Dr Riekie Smit

07/06/2026

Ironman 70.3 Durban today.
Beautiful weather in Durban ☀️
Finished 2nd in my age category.
Always better when racing alongside family and friends. And my husband and daughter also qualified for World Championship in Nice in September. Now the 3 of us has some training to do!

04/06/2026

Why I can’t give you a price in the DM comments…

“How much does a Thread Lift cost?”
“What is your price per unit or per vial?”
These are by far the most common questions we receive on social media. And while it’s completely natural to want to know the cost, treating medical aesthetics like a standard commodity skips the single most important step: A thorough, in-person medical consultation and evaluation.

Swipe through to see exactly why custom planning is the key to safe, successful, and natural-looking outcomes.

The Reality of Aesthetic Medicine
Every single face is unique. When you come in for a consultation, we aren’t just looking at lines, we are evaluating:
Skin quality & laxity
Facial shape & underlying bone structure
Deep tissue shifts
Your unique medical history

Case in Point: The Thread Lift
Take a look at the patient example in the carousel. For a successful Thread Lift, a doctor doesn’t just open a box of generic threads. Based on a precise clinical assessment, we must strategically decide:
The specific type of threads and barbs needed for structural support.
The exact length of the threads tailored to different facial vectors.
The precise amount of threads required to achieve a natural lift.
Quoting a flat rate or a price “per thread” ignores the expert clinical skill, customized planning, and high-quality medical products required to ensure your safety and satisfaction.

The Key to Successful Outcomes
A premium aesthetic journey is never “one-size-fits-all.” A comprehensive medical process always includes:
Good consultation & thorough evaluation
Bespoke treatment planning
Correct choice of high-quality medical products
An in-depth patient discussion (managing expectations, understanding risks, comprehensive aftercare, and long-term maintenance plans).
Investing in aesthetic medicine means investing in the expertise of the hands performing the treatment, not just the product inside the syringe or thread packet.

30/05/2026

My 1st 100 miler Gravel Bike Race! . From hartbeespoort dam to
Very long and tough! With many river crossings and beautiful countryside scenery. Finished 3rd in my age category. 5 hours 50 minutes for 100 miles (156km)

29/05/2026

The Dynamic Perioral Zone
Why Lip Filler Isn’t Always the Answer for Perioral Aging

When patients notice smoker’s lines, a downturned mouth, or structural thinning around the lips, the immediate instinct is often to ask for lip filler.

But the perioral zone is one of the most complex, highly dynamic areas of the face. Aging here is never just skin-deep—it’s a multi-layered process:

1️⃣ Bone Resorption: As we age, we lose structural support in the maxilla and mandible, causing the area around the mouth to structurally collapse inward.
2️⃣ Muscle Hyperactivity: The orbicularis oris muscle (the sphincter muscle around the mouth) tenses over time with speaking, eating, and expression, etched lines into the skin.
3️⃣ Dermal Thinning: Deep collagen depletion means the skin loses its elasticity and can no longer “snap back” after movement.

The Solution?
Treating this beautifully requires a multi-modality approach, not just volume.
To achieve a natural, youthful restoration, we often combine:
- Skin treatments, such as peelings, lasers or devices
- Advanced Biostimulators to rebuild the lost dermal foundation.
- Micro-Botulinum Toxin to gently relax hyperactive muscle fibers without affecting your smile.
- Targeted Superficial Hydration and Targeted natural fillers rather than structural stretching.

Anatomy and individual patient factors should always dictate the treatment protocol.

27/05/2026

Excessive sweating (hyperhidrosis) occurs when the nervous system overstimulates local sweat glands.
How does targeted intradermal treatment of botulinum toxin help to reduce excessive sweating:

• The Signal:Under normal or overactive conditions, nerve fibers release a neurotransmitter called acetylcholine, which signals the sweat gland to produce sweat.

• The Blockade: Micro-injections of botulinum toxin are precisely delivered into the intradermal layer of the skin, directly where the sweat glands reside.

• The Result: The toxin binds to the local nerve endings, temporarily blocking the release of acetylcholine. Without this chemical signal, the overactive sweat glands are not triggered to secrete fluid.

Clinical Expectations:
- Onset:Results typically become effective within approximately 1 week.
- Duration: The temporary blockade provides localized relief for roughly 4 to 12 months.
- Safety: This treatment is strictly localized to the target area (e.g., axillae/ underarms, palms); the body’s global thermoregulation remains unaffected.

! This procedure can be performed for suitable patients by registered and trained healthcare professionals (doctors). Discuss with your doctor first

26/05/2026

The Science of Microtoxin for Skin Quality:
Ever wonder how botulinum toxin can improve skin texture without freezing your expressions?

Swipe through to see the science behind Microtoxin (intradermal injections) and how it works at a cellular level:
🔹 The Target: Unlike traditional injections that go deep into the muscle, Microtoxin places hyper-diluted micro-droplets just beneath the skin’s surface. This targets the dermis while preserving your natural expressions.
🔹 Less Oil: It blocks acetylcholine (a key neurotransmitter), which temporarily slows down lipid synthesis in your sebaceous glands. Result? A clinically proven decrease in sebum and fewer breakouts.
🔹 Smaller Pores: By relaxing the microscopic erector pili muscles and interacting with the dermal collagen network, it creates a visible tightening effect that minimizes pore size.
🔹 Reduce Sweat: It interrupts the signals to your sweat glands, temporarily halting localized sweat production for a smooth, matte finish.

