FutureFace®: A Subtle and Sustainable Approach, Centred on You

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In an era where overfilled features dominate social media, Dr Barlodien Kotzé presents a refreshingly honest perspective on aesthetic medicine. This article introduces FutureFace®, a philosophy and procedure designed to preserve natural beauty while considering long-term facial harmony. With insight, caution, and care, Dr Kotzé calls for a more conscious and patient-first approach to injectable treatments. 

I remember being 29 (almost two decades ago now) and boldly declaring, “I will never do botulinum toxin.” Back then, there was only one neurotoxin brand in town, and aesthetic medicine wasn’t the booming industry it is today. But as I started my journey in this field, my thinking changed. That’s expected when you’re growing, learning, and seeing the full picture from the inside. 

What hasn’t changed, though, is this: I’ve always wanted to look like me. And I realised this resonates with all my patients. 

That single value (staying recognisably myself, just fresher) became the cornerstone of everything I now do in practice. And it’s the heart of what I’m introducing here: FutureFace®, a conscious, patient-first approach to aesthetic medicine. 

The elephant in the room: Alienization 

Let’s be honest: aesthetics has a problem. A big, pointy-chinned, snatched-jawline, duck-lipped problem. We’ve all seen the faces, whether on social media, walking past us in Woolies, or maybe even staring back from our own clinic galleries. 

This isn’t just about a bit of bad filler. It’s a pattern of distortion, what Dr Steven Harris rightly called alienization. It is the aesthetic equivalent of over-editing a photo until it no longer resembles a real person. And the truth is that we’ve all played a part in it, whether through overfilling, caving to social trends, or simply not knowing what we didn’t know. 

The causes? Multifactorial: 

• Lack of artistic sense: Yes, aesthetic medicine is medical, but it’s also art. 

• Poor anatomical understanding: There are still injectors who don’t fully grasp the structures they’re working over (and under). 

• Perception drift: Social media filters, unstandardised before and after photography, and altered baselines confuse our patients (and sometimes us) about what “normal” even looks like. 

• Greed: Let’s call it what it is. When sales matter more than subtlety, results suffer. 

And then came the game-changer… 

The longevity revelation 

For years, we were told by product companies that HA fillers dissolve after 3–18 months. Cue the “top-ups”. The frequent refills. The idea that we could just “add a little more” safely, time and again. 

But recent MRI studies threw a spanner in the works. One review showed hyaluronic acid fillers can persist in the face for years – in some cases up to 15 years after injection. 

Let that sink in. 

This isn’t a harmless product just “melting away” after a few months. This is cumulative material slowly building up, layer upon layer. It’s not hard to see how a face can become distorted over time, even with the best intentions. 

Patients are catching on. They’re asking more questions. They’re pulling back from heavy filler sessions, scared of migration, infection, and unnatural looks. And rightly so. The traditional filler model is overdue for a rethink. 

FutureFace®: A different ethos 

So what’s the solution? 

FutureFace® is my answer. It’s not a new trend or product. It’s a mindset. A commitment to treating your future face, not just the one in the mirror today. 

The key principles are simple but powerful: 

• Long-term vision: Every treatment must serve your future face. If it will not age well, it does not belong. 

• Natural enhancement: You already have beauty. Our job is to maintain and elevate it, not mask it. 

• Conscious and deliberate practice: No autopilot. Every injection is intentional and backed by a deep understanding of anatomy and ageing. 

• Avoiding over-injection: Top-ups just for the sake of “freshness” often do more harm than good. Less is usually more. 

• Individualised treatment: There’s no one-size-fits-all. Your face is unique. Your plan should be too. 

And yes, the earlier you start, the more subtle and preventative we can be. I always tell my younger patients: my aim isn’t to freeze time; it’s to guide it gracefully. 

The Conscious Injector 

A Conscious Injector isn’t just someone with a needle and product. They are someone who sees the full arc of your aesthetic journey, from your first consult to your future self at 50, 60, or beyond. 

They: 

• Respect the anatomy and the art 

• Understand the real longevity of products 

• Stay informed, ethical, and honest about what’s possible, and what’s not 

It is about saying “no” as often as “yes,” choosing quality over quantity, and helping you look like yourself, not a filtered version of someone else. 

In South Africa, your injector can only be a doctor or a dentist. Non-medics are not allowed to administer scheduled drugs. Be aware. 

The FutureFace®procedure 

To complement the philosophy, I also developed a minimal yet impactful treatment for younger patients starting to feel that “something’s changing” shift in their face. 

The FutureFace® procedure involves 3 ml of skinbooster (a product that will not build up in your face), precisely placed with a cannula to maintain structural support and delay visible ageing. The goal? To stay looking like you: not droopy, not puffy, not “done”. Just fresh, natural, and confident in your skin. 

My ideal “after” photo isn’t a week post-injection, it’s 10 years after we began working together. When you still look like yourself. Just great for your age and maybe even better. 

In closing: It’s time for a shift 

FutureFace® isn’t about fear-mongering or rejecting fillers entirely. Filler is not the enemy. Misuse is. Overuse is. Poor placement is. 

This is a call to slow down, think deeper, and treat more consciously. As professionals, we owe it to our patients to be better. And as patients, you deserve results that won’t betray you 10 years from now. 

Your face tells your story. Let’s make sure it’s one you’ll be proud of today, tomorrow, and well into the future.