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Photos added

In the interests of showing realself readers how disfiguring this procedure is until about 4 weeks afterwards, I decided to post some of the inexpert selfies I took until 3 days post the procedure. After that I just couldn't face the way I looked and tried to not look in the mirror - or take more photos. The bruising got a lot worse - the bruise seemed to "weep" down the side of my cheek and turned almost black before going more a greeny colour, then fading. I used Hirudoid cream but couldn't say whether it made a difference or not.

As I headed towards my 60th birthday, I was...

As I headed towards my 60th birthday, I was becoming increasingly dismayed at the wrinkled appearance of my skin. My once-plump cheeks seemed to have deflated, leaving nasio-labial folds of skin and other wrinkles which were starting to affect my self esteem and confidence. As I am still in the work force doing contract work and want to look good at interviews and in an increasingly younger workplace, I decided to have something done. I had approached a couple of plastic surgeons regarding a possible facelift some years previously, but couldn't afford the inflated prices they were charging (AUD 25,000 plus!). So when I met Dr Sarah Boxley while having a routine skin cancer check done and she mentioned that she performed the revolutionary new Arque Derma treatment for a fraction of the price of a facelift with excellent results, I was excited and hopeful. I did a lot of research into the procedure, read the reviews on the website (although they were all US-based - none in Australia), watched the online videos - and finally booked an appointment! I was rather nervous about having injections into my face (what happens if something goes wrong - it's your face, after all!), but decided to take a chance as there appeared to be a high probability of improving the droopy jowls and folds of skin, from what I was reading on the website about the now-patented procedure developed by Dr Lesley Fletcher. The Arque Derma procedure uses a technique which "arcs" the needle in the skin in a way which provides long-term structural lift, according to her website, and it appeared to have gained public exposure though presentations at conferences and research papers published in accredited journals. So I felt reassured.
I scheduled the procedure over the Christmas holiday period when I wouldn't be working. Dr Boxley had told me that there might be some bruising, and that I could cover the bruises with camouflage makeup, but probably wouldn't be keen to be in any photos or do much socialising! Duly warned, I stocked up on food and DVDs (I live alone!), and presented at the clinic in Fremantle, Perth, on 10 December 2014. The injections took about 20 minutes, with an anaesthetic cream being applied to numb the skin before Dr Boxley commenced. I could feel the skin being pulled as Dr Boxley turned the needle upwards in an arc , but it wasn't too unpleasant or painful, just a bit of a tugging sensation and some pinpricks when the needle went in. I could see an immediate plumping up of the skin when she held up the mirror to show me the effect of the injections on the right-hand side of my face, especially in comparison with the left-hand side which had not been injected. The injecting of the left-hand side was much the same as the right, and I drove home trying to hold an ice pack to my cheeks with one hand which I was instructed to do for the next couple of days to bring down the swelling.
Of course, I raced to the mirror on arriving home half an hour later - and was a bit taken aback to see (apart from the red track marks on my cheeks which made me look like some weird junkie) that my left cheek was higher than the right, and that the right corner of my lip had a distinct marionette line going from it down to the jawbone which wasn't there before I had the Arque Derma treatment! There appeared to be more filler in the left-hand cheek - and higher up - than in the right-hand cheek. I phoned Dr Boxley's practice immediately and made an appointment to see her two days later. By that time, a huge haematoma-like bruise had appeared on my left-hand lower cheek which was impossible to cover with make-up as it was a dark purply-black colour. When I saw Dr Boxley and expressed my concerns about the lop-sided effect with one cheek being higher than the other and the distinct marionette line down the side of my mouth to my jaw, she told me that I should wait 2-4 weeks to let the swelling go down so that I could see the full effect of the treatment, and that I wouldn't look anything like I did then in a month's time. So, hoping for the promised miracle, I went home. Although Dr Boxley had warned me that I would look like a "domestic violence victim" (her words), I wasn't prepared for it to take a full four weeks for the bruising to disappear, most of which time I spent hiding indoors. Perhaps this wasn't a typical outcome, but anyone contemplating this treatment would need to clear their diary completely for a month to be on the safe side. I did take arnica pillules as instructed for two weeks before the procedure and also for a couple of weeks afterwards, but they appeared to have very little effect. On the Arque Derma website, patients seem to have had virtually no downtime, which is surprising, given my experience. Dr Boxley did give me a sample of camouflage makeup when she saw the extent of the bruising on Day 2 and I bought some more myself to get me though the next few weeks but, despite the makeup, the bruising was still faintly visible and I felt very self-conscious so hardly went outside in 4 weeks. I therefore had plenty of time to monitor any subtle changes in my appearance, and was really disappointed that, once what I assumed was swelling had gone down, there was very little plumping effect in my cheeks, and the wrinkles and lines on my jowls were still visible. The track marks healed within about a week, and the dark bruise s-l-o-w-l-y faded, but I and a couple of friends in whom I had confided and who came to visit, couldn't see much change - except for the pronounced marionette line on my right-hand jaw. I was also concerned to see some faint bluey-grey marks through the skin on my cheeks which I understood after googling to be the Tyndall effect, where the injected filler shows through the skin if it has been injected too close to the surface. I was very unhappy with this, and had to apply lots of makeup to cover it up.
When I had my appointment with Dr Boxley a month later and she compared the before and after photos, she agreed that there had not been much improvement, and said she wasn’t satisfied with the results and that she wanted to reinject the right side of my face to lift the skin and even out the lopsidedness. After some thought, I decided against any further treatment as I really couldn't afford another month of near-isolation and time off work. Due to my disappointment with the treatment not working, I asked for a refund of the AUD 1100 I had paid for the treatment, and Dr Boxley readily agreed - which I took to be an admission that the procedure had been a failure. So at least, after a dismal month at home with nothing positive to show for it, I was not out of pocket, but am still left with a marionette line which is annoying (but tends to make me smile a lot more as the muscle then lifts this area of skin!). The bluey-grey mark on my cheeks are still faintly visible, but look like shadows under my cheekbones, so don't look out of the ordinary to the untrained eye.
Ultimately, the entire experience was disappointing and a waste of a month of my life. I would be interested to read an independent review from someone who is not associated with Dr Lesley Fletcher or her website as I am beginning to think this "revolutionary" technique is all a big con.

