Bottom line: when it comes to all things aesthetic and cosmetic, who’s simply the best for all those tweaks and nips and tucks?
This is actually a really easy question! Your best bet (and the only people who will ever touch my face if/when the time comes): Consultant Dermatologist or Consultant Plastic Surgeon who are on the IMC specialist register. There are several safety reasons for this as well as several really practical reasons. Because they have the widest scope of practice (which means they are qualified to provide a wide range of treatments) you are likely to get a very honest consultation – not just given the options that limited by someone’s scope of practice. Also: they have the highest level of training and expertise, hands-down. Fillers, in particular, should be done by someone who is medically qualified and can administer filler reversal agent and is trained in techniques to reduce rate of rare but devastating complications of blindness or tissue damage if the filler is accidentally injected into a vessel.
In addition, consultant dermatologist and plastic surgeons are very aware of the risk of patients who have other health conditions, or who are are emotionally or mentally struggling with aspects of their body image, and will be conscious of this during consultations. And that’s what you should expect as standard, because at the end of the day, your beauty isn’t worth your health. Mental or physical.
What’s “the best” procedure, for you, is then easily answered: ask your consultant. In an ideal world, this is where our discussion would end. Everyone would have access to qualified care.
Wait…isn’t an aesthetic doctor or cosmetic doctor the same thing?
Nope. And this is important. There is no category on the IMC register for aesthetic or cosmetic doctors. Docs who advertise their services, even prominent ones, may have little formal post-graduate training, and have instead done commercial or industry-sponsored courses. There are GPs who practice aesthetics so they are on the specialist register – but as a GP, not a dermatologist or plastic surgeon. However, since they are medically qualified, they are a safer option than many other options in that they are 1) accountable for patient safety and 2) have to meet a standard of care, including indemnity, 3) continuing professional development, and 4) have had excellent training in anatomy and tissue handling. Consultants in other unrelated specialties with a side-gig in aesthetics, likewise, may not have any particular expertise in cosmetics. But at least they are doctors…
Wait….so, you don’t have to be a doctor to inject people’s faces?
Nope, and the near total lack of regulation of this industry, frankly, should terrify you. The spectrum of expertise and safety after doctor continues through dentist, aesthetic nurses, and beauticians. All of whom offer aesthetic services. While botox is limited to doctors, dentists, and nurses, fillers can be injected by absolutely anyone with zero training. What should worry you is that reputable suppliers of these products don’t sell them to just anyone. So if your beautician offers you filler after nails, there is a question about 1) where it was sourced 2) level of training 3) emergency procedures in place 4) and there is certainly no access to prescription-only reversal agents.
For what it’s worth, this my list of things I would strongly advise NOT doing:
Do NOT do medical tourism in Turkey (cosmetic or bariatric). Not for any procedure. It isn’t safe. It isn’t recommended. It isn’t worth it. I promise. To say I’ve seen it go wrong is an understatement…
Do NOT get a lap band in an aesthetic clinic. Actually, do not get a lap band anywhere. There are much better procedures for the treatment of obesity, and around 40% of patients end up paying to have them removed at some point due to discomfort. Bariatric surgery should be with a Consultant Upper GI Surgeon with a specialty in bariatric surgery who works with a comprehensive multi-discplinary team with extensive pre/post care in an established private hospital.
Do NOT get weight loss treatment in an aesthetic clinic or from an on-line pill mill sponsored by a pharmacy. Weight is NOT Beauty. Obesity is a complex, chronic, and recurring disease. Medications, including semaglutide or liraglutide, should be prescribed as part of comprehensive care, which should include your GP or a Consultant Endocrinologist.
Do NOT use the latest technology to avoid recommended medical treatment. If you have sexual dysfunction, you should see a consultant gynaecologist (woman) or urologist (man) to get assessed before signing up for 6 session in a magic vibrating chair. If you have obstructive sleep apnoea and don’t want CPAP, a laser pointed at the back of your throat won’t fix a condition that is more much than just snoring, but also has serious health risks.
Do NOT be really impressed by science that you don’t understand. Much in the aesthetic world promises new applications of technologies of radiofrequencies, lasers, exosomes… Don’t be blinded by science. Ask questions. Your doctor should be able to explain the science in Plain English to you.
The most important thing to NOT do:
Don’t use aesthetics to mimic the appearance of health while ignoring your actual health.
A machine that promises to “tone your muscles” doesn’t give you a gym body: it can’t replace the health benefits of physical movement: bone health, heart health, mental health, lean muscle mass, lowering cholesterol, regulating blood sugar, regulating blood pressure, healthy sleep…. Supplements and IV drips can’t detox you. They can’t replace a healthy diet. And for the most part, supplements don’t work. IV drips don’t have any actual benefit at all.
The hard truth is that true beauty comes from the inside. I actually mean that literally. The boring stuff you already knew is the foundation of beauty, and short-cuts will never substitute:
Smoking accelerates skin aging and tooth discolouration, and can aggravate skin conditions.
Regular alcohol excess can lead to skin dehydration, accelerated aging, skin redness, bloating, or puffiness.
Good bone health, which needs adequate nutrition and physical exercise, is necessary for healthy aging (your face has bones – and yes, they can age!)
Sleep is everything when it comes to healthy aging and great skin. Beauty sleep is an urban myth that is, somewhat at least, true.
Stress can trigger many skin conditions and even hair loss.
Weight is not beauty! But since it’s routinely targeted by this industry, let’s talk about it: “yo-yo dieting” which is actually called “weight cycling” has been associated with a number of adverse long-term outcomes, including increased risk of cardiovascular (heart disease and stroke) risks.
And wear that sunscreen…there is nothing like prevention when it comes to our health or healthy aging.
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