My motto is “correction, not change”. Many practitioners give the field of cosmetic medicine a bad name by failing to appreciate the aesthetic proportions of the face as a whole.
It is all too easy to focus on problem areas without due regard for what looks naturally youthful. We have all seen grotesquely blown up lips in women whose filler should have been used elsewhere, if at all. So too the “pillow cheeked” look – an attempt to puff out all wrinkling at the expense of the natural contours of the cheek.
We must objectively appraise the whole face and be prepared to say “no” to our clients whose requests, we feel, are not in their best interests. A good aesthetic practitioner will use Botox® and fillers safely and will not create an unnatural look. A great aesthetic practitioner, on the other hand, will examine the face as a whole at every consultation and will ask him/herself “what more can I do to beautify this person’s face?”
The reality, however, is that most of our clients have a limited budget. The following question therefore becomes fundamentally important; which treatment will give this client the “wow factor”? therefore representing the best value for their money? Most of us benefit from Botox® in key areas at any age. A skilled practitioner can manipulate muscle action by enhancing the muscles that lift and by downplaying those that promote sagging. Fillers correct lines and depressions safely and reversibly.
We practitioners must aim to turn back the clock, to take our clients back 10 years rather than to change them into someone different altogether. The greatest accolade is when, at the two week follow up, a client reports that their friends comment on how good they look without being able to fathom out why. We don’t always get it right first time, however. We cannot gauge muscle strength accurately in each and every client. This is why the 2 week follow up appointment is all important when we can critically assess the effect of our treatments, allowing us to correct when necessary. In so doing we continue to educate ourselves and to optimise our technique in the future.
Lady St John of Bletso MBChB MRCOG