This is not a blog.
It is a record of thinking — clinical observations, questions worth asking, things the research says that rarely make it into a consultation room.
Written slowly. Published when ready.
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Non-Surgical Facelifts, Ranked From Worst to Best Value
A doctor’s honest ranking of seven non-surgical facelift treatments — what each one can realistically do, what it cannot, and why the ranking changes with the diagnosis.
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Glass Skin Versus Mochi Skin: What the Science Can Actually Deliver
Patients are asking for mochi skin, but what does that actually mean? Here is the evidence behind hydration, glow, skin boosters and the latest edible-sounding beauty ideal.
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Everyone Is Injecting Peptides. Do They Actually Work?
One of my patients injected a peptide for several months. He had been promised better recovery and better health. Nothing happened. Eventually he sent an unused vial from the same supply to a laboratory. No detectable active peptide. Only what appeared to be filler material. He had spent months injecting pharmaceutical fairy dust. Then there…
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Filler: When It Works, When It Does Not, and When It Goes Wrong
Filler can create some of the most beautiful results in aesthetic medicine. It can also, in rare cases, make you go blind. Both of those sentences are true, which is why this is a conversation worth having properly. I have been injecting for over two decades, first at The Sloane Clinic and now at SW1…
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Botox at 30, 40 and 50: What Actually Changes
The most common Botox mistake I see has nothing to do with the product. It is treating a 50-year-old face like a 30-year-old one. The molecule is the same at every age. The face is not. Fat sits differently. Skin recoils differently. The structure underneath has shifted. And the things that need to move, or…
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What Happened in Beijing Happens to More Women Than You Think
Last weekend, an athlete won the women’s elite race at HYROX Beijing in just over an hour. Somewhere around the halfway mark, her bowels gave out. She kept going. Through the burpee broad jumps, the rowing, the wall balls. Then she won. The internet has since split into two camps. One thinks it is the…
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Why Fillers Go Wrong
Nobody walks out of a consultation asking to look overfilled. And yet a great many people end up there, having said yes to something reasonable at every individual step. That is the part worth understanding. Overfilled faces are rarely the product of one bad decision. They are the product of ten sensible ones, taken in…
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Is Your Ultherapy Working?
Somewhere around week two, a patient looks in the mirror, sees exactly the face she had before, and concludes she has been robbed. I understand the feeling. You have paid a meaningful sum, sat through a treatment that was not especially comfortable, and been told to expect a lift. Two weeks later the jawline is…
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Ultherapy vs Thermage
It is the question I am asked more than any other, usually within the first five minutes of a consultation: should I do Ultherapy or Thermage? The honest answer is that the question is slightly wrong. These two treatments are not competitors in the way the marketing implies. They work at different depths, on different…
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Why Filling Facial Lines Can Make You Look Older
Look at these two faces. They belong to the same woman. Her bone structure, facial proportions and underlying volume have not changed. What has changed is the placement of light, colour and shadow. Over-applied — the face reads flatter and broader Precisely placed — less product, more definition Same face, same bones, same volume. Only…
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