Take Care

By: Liz Bardolph
Created on 25th March 2010

Liz Bardolph, BSc RGN INP, of Cosmecare has been working in the field of aesthetics for the past twelve years and is a founder member of the British Association of Cosmetic Nurses (BACN). Here, she shares with us her experiences and vision for the future

My experience
I gave up NHS work after having children, but after several years working in healthcare research, I was asked to help set up an
aesthetic laser clinic within a district general hospital. Working in the clinic, it soon became clear that I had found something I was truly passionate about, and I decided to do further training in
aesthetics.

In January 2000 I opened my own clinic in the centre of Southampton. These days, new clinics are opening all the time, but back then it was very unusual. The few clinics that were around tended to be doctor-led and almost all were in a hospital setting.

I was taking a huge risk - such a risk in fact, that the first bank I approached for a business loan refused point blank. However, I proved them wrong, and these days aesthetics is one industry that is showing the biggest growth!

Treatments over time
Dermal fillers have always held their own as the most popular treatment. When I first started out, the only filler around was collagen. In many ways it was a great product - it injected like
liquid gold and was great to use. However, there were some major downsides: it came from a bovine source, so you needed to have a skin test and then wait four weeks before you couldgo ahead with the injections. And even then this was not a complete guarantee against allergic reactions.

Another problem was its longevity - it didn't really run the distance. The effects lasted two, possibly three, months and then it was gone. I think that was what did for it in the end. And then along came Restylane, a product made from a non-animal source, so it could be used straight away, and it lasted. And the rest is history, really.

Dermal fillers are still the most popular treatment I offer; I started offering Botox three or four years ago, but I certainly don't suggest Botox immediately, and a lot of people don't want it - they would rather have something that leaves a bit of expression in their face.

My consultation is very thorough, to find out exactly what the patient is looking for and then to explain the various options and the differences between them very carefully.

Now and then
One thing that hasn't seen such a big change since I started out is the average age of my patient. These days I'm still mainly treating the older patient, people in their 40s, 50s, 60s - even one or two in their 70s. I think maybe that's to do with the sort of person I am. I have a very honest, no-nonsense approach, which people appreciate.

Patient expectation has always been high. In the beginning most of my patients had really saved hard for their treatments. These were professional, working women who were putting aside money each week to be spent on themselves, so the pressure was on me to make sure that the results justified that. Patients still save hard but nowadays more see it as part of good grooming.

Now, patients are much quicker to react if something does go wrong - I suppose this is partly due to the fact that there is more competition within the industry itself, so patients know they can always find another practitioner, but also to do with the Americanisation of our culture.

Hope for the future
My dream is that nurses will be seen as on a par with cosmetic doctors. Once, it was nurses who led the field, but somewhere along the line that has slipped.

Several years ago, a few of us worked with the University of Greenwich to put together a graduate diploma in aesthetic medicine and, although originally intended for nurses, the diploma is now being undertaken by doctors and dentists alike. It was the first of its kind. I do think ultimately that each aesthetic nurse should have an accredited qualification because these are serious treatments and should be treated as such.

The role of the nurse

There are often negative opinions expressed about the role of nurses in aesthetic medicine but I strongly believe that nurses can deliver as good a result and patient experience as doctors, dentists and surgeons can. Often you'll find that it is nurses who have trained doctors in giving injections.

I am a founder member of the British Association of Cosmetic Nurses (BACN), which was established in 2009 to ensure the safety of patients, work to raise standards, to establish a register of qualified and insured independent nurse practitioners and to be a voice to be heard within the aesthetic industry, the media and general public (www. cosmeticnurses.org).