by health insurance, the full amount of the fees associated with the treatment is covered, except for the anesthesiologist’s and the surgeon’s fees.
The anesthesiologist’s and the surgeon’s fees may be totally or partially covered, depending on your complementary health insurance.

The anesthesia scares me…

Most patients fear the anesthesia. However, anesthetic protocols are adhered to and supervised for your safety. The consultation with the anesthesiologist is mandatory before the surgery. You will need to explain all your medical history so that he/she can take all the necessary precautions. The anesthesiologist will be able to reassure you and, if necessary, be able to prescribe a treatment to help you relax.

How many appointments are planned before a surgery?

Two(2) consultations are advised before a surgery. The first one is to evaluate and determine the most appropriate solution for you as well as give you all the necessary information including a detailed estimate.
During the second consultation, you will be able to ask for any clarifications needed and to sign the mandatory documents consisting of the informed consent and estimate. All the practical details of the surgery will be attended to as required.

In case of neuroleptanalgesy or general anesthesia, you will need to make an appointment with the anesthesiologist.

Is there a period before receiving treatment?

There is an absolute legal waiting period of 15 days between the first consult and the surgery. This delay shall also apply to every non-emergency functional surgery, including the treatments covered by health insurance such as prominent ear, breast reconstruction after cancer, breast reduction, etc..

How is the surgery planned?

You will be able to reserve a date for your surgery after the first consultation. This date shall comply with the legal delay of 15 days.
You can also contact Catherine later, when you have chosen a day, to define the date of the surgery and make appointments for the second consultations and the follow-up consults.

When should I plan a surgery?

The period of convalescence must be taken into account. Depending on the treatment, it means physical activities may be reduced or social interaction may be avoided so relatives do not know about the surgery (bruising, visible swelling on the face…).
This period varies depending on the surgery and your personal needs.
If you undergo an aesthetic treatment, no labor disruption can be prescribed, so you will need to plan a leave of absence if you work.

What are the indications before a surgery?

Aspirin-based, anti-inflammatory and oral anticoagulant medication must be avoided 10 days before the procedure in order to reduce the risk of bleeding.
We strongly advise the patients to stop smoking 1 month before the surgery to favor a rapid healing.
Oral contraception should also be stopped 1 month before the surgery in order to reduce the risk of thrombo-embolic accidents.
We recommend a homeopathic preparation based on Arnica Montana and Hypericum Perforatum.

How is the surgery performed?

Depending on the date of your surgery, you will make an appointment with the anesthesiologist at least 48 hours before the intervention.
You will be given all the preoperative indications.
Your entry time will be defined in the week preceding the surgery.

What happens on the day of the surgery?

You need to fast on the day of the surgery: no liquid or food for at least 6 hours before surgery. When arriving at the clinic, you will be admitted. You will be led to your room. You will need to dress in the clothing the clinic provides: medical gown, slippers and hygiene cap. You will be led to the operating room where you will meet Doctor Rajaonarivelo, your anesthesiologist and Dorothée, the assistant. After the surgery, you will remain under observation for about 1 hour in the recovery room. Then you will be able to go back to your room, where you will enjoy a light meal. We take care that you do not wake up alone immediately after a surgery as the anesthesia can cause fatigue or some side effect. This effect will disappear in the hours following the surgery. You will be able to leave the hospital on the same day if the treatment is performed in the day care department or on the next day if the procedure was done in a traditional hospital. In every case, Doctor Rajaonarivelo will check your condition before you leave.

Can I have a shower after the surgery?

Of course. Showers are advised for after the surgery. It was believed that a scar should not be subjected to water. But, it was determined that showers have a beneficial effect by actively cleaning the wounds. However, baths should be avoided for 3 to 4 weeks after the surgery.

How many follow-up appointments will be planned after the surgery?

Two(2) appointments are generally planned after the surgery: one on the 3rd or the 4th day, and a second one around the 10th day.
Following appointments take place on the 1st, the 3rd and the 6th month after surgery. A monitoring may take place 1 year after the treatment.
Concerning aesthetic surgery, all the appointments are included in the initial estimate.
Patients living outside Paris or abroad can plan follow-up appointments by Skype or Face Time if they cannot come to the office.