🔬 The Scientific Takeaway: Microtoxin isn’t just masking symptoms—it alters local cellular signaling to optimize skin health, oil production, and texture from the inside out.

23/05/2026

Microtoxin for acne?
When we think of neuromodulators, we usually think of relaxing deep muscles to soften expression lines. But when injected using a specialized technique called ‘Microtoxin’, the mechanism shifts entirely.

Here is the science behind why it is becoming an emerging tool for managing oily, acne-prone skin:
🧪 The Intradermal Mechanism:
Unlike traditional placement, microtoxin is highly diluted and injected superficially directly into the dermis—the upper layers of the skin. Because it never reaches the deep underlying muscle, facial expressions remain completely natural and unaffected.
🛑 Reducing Oil Production:
In the dermis, the toxin targets the nervous system’s signaling pathway. It blocks the release of acetylcholine, a neurotransmitter that triggers both sweat and sebaceous (oil) glands.
🦠 Starving the Breakouts:
By temporarily lowering sebum production, the skin environment shifts:
1. Pores naturally look tighter and less stretched by oil.
2. The C. acnes bacteria lose the excess sebum they thrive on, reducing inflammatory acne.
3. Overactive skin flushing and localized neurogenic inflammation are calmed.

While microtoxin offers incredible relief for severe seborrhea (excessive oiliness) and mild-to-moderate acne for roughly 3 to 4 months, it is generally considered an adjunctive treatment—meaning it works best alongside a foundational skincare and medical routine, rather than as a standalone cure.

14/05/2026

Poikiloderma of Civatte is a benign (non-cancerous) skin condition characterized by a combination of:
• Hyperpigmentation: Brownish discoloration.
• Erythema: Persistent redness or visible broken capillaries (telangiectasia).
• Atrophy: A slight thinning or « crepey » appearance of the skin texture.
It most commonly appears on the sun-exposed areas of the neck and upper chest, often sparing the shaded area under the jawline.

Why does it happen?
The primary cause is chronic UV exposure over many years. However, other factors can play a role, including:
• Hormonal changes.
• Genetic predisposition.
• Potential reactions to certain chemicals in perfumes or cosmetics applied to the neck.

Management & Treatment Options
While the condition is harmless, many seek treatment for the visible changes in skin tone and texture.
• Sun Protection: Mid-day (9am to 3pm) application of broad-spectrum SPF 50+ prevents the condition from worsening.
• Vascular Lasers & IPL: KTP laser, Intense Pulsed Light (IPL) or Pulsed Dye Lasers (PDL) are highly effective at targeting both the redness and the pigmentation.
• Other energy based devices: LED, RF.
• Topical actives: These can help improve skin texture and stimulate collagen.
• Skin Brighteners: Ingredients like Vitamin C, Niacinamide, or Azelaic Acid can help even out the pigment over time.

Pro-Tip: Always remember to extend your skincare and sun protection down to your neck and décolletage—not just your face!

14/05/2026

12/05/2026

The Science of Thread Lifting:
Tissue Repositioning vs. Skin Restructuring

Understanding the distinction between different thread technologies is essential for managing expectations and achieving optimal clinical outcomes in neck and lower face rejuvenation.
Addressing aging in this area typically falls into two categories: mechanical lifting or biological skin improvement.

• Tissue Repositioning: The Role of Anchor Threads

When aging presents as sagging or hanging tissue, such as the formation of jowls or a loss of definition in the submental (under-chin) area: Anchor Threads are utilized.

These threads feature microscopic barbs or cogs that engage with the subcutaneous tissue. By anchoring into the tissue, they allow for the physical repositioning of sagging fat pads, moving them laterally to contour the lower face and sharpen the jawline.

When are these used? Significant tissue laxity where a physical lift is required to restore anatomical positioning.

• Skin Restructuring: The Role of Mono Threads

For concerns involving crepey texture, fine wrinkles, or thin, loose skin, the focus shifts to Mono Threads. These are fine, smooth threads that do not have a mechanical lifting mechanism.

Biological Action: Multiple fine threads are placed superficially in a mesh-like pattern just under the skin.
Their presence acts as a scaffold that triggers neocollagenesis—the stimulation of new collagen strands.

When are these used? Improving skin quality and tightening the dermal layer from within rather than physically moving the underlying fat.

‼️The Importance of Clinical Evaluation

Successful rejuvenation is not a ´one-size-fits-all’ process. A treatment plan may involve one or both types of threads depending on a patient’s unique anatomical needs.

‼️All medical aesthetic treatments require a comprehensive personal consultation and evaluation. This allows for a thorough assessment of skin thickness, tissue mobility, and overall suitability. Because these are medical procedures tailored to the individual, a treatment quote can only be provided following a formal clinical assessment.