Practice made perfect

With a passion for female wellness, Dr Mayoni (MBBS, BSc, MRCS), a surgeon with over 20 years of medical and surgical experience, has carved a name for herself within the world of aesthetic medicine through her 360-degree approach to treating patients. Her holistic treatment plans incorporate safe yet effective devices, injectables and topicals alongside lifestyle recommendations that leave patients looking and feeling their best. Here Dr Mayoni shares her secrets to running a successful clinic and operating as an ‘integrative aesthetic’ doctor.

Get to know your patients
I remember one of my mentors when I was a surgeon always said, ‘I can teach you to do any operation, but the art form of surgery and medicine is doing the right thing for the right person at the right time,’ and I think that's critical. I plug myself into my patients lives, and I want to know everything about them. I want to know how often they go for walks. What’s causing them stress and everything in-between. In fact, my opening line of questioning starts with how old they are? What they do for a living? How stressful is that job? As well as have you got any children? How well are they? Are you looking after them? How? What does their mental health look like post COVID (as this responsibility of care often falls on the mother or the female looking after them)? I also want to know their relationship status, and what's that relationship like.

Patients soften immediately during these in-depth consultations, because since COVID it’s more than likely no one has asked them how they are, or maybe no one has ever asked. So, while it’s really easy and tempting to look at someone and tell them what you think they need, asking the right questions will help you understand what your patient actually needs and how your aesthetic offering can work for them.

Back to basics
Refocusing on anatomy and physiology is key to getting the best results for the majority of patients who want a natural effect that leaves them looking like a fresher, healthier version of themselves. Thankfully, we are beginning to move away from the world of just treating some lines, or some sagging in isolation, as practitioners go back to what they have learnt about anatomy and physiology— namely that the face is multi-layered, and each layer, therefore, ages in a different way at a different rate. This means that layering treatments is the best route to patient satisfaction, and dispelling the myths perpetuated on social media that one treatment will ‘fix’ everything is key. Education is an important part of your consultation process, so share with patients why you’re recommending multiple treatments, and take the time to explain how they work, as well as what impact they will have synergistically versus in isolation.


Where to invest
When it comes to what treatments you should offer, focus on what you can use to treat all the layers of the skin. In terms of the periosteum and the deepest structures, you want to be using something that's going to be reconstructing and supporting the face, and this would commonly be a hyaluronic acid dermal filler. For the muscle and SMAS layer you should be using some sort of energy-based device which has a high intensity focused ultrasound or radio frequency to boost collagen. In the subcutaneous layers, you want to be thinking about identifying where the volume loss is and using dermal filler to re-establish structure. Then, of course, botulinum toxin is a beautiful holistic, whole-face treatment that supports all the others.

These are the ideal core offering.But peels, and microneedling as well as polynucleotides (one of my favourite treatments) are a fantastic addition. As are threads as they help tighten and redefine the facial contour without resorting to the overuse of dermal filler. And of course, skincare. Every single patent of ours walks out of our clinic with a skincare plan. They may not decide to take us up on it, but we encourage them as much as possible to stick to the basics. With so much skincare information out there, we need to ensure that we keep our advice pointed towards the patient and recommend products that will target their issues. Then their skin is primed, and ready for injectables or other treatments, and will support healing, which has a noticeable impact on the overall health and appearance of their skin.

But don’t rush out and swipe your credit card just yet, if you can it's worth getting some business advice and bringing on a thrifty consultant who can help you develop a business plan that will see the best return for your investment.

This article is based on Dr Gooneratne’s talk, Everything, everywhere, all at once, at WMP23. Registration for this year's event is now open at wigmorepresents.com