Carry On Doctor

By: Andrew Winter
Created on 07th June 2010

As one of the very first cosmetic dermatologists in the UK, Dr Andrew Winter has witnessed firsthand the rise of nonsurgical cosmetic treatments. Here he shares his experiences with Cosmetic Surgery & Aesthetics Guide...

These days, non-surgical aesthetic treatments are very popular and there are a large number of people trying to jump on the bandwagon as practitioners. Back in 1993 when I started out, however, it was very different.

I fell into aesthetics almost by accident; I was working as a clinical dermatologist and was asked by a local clinic in Warrington if I would come in and do some cosmetic work for them - just the odd chemical peel or skin consultation, once
every couple of weeks. learning the ropes

Then in 1996 I went on a Botox course in London, run by a Harley Street surgeon, and that's what got me really interested in helping to slow down the ageing
process. I followed the Botox course with one on collagen, which was the only dermal filler available in those days, and I went down and spent some time
with an experienced clinician, watching him at work.

Once I'd learnt as much as I could about the various treatments available, I started to build up my business. The first thing I did was to commence working with beauty
therapists, offering Botox and filler treatments to their clients. I can remember standing up in front of an audience of doctors and surgeons and saying, "you
probably think I'm mad going in with a beauty therapist, but one day it will be commonplace", and I'm pleased to say I've been proven right about that.

Money matters
I think what's really interesting about this industry is that the overall costs of procedures haven't really changed hugely in the past 14 years. What have changed are consumer attitudes to cosmetic treatments. For example, when I first started offering Botox I was charging about £150 per area. And that hasn't really changed
- I might have put it up by say twenty pounds, and I think the same for fillers, but in 14 years that's barely an increase at all.

Relatively speaking, however, 14 years ago that was an awful lot of money, so it was far too expensive for the average person to afford. Due to relative costs, I had significantly fewer patients in those days.

So price was one concern, and I think the other issue was scepticism amongst consumers. People didn't really understand the concept of aesthetic medicine, and they didn't like the idea of poison in their face.

A turning point
I think what changed things was in the early 2000s when Boots started offering Botox and dermal fillers. It became obvious that it must be a safe thing to do,
because a company like Boots wouldn't risk their reputation, so that lent credibility all round.

The other positive aspect which came out of this was that prices became more stable. Beforehand, prices would vary significantly from one practitioner to the next.

Changing faces
There is a lot of talk in the media lately about trends in cosmetic work - so we went from the 'windtunnel effect' of the 1980s to the frozen, over-Botoxed look of the 1990s, to the 'pillow face' look we've seen more recently, with people having a lot of filler injected into their cheeks.

In fact, I don't think the situation is that simple. Perhaps people do want less Botox these days, to give a bit more movement to their face, but as far as fillers are concerned you have always had people who want dramatically big areas filled, whereas others are happy with a more subtle look. Different people want different things, and they always have.

I think one thing that has changed is the move towards prevention rather than cure - so people are starting to have anti-ageing treatments almost before the signs of ageing begin to appear. I encourage this, because it does work. It's a very individual thing, however, based on a person's philosophy, their finances, and of course how they are ageing.

Safety matters
I was one of the first members of the British Association of Cosmetic Doctors, an association set up in the early 2000s by Patrick Bowler and Rita Rakus.

The aims of the BACD are to ensure credibility to the profession and to enhance our own learning; but more importantly we want to increase public safety, to make sure that cosmetic doctors are accountable to a body and can be taken to task if something goes wrong.

I find it alarming that medicines such as Botox are being administered to patients without the supervision of a suitably qualified medical practitioner. I know of instances where, for example, beauty therapists have administered such a medicine, to disastrous effect.

Cosmetic practitioners have been clamouring for some kind of official regulation of the industry for some time now, so I am delighted at the recent launch of the IHAS Quality Assurance Mark, which offers patients the chance to find out if a clinic or practitioner is suitably qualified to offer cosmetic injectable treatments safely.

Facing the future
I think the future holds great things for the medical aesthetics industry. As demand from the public grows, so more innovative products and treatments will become available, and safety measures will become more stringent. The only way is up.