“Are You Looking for Botox or Laser Treatment But Don’t Know Where To Go?”
by Dr John Tanqueray, Cosmetic Physician
If you’re thinking of having cosmetic treatment you need to find a clinic/practitioner you can trust. You want your treatment done in a sensitive way to make sure you keep a natural look, and you want it done safely and with the best products.
Sadly we all see examples of poor treatment either in magazines or on television, and walking down the local high street as well. But remember that most of your friends who are having treatment probably just look great, and no-one knows they have had any treatment.
In good hands treatments like Botox or dermal fillers can be very effective and safe, but all medical procedures involve possible risks of side-effects or complications, so you are better finding the best trained and most experienced practitioner.
How can you best decide which of these people you can trust with something as precious as your face?
I suggest you should be as questioning when it comes to choosing your clinic as you would when making any important decision. It makes sense to be cautious.
The following advice is based on my experience over the past 9 years running my own cosmetic clinic and meeting people who have had a bad experience elsewhere.
RULE NUMBER 1: Assess Your Practitioner Before They Assess You!
Just as you wouldn't buy the first house you see, you shouldn't assume that the first person you see about your appearance is going to suit you best either.
You need to find out what you can about their background and skill, and decide how comfortable you feel with their advice and the way they talk to you.
So, here are my top suggestions:
1. “What Is Your Background/Qualification?”
In the UK you may find the answer ranges from a plastic surgeon, doctor, nurse, dentist, physiotherapist, pharmacist, beautician or none of the above. (Anywhere else in Europe and the USA only medically qualified doctors can administer injectable cosmetic treatments.)
Which of these would you feel will have knowledge of dermatology, anatomy and diagnosis of related medical conditions, and the knowledge and experience needed to help should any problems arise after treatment?
Don’t be afraid to ask questions – I am very surprised how few people ask searching questions about me and my practice, and when they do I welcome them. No practitioner should be surprised to be asked and shouldn’t be offended – in fact the more offended or uncomfortable they are the more likely they’re not as qualified as you’d like!
2. “How Long Have You Been Doing These Treatments And What Specialist Training Do You Have?”
A good question and of some help but remember that just because someone has been offering treatments for a long time this is no guarantee that they’re good! As a trainer of practitioners from relative beginner to more experienced I've seen a very wide range of skill levels, even when someone has been offering treatment for a long time.
Good training is essential, but do they have evidence that they have been assessed after they've had training? Remember that simply attending a training session is no guarantee that they are good at what they are doing.
3. “Are You A Member Of A Recognised Professional Body?”
In the UK this might include General Medical Council (GMC), British College of Aesthetic Medicine (BCAM), British Association of Aesthetic Plastic Surgeons (BAAPS), General Dental Council (GDC) or Nursing and Midwifery Council (NMC).
You can always check with the relevant governing body if you are unsure of someone’s qualifications.
4. “How Many Treatments Have You Carried Out And What Complications Have There Been?”
For this one you just have to see how the question is answered as they could say what they like, but it should give you a guide. No-one with experience will say that there has never been a complication, and shouldn't be ashamed of saying so as these are a medical fact of life. If someone insists that they never see any problems then you might question them further.
If a practitioner can quote their own rate of complications then you should be impressed – this means that they monitor their treatments and results and take their practice and education seriously.
5. “How Easily Can I Contact You Or See You If I Have A Query Or A Problem?”
Some practitioners can be extremely hard to get hold of when it comes to asking for advice following a treatment, especially if you have a problem or concern. This is distressing and stressful if you are the patient. For example if your practitioner travels to a clinic only once a month they will not be available very often, so make sure you feel comfortable that advice in person will be available if you need it. For a more invasive procedure you should be given a mobile phone number to ring in case you have any worries out of normal hours.
6. “If I Have A Problem That You Can’t Deal With What Would You Do?”
