From upselling treatments to pushing weight loss products, is it right for aesthetic practitioners to push their own biases and personal beauty ideals?
As I lie back, close my eyes and relax into the soothing strokes of the beautician beginning my hydrafacial, the peace is disrupted by the sound of her sucking in her teeth. Within seconds I’m transported far from the calming and relaxing facial I’m paying £190 for and thrown into a pit of self-consciousness. “Your skin is so dehydrated and dry, I can barely do the extractions,” she tuts. Over the course of the next hour, in which she pokes and prods my face, she adds, “you have extremely dry skin”, “you have too many spots to get out in one go”, “you have lots of broken capillaries around your nose”, “your cheeks look red and predisposed to getting broken veins” and “you have deep lines in your forehead”.
I nod and listen to her advice on how I can book extra treatments to remedy all of the above. £25 for an extra consultation and laser patch test, £150 for the laser around my nose but this would require ‘more than three sessions’, £190 for another hydrafacial, up to £400 for the lines on my forehead and nearly £200 in products I can use at home. This was the solution the beautician advised for the ‘problems’ I didn’t know I had. I declined, not having a spare £1,000 to spend, went home and cried.
This was not a one-off occurrence. My hygienist once told me that I should consider getting my teeth filed down to look more aesthetically pleasing and that she could ask the dentist to give me a consultation to sort my smile out. I was once scoffed at during a laser session on my bikini line when I said I didn’t want all the hair removed. The same person looked at my acne and asked if I’m clean and if my house is clean. All of these experiences have had an impact on my self-esteem and resulted in a strange catch-22 where I dread visiting beauticians, while also chasing the hope that in going they will dramatically be able to improve my skin so that I feel better about myself.
All businesses need to make a profit and rely on promotion and upselling to do so, but when the business involves our health – both physical and mental – the ethics become a lot murkier. During a time when appearance is so intrinsically wrapped up in our self-worth, who gets to decide what the ideal is? Where is the line between expert opinion and personal judgement? And is it right for people in positions of responsibility to push their own aesthetic biases – particularly in an effort to sell products and make money?
London-based aesthetic doctor, Dr Harris, has turned patients away before for treatments such as Botox. In his practice, if he believes a treatment would cause physical or psychological harm, it is not something he will go ahead with. But he is an exception, and he puts the blame on the beauty industry for following a business model rather than a medical one. “The goal in the medical beauty industry is to sell as much as possible for financial gain, often at the expense of the well-being of the patient,” he says. “Completely unethical.”
In the UK, there are currently no regulations for aesthetic medicine and no qualification requirements, though the government is working on some legislation. At the moment though, anyone can inject you, Harris explains. This is one of the reasons we are in what he calls an “epidemic of overfilled faces” and he spends a quarter of his time reversing and correcting treatments done by other practitioners. “There is nothing to stop the ‘aesthetic practitioner’ from giving unsolicited advice towards overfilling and distorting faces for financial gain and indeed, that appears to be happening.”
It’s not just in person that beauticians and aesthetic medical practitioners are pushing unsolicited advice. In the last few years, there has been a huge rise of these experts taking to social media platforms like TikTok and Instagram to give their opinion on everything from what procedures celebrities have had done to what the general public should be doing. Plastic surgeon Dr Michael Keyes shares (presumably) unconsented simulations of celebrities after plastic surgery, while aesthetic nurse practitioner Miranda Wilson went viral last year after posting a video in which she listed what procedures she would give Stranger Things actress Natalia Dyer.
“This video is so toxic that if TikTok is showing shit like this to children, it's no wonder our youth is suffering from such high rates of suicide and depression,” @davenewworld_2 tweeted about Wilson’s post to over 14k likes. Even more sinister is Dr Lin Humble, an MD, and Botox and filler injector. “Patiently waiting for women to realise there’s a weekly shot to take all hunger away,” she captions in a now-deleted video promoting Semaglutide injections, a diabetes treatment that can also be used to aid weight loss by surpressing people’s appetite. “The weight loss industry has an iron grip on medicine and medical professionals. TikTok is not the problem. It’s fatphobia,” Marquisele Mercedes said in a tweet.
When doctors are prioritising their own prejudices about weight over the health of their patients, when surgeons are imposing their aesthetic ideals on people without consent, it’s a problem. And considering the top percentage of users on TikTok are aged ten-19, videos like Dr Humble’s are a terrifying insight into the messages about their bodies young people are being exposed to. This sort of behaviour on social media is something that professionals need to be held accountable for, especially when people trust them with the way they look.
If you ever find yourself in a position where you are being upsold or pressured into treatments, Dr Harris advises that you seek a second or even third opinion. “Tell the practitioner directly you are not interested, or if you feel uncomfortable with a direct approach, then let them know you would like a ‘cooling off’ period,” he adds. “Practitioners who follow a medical model are required to give you this period if they are suggesting new treatments. If a practitioner does not mention the ‘cooling off’ period, then that in itself is a red flag.”