The Big Interview: Dr Stephen Bassett

By: Katharine Griffiths
Created on 08th October 2010

Torn between medicine and the law in his youth, Dr Stephen Bassett of ShapeCymru took the Renaissance man approach and has done both in a varied career. Now, he has cherry-picked the best of both disciplines and finds his work as a cosmetic doctor perfectly fits with this way of working

For most of us, becoming a doctor would be enough for one lifetime. What prompted you to also train to be a lawyer?

I was born in a coalmining village in south Wales where the usual career paths if you were good at school were either medicine or the law. I loved science so decided to become a doctor – and it made my mam proud – but I’d always been fascinated by the law since watching the OJ Simpson trial unfold on television in 1994.

In 2002, I was working in a busy general practice and one day looked at my consulting room wall and thought, ‘I don’t want to be doing this for another 30 years’, so embarked on a law degree. I did the first year, not really expecting to even pass the exams, but won the Hammicks prize for best student and resigned from the practice on the spot.

The second year turned out to be a herculean effort, partly because I wanted to match my achievement in the first year and partly because the second year was considerably harder both academically and in terms of workload. I also had a family to support so was working full time, doing mainly emergency locum work, to finance this goal.

After all this effort why did you choose not to become a lawyer?

The same reason why I didn’t want to remain within the NHS; it was no fun. When I looked at the law as a career, which you never really see until you’re right on the cusp of filling out job applications, I realised it would be as confining a career path and as bound by the restrictions of bureaucracy as general medicine.

This is one of the things that I find attractive about cosmetic medicine. It is a freer, less regulated industry which, although that does present its own set of problems, allows imaginative, creative cosmetic doctors to build decent, hands-on, patient-orientated practices.

Cosmetic medicine attracts people who enjoy innovation but also want to do a very professional job for their patients.

Is this why you decided to enter cosmetic medicine?

There is also a personal element. In 2005 I developed a malignant melanoma which had to be treated surgically and I spent two weeks in hospital having skin grafting and so on. At that point I realised that I knew very little about the skin and decided to study it.

I found it fascinating and it led me to explore cosmetic medicine. I got hooked the first time I injected someone with botulinum toxin and saw the impact it had on that patient.

Law is still very important to me and I’m an accredited mediator with the UK’s largest mediation provider, the ADR Group. The NHS moves very slowly so at the moment there is little mediation involved in clinical negligence cases, partly because the litigation lawyers don’t want to relinquish such lucrative cases, but I think this is an area that is ripe for mediation. It is very satisfying to combine the legal and medical aspects of my training.

You have trained with the best in the business – in particular, Dr Jean Carruthers, who discovered the cosmetic applications of Botox. What extra benefit does this bring to your patients?

I think it would be a terrible way to spend my life if I just went for the fast buck, low challenge, ‘bit of Botox’ type of practice so I’m always keen to explore the latest technologies and treatments and decide if they are good enough to present to my patients.

At the very top of the industry people like Dr Jean Carruthers are keen to share their knowledge and innovation and they are accessible at events like FACE, which isn’t the same when you’re working in the NHS.

Obviously the medicine and pharmaceutical companies fund these events so you have to be sceptical, if not cynical, about potential conflicts of interest, but FACE is an incredibly educational event with high profile speakers.

You are the medical director of the Aesthetic Training Academy. What standards do you set in your practice that you feel it is imperative that other cosmetic doctors and nurses embrace?

I set the same level of professionalism in my cosmetic medical practice as I do in my other medical work, now mainly emergency room work. The people I see are patients, not clients and I give them the same level of explanation, attention to detail, documentation and follow-up.

How does being involved in training others benefit you?

If you have to teach others then it forces you to stay abreast of your subject. At the Aesthetic Training Academy we keep the number of delegates to four or five so everyone gets hands-on training and proper assessment. Too often in this industry it’s a case of turning up with 30 others, falling asleep at the back and getting a piece of paper.

If practitioners decide to do courses at the Academy that means that they are also not just interested in making a fast buck; they want to be stimulated. And this in turn keeps me stimulated and challenged.

What’s special about your clinic?

I think we have managed to integrate a relaxing, holistic, spa-style environment with a dedicated clinical facility, preserving the best elements of both. It’s quirky, as it’s the only flotation centre in Wales, able to offer facial rejuvenation acupuncture alongside other treatments.

But at the end of the day I treat the people who come and see me as patients not clients and it is a proper medical consultation. You have to explain properly that there is a very small but real risk that things can go wrong.

You offer both face and body treatments in your practice. Which do you find the most challenging or rewarding?

I am increasingly interested in facial aesthetics. I offer my patients VelaShape because I think it produces good results but, as a rule, I feel that the area of body contouring has got bogged down. There are a lot of wacky treatments out there that aren’t medically proven and produce very variable results.

Also many of the ‘non-invasive’ body technologies are pretty invasive and can be very costly – almost to the level where you would actually be better spending your money on surgery.

VelaShape is fantastic for mid-body contouring, particularly post-pregnancy, but there is a threshold beyond which the only thing that will work is an abdominoplasty. I’m very honest with my patients because I don’t want them disappointed.

Facial cosmetic medicine is very evidence based. If a patient comes to me and asks if botulinum toxin will work, I can say yes, it will work, it will produce this effect, that will last this long and will cost this much.

I note that you often offer combinations of treatments. Why do you think this produces the best results?

A colleague in Canada, Dr Stephen Mulholland, describes ageing as a combination of descent, deflation and deterioration. These three processes cannot be treated by one or even two modalities.

I usually recommend muscle relaxing injections first, but a large percentage of my patients go on to volume replacement. It is dated practice now not to rejuvenate the midface area with deep volume repair using treatments such as Radiesse.

Then you need to treat the surface with fractional methods. I use eMatrix, having introduced it to the UK and increasingly the dermaroller, which I view as a true fractional treatment.

Finally, we conclude with ongoing skincare programmes using physiciangrade cosmeceuticals and cosmenutricals – I prescribe Medik8 and SkinMedica products that hydrate, repair, correct and protect.

What do you see in the future for cosmetic medicine?

I just think you have to expect the unexpected – and it will probably be something that is already in use. Botulinum toxin had been used clinically for nearly 30 years before it occurred to Jean Carruthers that it had cosmetic applications.

Pharmaceuticals could be huge. At present we don’t use many drugs in cosmetic medicine and there is evidence to suggest that they could play a role in the future.

And are you happy to stay in this field?

My drive in life is to avoid wage slavery, an approach which has its ups and downs. The big downside is the occasional night lying awake in a cold sweat, but the upside is not doing work you don’t want to do or getting stuck in a groove. I have found a huge outlet for that in cosmetic medicine; it’s much more rewarding than being a GP or a lawyer.

CS&AG