Cosmetic Tweaks

Cosmetic Tweaks

We were completely horrified recently to be present at a show where Botox – and tooth-bleaching – were being carried out in an unsterile conditions. Patients were signing up, on the spot, without asking any of the questions that we believe are really important before you opt for any kind of cosmetic ‘tweak’. So we thought we’d share with you some advice from our book The Anti-Ageing Beauty Bible, which we believe should be required reading before any woman lets anyone near her with a syringe, a laser or a tray of dental bleach, come to that.

We turned to Wendy Lewis for this info. She’s our go-to on cosmetic ‘tweaks’ and clinic treatments, and is known as ‘The Knife Coach’, running the truly independent Global Aesthetics Consultancy in the UK, Europe and America (as well as writing books, which we list at the back of this one). Basically, there’s nothing she doesn’t know about who’s the best, what’s new – and the questions that every single woman should ask, not just before undergoing major surgery, but even having what may seem like a minor procedure like Botox.

As Wendy says, there are – amazingly – people who sign up for fillers, Botox, lasers, peels and even full-blown facelifts without giving the issue much more thought than if they were shopping for a new face cream. Less, actually, from what we saw at that show…!

We can’t tell you whether you should have a filler injection, or whether you really need a facelift. We believe this is very much a matter of personal choice. (Though ours is not to.) But it is vital to know the right questions to ask, before you take the plunge – to optimise your chances of a successful treatment, and a good outcome.

Get real. Although some of the most popular procedures are non-surgical, none of them are non-medical. They should be performed in a clinical environment under good lighting and under the direction of a qualified and medically-trained professional. For example, wrinkle-relaxing and filling injections should only be done by a medical aesthetics practitioner, which in the UK includes doctors, nurses and dentists.

Have an initial consultation. Make an appointment with one or preferably two healthcare practitioners. Insist on having adequate time with the individual who will actually be carrying out the procedure – not an assistant or sales person. Your relationship with the person who will be doing your treatment is most important, and he/she is not interchangeable.

Ask serious questions – see below.

Ask for detailed printed information on every procedure you are considering. Every doctor should have his own materials, pre- and post- treatment instructions, or at least brochures from companies whose products he/she is using, and there should be more consumer information on the websites of all of these brands. However, be aware that no honest or responsible practitioner can guarantee a specific result – we are all individuals and everyone responds differently.

Ask to see photographs of other patients. You should be able to look at real photos of clients who have undergone the procedure/technique carried out by this specific practitioner. This is most important: there have been instances where one doctor may be showing patients another doctor’s results, or labeling the filler company’s ‘before-and-after’ photos as his own work. The caveat: be aware that you can expect to see only photos of the best case scenario and judge from there – no one will show their worst results. It is impossible to predict the exact result that you may get from a procedure, but photographs offer a good guideline for what is reasonable to expect.

Check out the practitioners’ qualifications, experience and training. Find out what professional organizations he/she is a member of and visit their websites for confirmation if needed. Check online to see if the practitioner has had any legal cases brought against them, and what the outcome was.

Tap into your intuition. How do you get along with the person who is going to be wielding the needle? You should feel you can trust him/her with your face and/or body. If you don’t get a good vibe, move on. There are many practitioners and clinics to choose from.

Have a good look round. Is the clinic clean and orderly? Does he/she employ professional assistants and nurses? Ask to see inside the room where the procedure take place, and satisfy yourself that it is a proper clinical setting that is required for a medical treatment. Also look at the other patients in the waiting room – do you like the way they look? And do you like the way the staff or even the doctor looks? If not, run a mile!


  • What is the medical name of the treatment the practitioner is recommending?
  • How long has it been on the market?
  • How long has the practitioner been using it?
  • What is the name of the manufacturer and where are they located?
  • What clinical studies have been done?
  • What is the source of the filler material – is it natural, animal or synthetic?
  • What are the possible side effects?
  • Could I be allergic to it or have a reaction?
  • What does a reaction look like and how long does it last?
  • What can be done if I have a reaction?
  • How many treatments will I need and how often will I need to come back?
  • How much will each treatment cost?
  • What if I don’t like it, what can be done?
  • Can I still have other treatments (fillers, wrinkle relaxers, lasers, peels) later on?
  • Is this the best laser technology/filler/injection to accomplish my goals?
  • What are the alternatives available?
  • Does it have a CE Mark?
  • Is it FDA-approved?
  • Is the manufacturer planning to apply for FDA approval in the near future?
  • Is it licensed for cosmetic use?

Before treatment, Wendy recommends:

  • Avoid aspirin products (Nurofen, ibuprofen), blood thinners or vitamin E for one to two weeks before treatment to prevent increased bleeding and bruising.
  • Don’t have a treatment on an empty stomach – you may get dizzy or faint.
  • Ice packs before and after can help with pain and swelling.
  • Bring concealer with you to cover up bruises or needle marks.

To research your practitioner or clinic:

The British Academy of Cosmetic Dentistry/

British Association of Dermatologists (British Cosmetic Dermatology Group)/

British Association of Oral & Maxillofacial Surgeons/

British Association of Plastic, Reconstructive and Aesthetic Surgeons/

British Association of Plastic, Reconstructive and Aesthetic Plastic Surgeons/

European Society for Laser Dermatology/

General Medical Council/

And do check out Wendy’s own website,, or e-mail


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