I have put a cashmere blanket across the treatment couch, so she immediately senses she’s in the hands of a sophisticate: someone who understands and appreciates her needs. My uniform is white, with creases in all the right places. The blinds are pulled down, the lighting soft. A candle burns on the windowsill, filling the room with delicate floral top notes. Hidden speakers play the sort of music she listens to during her regular mindfulness sessions: whales burbling, flutes warbling, water dripping from the canopy of a tropical rainforest.
‘Just relax,’ I say, as she lies back. ‘Close your eyes.’
Before she can ask questions, I dab at her face with a wet wipe.
‘This is a special non-alcoholic cleanser,’ I explain. ‘Gentle on the skin, with no harsh, drying effects.’
They always love the mention of ‘non-alcoholic’. Despite the fact that they’re about to put their bodies through a process of artificial cosmetic enhancement, they feel reassured that this initial cleaning stage won’t strip their skin of its natural moisture.
‘Keep your eyes closed and take deep breaths,’ I say, moving away from the couch towards the shelf where I keep my mobile plugged into its charger. ‘In…. then out again. Nice and slowly.’
There’s a text waiting, from a friend who’s away on a training course. Apparently she drank too much vodka last night and ended up having sex with a bloke she fancies from marketing. I send her a smiley face emoji. Then I add a thumbs up and a red heart.
The woman on the couch clears her throat, and I look round to check her eyes are still shut.
‘Nearly ready,’ I say, my voice as soothing as the burbling whales and warbling flutes. ‘I’m just making the final preparations.’
I check my reflection in the wall mirror. There’s something between my front teeth – possibly cashew from this morning’s muesli – and I lever it out with my fingernail.
‘Right,’ I say, moving back to the couch. ‘Let’s make a start. Keep your eyes closed and breathe normally. There may be some discomfort, but the process isn’t painful.’
This is a lie. It will sting, possibly even hurt a lot. But it’s amazing what people will put up with, for the sake of beauty.
I reach for the syringe, lying on a white sheet on the table. I prepare everything before the client arrives, mixing the crystalline substance with saline – the recommended dilution is half a teaspoon for each vial, but I add extra saline because it gives the impression they’re getting more for their money.
‘I’ll start on the right hand side,’ I say, smoothing the area with my forefinger, the papery skin crinkling into waves. Freckles litter her bronzed forehead: she’s probably just back from the Caribbean.
‘The first injection will go here.’
As the needle pricks her skin, she yelps.
‘Well done,’ I soothe. ‘Four more, then we’ll repeat the process on the other side.’
I take my time, it’s important not to rush.
‘Apply some ice when you get home,’ I suggest. ‘There isn’t usually any bruising, but it depends on the sensitivity of your skin.’
I have now finished this side. One of the pin prick holes is bleeding, so I clean away the crimson bubble with a wipe. I’ve actually run out of non-alcoholic ones, so this is a cheap pack from Superdrug. It’s scented with Tea Tree Oil so, to the inexperienced nose, smells suitably medicated.
‘How long should I ice it for?’ she asks, her voice wobbly.
‘Twenty minutes on each side,’ I say.
The ice is worse than useless; applying direct pressure to the area, is more effective in controlling bleeding and bruising. But for some reason they like being told to use ice. I’m never sure how many of them manage twenty minutes: by then they’ll have lost all sensation in their skin and will probably be struggling with the onset of hypothermia.
Once the other side of her forehead is done, I move to the eye area. This woman has a raggedy network of crow’s feet, the result of a lifetime’s excessive exposure to the sun, during one expensive holiday after another.
She’s trying to be stoic: it’s heart warming. I dig the needle a little deeper on the last injection.
‘All done!’ I say, putting the syringe on the table and covering it with the white cloth. ‘You were terribly brave! Some of my ladies have a little weep, but you’re clearly made of stronger stuff.’
She has opened her eyes now, and they’re brimming with tears. But she is swallowing hard: pleased to have been more resilient than others who have lain on this couch before her.
‘Goodness,’ she whispers. ‘It was worse than I’d expected!’
‘Take your time getting up,’ I say. ‘Avoid exercise for the rest of the day, and take painkillers if it feels sore.’
I’m guessing she has a bathroom cupboard full of Tramadol in her en-suite at home, which is good because she’ll need it.
‘Don’t expect instant results,’ I say. ‘It may be up to ten days before you notice any change.’
Her mouth falls open.
‘But… I thought I’d see the difference immediately?’
‘I’m afraid not. A common misconception. This treatment isn’t a quick fix. You may also need to pop back to have a chat about that crease, between your eyes.’
I tap my finger onto the area in question.
‘There’s a deep line there, and one session won’t make an impression. But we could think about using a filler?’
Beneath the bleeding dots at the edge of her face, she’s looking concerned.
‘But I hoped this would be all I’d need?’
I smile, resting my hand on her arm. People are so naïve about botulinum toxin. They hear their friends rave about it, and read testimonials from middle aged celebrities. They think it’s a miraculous cure-all, and presume that, when they walk out of my little room, the crevices decorating their elderly skin will have disappeared.
What they don’t realise is that Botox doesn’t erase wrinkles, it just relaxes them. Some of the superficial lines may disappear, but the deeper ones will still be there, and they’ll pay a price for attempting to turn back time. Right now, the bleeding and bruising are minimal. When this woman returns to lie on my couch for the third or fourth session, her face will have become bloated and shiny. The wrinkles will no longer be as visible, but only because the skin around them has swollen.
The puffer fish look, I call it.
I hold out her expensive coat.
‘So, you’d recommend some filler… for this bit?’ she says, tentatively.
‘I think it may be the only option.’
She smiles, reassured that something can be done.
I don’t worry her with the fact that there is controversy about using filler in the area between the eyes; research has suggested it can block facial veins, and the resulting loss of blood turns the skin white and lifeless. Patients have been left scarred.
That’s not as bad as the droopy eyelids though, which may eventually require surgery. Or the double vision, headaches and flu-like symptoms, which can be a sign that the toxin has worked its way into the central nervous system.
I’d never dream of using this stuff myself.
I pop her Gold Amex into my card machine and her shaky hand types in the PIN.
‘It has been lovely to meet you,’ I say, opening the door. ‘Take it easy for the next few hours.’
She smiles at me, lower lip quivering. I wouldn’t be surprised if she’s already feeling nauseous. The skin around her eyes is very red.
She slides on an outsized pair of designer sunglasses.
‘Thank you so much,’ she whispers.
I close the door, and listen as her Jimmy Choos click down the stairs towards the street.
Over the next few weeks she’ll convince herself that the poison in that little vial of botulinum toxin, has indeed lessened her wrinkles. She will examine herself in every mirror she passes, glance at her reflection in shop windows, looking for signs that this procedure has succeeded. Her brow is surely less furrowed! Her crow’s feet are less deep!
Whatever happens, she won’t complain. However swollen and sore her face becomes, she will never admit this was a mistake, that vanity was her downfall.
Walking away down the high street, she is probably already coming up with excuses; for a start, she’ll need to justify the £450 that has just zipped into my bank account. She will also be working out how to explain away the inflammation and bruising. An allergy perhaps? A reaction to an insect bite?
But I’m sure she’s worrying unnecessarily. I doubt she’ll need to do any explaining, when she gets home to her equally wizened husband. He won’t notice there’s anything wrong with her face, because the sad truth is that he hasn’t looked at her properly for years.