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What I am doing differently in 2023

The most seasoned business owners know firsthand that in order to succeed, you have to be willing to fail, sometimes many times over.

Each time this happens, you pick yourself up and keep moving, learning from what worked, and what did not.

Why do this to ourselves? While it seems like an exercise in self flagellation, the key is in the mindset it teaches you.

I’ve learnt far more from my failures than I ever have by cruising and through success, even if none of us actively chases failure. In many ways, failure teaches us what we are truly made of, and teaches us grit and resilience.

So why is this relevant in 2023 to Skin Essentials?

In 2023 I am bringing about changes to the way I do business and I’m terrified if I am honest.

Terrified because it’s raw, honest and comes from a place of wanting good for my patients, my staff and myself.

Terrified because honesty, no matter how kind, can always be taken the wrong way when people receiving it feel defensive.

Terrified because there’s always the fear that in making the changes, I will lose business and my business will tank and…and…and…

I’ve done a lot of hard things in my life, as we all have; and one of the things I love about myself is my innate optimism, my ‘glass half full” approach to things especially when they are hard, and the immense privilege I have of having an education in a field where, even if Skin Essential does tank and I do close, I’ll have other options.

So what are the changes and why?

I entered medical aesthetics reluctantly in 2015/2016. I really didn’t want to do it because of all the fake faces I saw around me. It seemed fake, vapid and entirely unnecessary. At the same time, I was beginning to see early signs of ageing in my own face and a visit or two to the local chain clinic for skin needling left me with disastrous and painful results.

I was stumped for next steps based on evidence rather than hype and fads. So I began to look into it, initially for myself, then as my knowledge increased I met patients and friends who wanted someone reputable, who would do good work, give them results and a longterm plan for ageing well.

Like me, they were mostly women who had tried many things and had little success, and occasionally bad outcomes and they wanted someone they trusted to do the planning for them, so they could just show up, and get the work done and be told what to do.

These are my best longterm patients, who come in when told to, get on the chair and say “whatever you think best doc!”.

They trust me, trust the process, are realistic about what is achievable including over what period of time; they are patient, they remain calm with common side effects such as bruising, swelling, lumps and bumps and they show up.

These are, quite simply, my ideal patients. Price is important, but not the most important factor, and as long as they know what they need to save in time for the next appointment, they plan appropriately.

In 2023, I am moving away from a lot of the interactions that I found draining in 2022 with patients who, quite simply, were not aligned with me and the way I work, in part as I was not clear enough about it.

So what are some examples of patients for whom I am unlikely to be the right doctor? 

1. They are not looking for a longterm plan to help them age well. 

Full face rejuvenation is my signature treatment and the one that gives me the greatest joy and the best results for my patients.  I am really not a fan of just some anti wrinkle to one area and  lip/ cheek filler as and when a patient feels they need more and orders some. It is not how I work.

I look at the whole face as pieces of a jigsaw puzzle - as the ageing process begins to take hold, pieces of the puzzle go missing, and it takes more than just 1-2 mls of filler or some anti wrinkle treatment initially, to begin to correct this.

For those patients who start at a good time, as early as their 20s and early 30s, it’s true that initially there’s not much to do beyond a focus on the basics including excellent, personalised skincare but having a comprehensive plan allows us to stay on top of it and to plan for what is likely to come and to prepare for it.

These patients may need either occasional enhancement eg lip filler or maintenance by way of some anti wrinkle treatment to target early lines and wrinkles, some undereye correction and any other early signs of ageing.

Costs are usually around $3000 a year or thereabouts depending on where you start and what’s needed.

The older patient, as early as mid 30s and up, needs far more work if nothing has been done until then. This is the work I refer to as restorative.

Many pieces of the jigsaw puzzle are missing and there are changes under the skin that need to be looked at.

For these patients, the work involved at the beginning is more extensive over several months, usually in stages to get to maintenance and involves skin improvement as well as injectables and possibly permanent fat dissolving.

Costs are typically $6000-10000 during this period depending on what is needed then maintenance is closer to $3000 a year or thereabouts.

I won’t do just tear trough filler when what you need is mid face support to your temples and cheeks also.

I won’t do just lip filler if you also need support around the mouth and to the chin to avoid a Marge Simpson lip.

I won’t do just some anti wrinkle so your forehead and upper face are completely frozen while completely ignoring your lower face which looks a decade or more older.

There are so many more examples, but we all know what I am talking about because we’ve all seen it.

In 2023, I have decided to focus more on these patients because the entire face is one unit, and treating only one area without treating the others leads to an imbalanced outcome that we can see all around us by way of fake, frozen and odd looking faces.