Provider Review

Dr Sarah Boxley
Overall rating
Doctor's bedside manner
Answered my questions
After care follow-up
Time spent with me
Phone or email responsiveness
Staff professionalism & courtesy
Payment process
Wait times

Dr Boxley was very confidence inspiring when I met her at my skin cancer check-up in 2012 as she enthusiastically described what she, as the only Arque Derma practitioner in Australia, could do to de-wrinkle my skin. However, with hindsight, I became a bit concerned by certain omissions on the day of the procedure, such as not giving me any post-operative instructions (I later read on the internet that one should stay out of the sun and not exercise for 48 hours after having dermal filler injected). When I asked two days later which filler she had used, she was unable to confirm that she had used Voluma, vaguely saying that she thought so, but didn't offer to look at my records to confirm that it was. I was so surprised at her lack of recall about a recent professional treatment that I didn't pursue it immediately (but did make a point the next time I saw her of asking her to check which filler she had used). I also became increasingly concerned about the possibility of some cheap generic filler having been used, and spent the next few weeks worrying and especially as I was not seeing any improvement in my appearance. On the Arque Derma website, most people said they had seen immediate results, which made me even more concerned! So I suppose I only have Dr Boxley's word for it that Voluma was injected. I was not shown any label from the vial of filler used. My feelings are that Dr Boxley possibly doesn't see enough people wanting the Arque Derma treatment to have become proficient in its application. I don't see it advertised here in Perth except on her website and would never have heard of it if I had not met her by chance when having a skin cancer check. I personally would not recommend the Arque Derma procedure to anyone due to the lengthy downtime and the lack of results, despite all Dr Boxley's promises. I was also surprised when doing some post-procedural research to learn that Dr Boxley is not a dermatologist (as I had assumed she was when I met her at the skin cancer clinic), but instead is a GP who has done the required number of hours of training in the Arque Derma technique ("at least one intense 8-12 hour training", according to Lesley Fletcher's website). That is not a very long training period when one is allowing someone to stick needles into your face and, knowing that, I would pursue the plastic surgeon option in future (if I can afford it and ever want to go down this path again!) and seek out the services of a recommended and reputable plastic surgeon. I feel that I was naive in allowing myself to be convinced that an inexpensive procedure carried out by a GP with a limited amount of training would be the answer to my wrinkle problems. This is what the cosmetic surgery industry relies on - gullible and uninformed patients looking for a quick-fix solution, and willing to spend disproportionate amounts of money in the process of seeking eternal youth.