What a Difference 15 Years Makes in the Aesthetic Industry

Dr Patrick Bowler, our medical director, has been awarded The Brinkenhoff Award for Lifetime Achievement and Services to the Industry.

This month, I watched Courthouse Clinics, my nationwide chain of cosmetic treatment centres, turn 15 years old. It’s hard not to spend some time reflecting on the changes we’ve seen in the aesthetic industry in this time. In 1998 I opened my first clinic in an old court house (hence, then, “Courthouse Clinics”), offering limited treatments at what was really quite a considerable cost. Since then, the “artist’s palette” of non-surgical enhancement has developed in ways we never would’ve even considered.

Our “menu” when we started out consisted of basic skincare rejuvenation treatments, collagen injections, some of the earliest uses of Botox, and, by 2000, examples of the first laser hair removal treatments. One of my first laser patients was a man looking to reduce his back hair, and a course of treatments cost him £7,000 plus. Now, the same procedure will cost a fraction of that price, and will most likely be not only pain-free, but also considerably more effective.

The biggest explosion in our industry has come as recently as in the past five years, where a complete non-surgical service now ensures that enhancing key features is more straightforward then ever before. Lasers have developed to envelope hair removal, skin, veins, and fat melting. We can use Botox not only to iron out brows, but also on crow’s feet and to tighten neck and jaw lines. Patients can totally alter the way they look without ever having invasive surgery, whereas when we started out the choices in anti-ageing treatments were either collagen or going under the knife. There’s a lot more to be done, and with much subtler results, now.

With the advent of the Internet has come a noticeable increase in the conversant nature of patients, too. Historically patients would come to us with a problem, asking us what we recommended as a solution. Now, patients tend to have much more knowledge about the opportunities available to them. I believe that access to information online has contributed to the rise in numbers we’ve seen coming to us: seeking treatment can be a hugely personal thing, and getting online helps patients to find the cosmetic treatment answers they’re looking for, and the confidence to understand that they’re more common than they first think.

Of course, with the increase in treatments and the reduction in cost, it’s inevitable that the industry will struggle with non-medical outsiders. It’s common for at-home Botox parties, beauty salons and even hairdressers to offer Botox, remotely prescribed by a doctor or dentist (!) who should know better. Reduced cost of medicines has seen competition increase, meaning some view the administration of Botox, dermal fillers and laser treatments as the perfect money-making opportunity. It all puts a real boot in the dignity of what should be a medically-led and professionally monitored process.

A good doctor will not be afraid to tell a patient no, and that’s the one thing that hasn’t changed since my first clinic opened. Despite the avalanche of industry “cowboys” giving what we do a bad name, the most effective way for patients to find themselves the best doctor is to search for a doctor who will give a natural result and not be afraid to turn away a patient for work they don’t need.

I recently had a patient in who came to see me after ten years. Back in 2003 she wanted work done for virtually non-existent lip lines, and I turned her away. She said that stayed with her, and that she was so grateful that ten years later she sought me out for work she now had more need for. That’s something I’m very strict about, and any other professional will be too: a little help where it might be needed, not just because we can. That’s advice that is timeless.