Just as pillowface is a problem, so is a frozen and gaunt, hollow face due to fear of fillers and anti wrinkle treatment doses that are too high.

My personal signature is on every face I touch and in 2023, I’ve decided to be as transparent as possible about what is expected of patients that want to work with me as well as an idea of the type of results that are possible as shown here and on my instagram page and indicative costs to help you decide to book or not.

Balance is everything in medical aesthetics done well such that only you truly know what was done.

2. They are impatient with the process 

In 2022 I saw many patients who began with the best of intentions but then fell away along the way.

They didn’t understand instructions despite verbal and written instructions or didn’t realise that skin takes time - usually 3-6 months on average, or longer and that the bulk of the work would be done by them at home, with some in-clinic followup as needed.

I know I can get you results, but only if you are disciplined and committed to the process and wiling to invest, otherwise it is a waste of your money and our time together.

3. They don’t appreciate that good medical aesthetics is not cheap

Many who booked to see me in 2022, often off media articles, had no idea how much good medical aesthetics actually costs.

Shock and disappointment aside, it’s heartbreaking for me to turn people away, or to know that we have spent time in a consultation in which they’ve come to realise how much needs correcting, and are unable or unwilling to budget for it.

Unlike many others out there, I won’t start with 1-2mls of filler if in reality you need 8-10mls and lack the budget for it.

It’s unfair and unkind to you and it is not good medical care.

Because of this I commonly say to patients, “I don’t work to your budget. I tell you what you need and you can decide if you want to budget for it, and then we can begin.”

4. They frequently rescheduled at short notice

In 2022 I had several patients who repeatedly cancelled last minute or rescheduled just outside the late cancellation period.

When you make an appointment you are reserving my time and when you cancel without much notice, this is a large slot of time that often cannot be filled last minute - this is not sustainable for my business.

More importantly for you, when you frequently reschedule or delay discussed and agreed to treatment, you rob yourself of the results since they largely rely on your showing up and doing the work.

So in 2023, I’ve decided that I will be even more upfront about this, and their willingness to be held accountable if we are to work together.

5. They have more than average anxiety around side effects and downtime following procedures 

In 2022 we had many emails days or weeks after treatment asking if “this was normal.” We also had people who panicked over common side effects such as bruising following treatment.

All medical aesthetics is medical - anytime your skin is pierced with sharp instruments or injured in some other way through treatment eg a chemical peel, side effects and some downtime are common.

We do not provide ongoing medical advice without consultation for non urgent issues/ questions as it is not medicolegally possible to do so.

We do provide complimentary reviews if you feel the need whereby you can come in and be assessed; if it’s a non urgent issue, we ask you to make a note and raise it at your next clinic visit.

6. They had unrealistic expectations of what is possible with non surgical medical aesthetics 

Rarely, I saw people in 2022 who had left it to their late 50s and early 60s to realise they were really unhappy with the way they looked and seeking a quick fix. For many of these patients, they best option was plastic surgery if they wanted an extensive change, or significant lifting.

It is important to me to be upfront with people when surgery is the best possible option for them, and not to take their money to disappoint them.

Equally, it is important for patients to realise that once there is disease, such as acne, or pigmentation or signs of ageing, medical aesthetics can help improve this, and to help you maintain it, but it’s impossible to correct it 100% and in every lighting possible.

Realistic expectations are key to an effective working relationship at Skin Essentials. I do not sell snake oil.

In summary…

In 2023 I will be more proactive about turning away patients who are not ideally aligned with the way I work and ready and prepared to do the work.

Seeing patients who are not prepared for the reality of what medical aesthetics involves, including the cost and timeframe, is a waste of their money and our time together.

Patients who only want one or two things and nothing else eg only anti wrinkle but not filler for their facial rejuvenation are also likely to end up with poor results over time and at the end of the day, every face I touch is a walking advertisement for me and my work; it’s my calling card and my signature.

Is this tough? Yes, and it helps you decide if I am for you or not prior to making an appointment.

Am I scared? Also yes, but working with patients who are not on the same page as me, causes me more anxiety and resentment than I’m prepared to take, which is unkind and so it means that it’s a win even if I fail.

In life, we must be prepared to make difficult and scary choices in order to have a chance to succeed and while I know I hold my patients and staff to a high standard, it is only because I want the best for them, and I hold myself to the same high standard. Without effort despite the fear, success is not possible.

Here’s to our success working together in 2023 if you choose to, now you understand how I work.





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Suite 9, 42 Bigge St Liverpool 2170
02 97348845
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