Changing the Face of Aesthetic Medicine: Dr Alex Stedman

It was the desire for continuity of care and variety, as well as a love of procedural work, that first attracted Alex to general practice and then to aesthetic (or cosmetic) medicine. Since first beginning her training in this field ten years ago, Alex has discovered that aesthetics is a perfect area for those doctors like her who love both the science and art of medicine. ‘The results are definitely in the hands of the person who is doing it. Anybody can pick up a syringe full of stuff, but it’s where you put it that makes the difference’. Working in aesthetics allows Alex to develop close relationships with clients, and she is genuinely delighted by their transformations. ‘I love the fact that you can change the way a person feels just by changing subtly the way they look. That’s quite exciting’.

Alex’s training in this area involved studying in London followed by extensive mentoring by experts in the field. The products she has chosen to use are the anti-wrinkle injection Dysport (which, like Botox, contains botulinum toxin) and the dermal fillers Restylane, Emervel and Juvederm for smoothing lines and correcting volume loss. Each product is used with a different bodily tissue in mind, and Alex always makes sure that she chooses the right product for the right area and client so that she ‘doesn’t do (her clients) a disservice’. There are no Medicare rebates for aesthetic injections, so the costs varies between $120 and $3000 depending on what you have done, where you have the treatment and how much product is used.

Dysport takes about three to five days to work, and the smoothing effects last for three to four months. The fillers on the other hand can last from nine to twelve months, with the added benefit of improving the skin. ‘The skin is always in such good condition (after fillers) because the hyaluronic acid in the product stimulates natural collagen production. So while the actual volumising effects of the fillers may wear off after twelve months, the tone, elasticity and integrity of the skin stays’.

According to Alex, her clients often come in wanting to ‘brighten themselves up’ and to ‘feel a bit fresher’. These are usually ladies aged 30-65 years, although men make up about 5% of her client base. Alex’s clients come from all walks of life, and she prides herself in making these treatments accessible to ‘regular everyday people’.

While the majority of clients have the odd wrinkle or line removed, aesthetic medicine is by no means limited to this. ‘I’ve had clients who have had facial palsy on one side’, Alex explains. ‘The Bell’s palsy side of the face maintains it’s youth better than the other side. When they get older the unaffected side becomes more obvious, so you can balance (the face) out by treating the unaffected side’. Alex also has clients with facial injuries and scarring, and has successfully treated those suffering from chronic tension headaches.

Dysport also has the potential to help break the habit of frowning by paralysing the muscles involved, and even prevent wrinkles from ever developing. An additional Dysport bonus, according to Alex, is that if a client can’t frown then their mood may also benefit. ‘We do know that the way your muscles are positioned on your face feeds back to how you feel. So if you have an inability to frown, you can feel more relaxed’.

Talking with Alex, the thing that strikes me most is her combination of warmth and pragmatism. I also like her frankness and humour, and feel that if she was ever approaching me with a needle in her hand I would be completely safe. There are multiple reasons for this: she’s very experienced and constantly striving to increase her knowledge; she works in a reputable medical environment; she is someone you can access again and again. Alex also understands her own limits: ‘I try not to overstretch what I can do. If I can’t achieve a good result with a few millilitres of filler then I suggest the patient sees someone who may need to take it to a surgical level’.

Probably the thing I like most about Alex’s approach to aesthetic medicine is that she tailors her appointments to the client, and refuses to put any pressure on them. ‘If a client is very clear about what they want and I feel they are well informed and well experienced, then I’m happy to treat them on the day. However, if it’s a new client I like to give them a bit of breathing space, a little bit of thinking time, because it can get all very exciting and emotional’. Alex understands that people can get caught up in the moment, and doesn’t want her clients having any regrets. She often tells her clients to ‘go home have a think about this and then let me know what you decide to do’.

Unlike some in the aesthetics industry, Alex isn’t afraid to tell the truth and say no to her clients when needed. ‘I do get some young girls in who are absolutely perfect who just want their lips a bit bigger, and then we do try and have a sensible discussion about what looks good and what doesn’t. I often say to people ‘go and buy a pair of shoes instead of worrying about having your lips done. I think you have a need that is not going to be fulfilled by having an injectable procedure done’. I will very comfortably say no, I am not going to treat someone’.

Throughout our discussion Alex emphases the importance of managing the expectations and pre-conceived ideas clients have. ‘My job is not to make people think that I’m going to take away every single line and wrinkle, because then they’ll just look freaky. Plus you can only take people back to where they were, you can’t take away features that have always been there’. She goes on to use the example of laugh lines: ‘if someone has laugh lines (around their mouth) and you look back at a photograph of them when they were fourteen they’ll still have those lines. If you take those away they’ll look strange’.

At the end of our conversation, I ask Alex if she has any information that she would love clients to know. Here are her answers:

• Anti-wrinkle injections and fillers do not have to be maintained. You can have one off treatments if you like.
• Your skin doesn’t look worse once you stop having injections or fillers.
• ‘It doesn’t have to look strange. If it’s done carefully and you only have a small amount done you will just look fresher, not freaky.’
• One of the advantages of injections and fillers is that while they are more definitive than covering up with makeup, the effects are temporary (unlike cosmetic surgery). This gives people the opportunity to ‘have a dabble’ with different looks and effects.