There may very rarely be a situation where more specialist advice is needed if an unusual problem arises. Someone who has thought this through will have a ready answer to this question, which might be that they have a more experienced contact in the profession, or the product manufacturer will provide back-up and advice (however I know from experience that not all manufacturers are good at this).
7. “Which Products Do You Use And Why?”
I’m sure you have heard about the breast implant scandal where industrial grade ingredients were being used in medical products to make them very cheaply. This ended up making more profit for the clinics using them but had disastrous results for the patient.
There are plenty of people in the industry who believe that there will be problems in the future because untried and untested treatments are frequently being launched with little proof that they are safe over a long period.
As an example there are at least 4 major brands of botulinum toxin (the main ones being Botox itself, Xeomin, Azzalure and Dysport) with other manufacturers, not always reliable, appearing around the world; there are several hundred different types of filler available in Europe. Cost for the different brands can vary greatly, but a clinic using a cheaper brand may still charge the same as a clinic using a more expensive one. You need to be sure that your clinic chooses their recommended filler/s because they are effective and safe, not because they are the cheapest and maximise their profit!
A well-established company will have done a lot of research to back up their claims of safety, effect and durability, while others may only have tested their product on a small sample of people over a short period of time – I know which I’d rather be treated with!
The same is true with lasers – the cost to buy can range from £20,000 to £80,000 for equipment that is supposed to do the same job. Ask yourself why someone would buy such an expensive machine if a cheaper one would work as well and be as safe?
That’s the seven questions but here are a few other things to think about before making your final decision about who to trust:
Are You Being Given A True Choice Of Available Treatments Or Just Being Advised To Have A Treatment That Your Practitioner Happens To Do?
If you are asking for advice on a particular problem you want to be sure you are offered the full range of options so you can make a choice based on the risks, benefits and costs of any treatment. Ethical advice would also include suitable treatments not offered by your practitioner – GMC guidance lays down that this is an important part of the consent process.
For example it is now agreed that the most fundamental part of facial rejuvenation is to have enough volume or “lift” in the cheeks, but there will be practitioners who don’t have the skill to treat this area so will never offer it to you.
If your practitioner is involved with research into new treatments, is asked for opinions on products by companies in the aesthetic field, or if they are appointed as a trainer by one of the big companies then this is a good sign that they are respected within their profession.
A good practitioner should make their own assessment of your situation and make suggestions to you that you might not have thought of rather than just give you the treatment you’ve asked for – they should be the expert advising you after all.
Don’t forget to use your gut instinct. If someone appears open and easy to talk to the chances are that they will listen and be sympathetic to you when it comes to treatment, and you’re more likely to be happy with the results; if they don’t appear to listen or explain things, don’t seem confident when answering your questions, or you just don’t feel comfortable with the clinic setting then you would do better to look elsewhere.
If you don’t feel comfortable with the clinic set-up or the person you are consulting then simply go elsewhere.
Beware if the clinic seems more concerned about selling you a treatment or series of treatments than addressing your concerns. Be especially wary if you are told that a certain price will only be valid if you book today, or if you are told that you could have additional surgery at the same time at a special rate. This is purely a sign that the clinic works on commission and may care more about its profit than your well-being.
A quick word about Harley Street
There are some top-notch people working fromHarley Street, but an address there is not always a guarantee of quality. Anyone who wants to can hire a room there, even for half a day a month. This will then allow them to advertise that they have aHarley Streetclinic which sounds impressive but in this case would mean very little. I saw a patient recently who had tried to complain after having treatment inHarley Streetbut could not track down the person who had treated her, and she doubted whether their qualifications were what she had been led to believe.
My final piece of advice
In the end there is no harm in visiting a few clinics so you can check out different opinions on what would suit you best. This way you may receive different opinions and you’ll get an idea of where you feel most comfortable.
Good luck in your search, and please let me know if you have found this helpful.
I’d be very happy to hear about any good or bad experiences you have had with your treatments. E-mail me at email@example.com .
Dr John Tanqueray
Director of Mulberry House Clinic,Northampton,UK