If I could write a formula for the perfect aesthetic practitioner, it would include: a medical background; plenty of serious, specialist training; years of hands-on practice; an artistic eye; a kindly, unflappable couch-side manner; and the respect of their peers.
It’s a tall order, yet with over 25 years reporting on aesthetic medicine and through building my website The Tweakments Guide, I’ve met hundreds who fit it. I’ve watched them work, seen their results up close and, in many cases, been on the receiving end of their needles, lasers and devices.
I’m 62 and have had nigh-on 250 tweakments over the past 25 years. These include Botox three or four times a year to soften frown lines, with occasional sessions of microneedling, or hydrating skin booster injections, or polynucleotides (so-called ‘salmon sperm’ treatment, where fragments of purified fish DNA are injected into the skin to wake up the cells that make skin-supporting collagen) or ‘biostimulators’ (another type of injectable that kick-starts collagen production more strongly than polynucleotides).
Why is it so important to choose a great practitioner? Because in a bewildering and crowded field of certificates and social-media bragging, what really matters is skill, safety and judgment. The best practitioners – whether they’re cosmetic nurses, doctors, dermatologists or surgeons – will help you get the results you want, and for most of us that’s to look like ourselves but a bit better; rested and refreshed, not ‘done’.
The following names are people I know and rate. Their expertise is by no means confined to the category they’re in here (except for the surgeons – you need them to be specialists!).
Thinking about a procedure? Don’t book anything until you’ve read what’s below…
Botox: relax not freeze
Every practitioner offers some type of wrinkle-relaxing injections – an estimated 900,000 shots of toxin are injected in the UK each year. But what you need in your 50s and beyond is someone with an expert eye for assessing where your facial muscles will benefit from a little relaxation, and where to leave well alone.
I’ve been seeing Dr Sophie Shotter (illuminateskinclinic.co.uk, Kent and London) for several years, and the neat injections she places across my forehead, around my eyes, in my jaw muscles and down my neck make me look relaxed, never frozen.
I’m 62 and have had nigh-on 250 tweakments over the past 25 years – and in a bewildering and crowded field of certificates and social-media bragging, what really matters is skill, safety and judgment
Elsewhere, Dr David Eccleston (medizen.co.uk, Birmingham) and Dr Nestor Demosthenous (themayfieldclinic.co.uk, Edinburgh) also do fabulous work. From £500.
Filling stations
Many people have been running scared of filler, yet dermal fillers are the only tweak that can restore lost volume to a mature face or sharpen softening facial contours – often what we need once we reach our 50s.
Ask experts like Miss Jonquille Chantrey (oneaestheticstudio.com, Alderley Edge, Cheshire), Dr Suha Kersh (23md.co.uk, London) or Dr Rashpal Singh (drsclinic.co.uk, Middlesbrough) whether they are still using filler, and they all say of course they are – but in a careful, only-where-necessary way that leaves patients looking surprisingly well.
And if you still don’t like the idea of normal, hyaluronic acid-based fillers, Dr Sherina Balaratnam (sthetics.co.uk, Beaconsfield, Bucks) is offering what you might call a DIY filler called Cellenis, made from your own blood – a genuinely all-natural option which gives a nice result. From £500.
Lift those lids
Peering at our midlife faces, many of us can see that an eye lift – a blepharoplasty – would wake up our looks no end. If you’re up for surgery, all the following are excellent.
How well do I know their work? Mr Naresh Joshi, the king of this category, did my first eye lift in 2012 and I couldn’t have been more pleased with the results (appointments, 020 7460 5739, in London, from £9,000).
But what if you don’t know whether non-surgical tweaks would suit you better? Top eye surgeons Mrs Sabrina Shah-Desai, (perfecteyesltd.com), Mr Daniel Ezra, (danielezra.co.uk) and Miss Elizabeth Hawkes (who did my second upper eye lift in 2021, and corrected a drooping eyelid at the same time; drelizabethhawkes.co.uk) all offer a range of non-surgical options alongside blepharoplasty.
Surgical eye lift, from £5,000; non-surgical, from £500.
Follow your nose
When it comes to rhinoplasty – as surgical nose jobs are properly known – Mr Charles East (rhinoplastylondon.co.uk, from £16,000) is the expert’s expert and has a manner as reassuring as his reputation.
For non-surgical nose improvement – much more tricky and potentially dangerous than it looks – you need a maestro like Dr Ayad Harb (drayad.com, Bicester, Ascot and London) or Dr Yusra Al-Mukhtar (dryusra.com, Liverpool and London). From £750.
Lovely lips
None of us wants a trout pout, and none of these practitioners would ever give you one. Dr Steven Harris, (harrisclinic.co.uk, London) is fierce in his fight against ‘alienisation’ and delivers masterly education on lip structure on his Instagram page.
No one wants a trout pout, so it’s important to make sure you choose a reputable practitioner who can leave your lips plump and shapely
I can vouch for Dr Kuldeep Minocha’s ‘less-is-more’ lip technique (l-art.uk, London), and also for the subtle boost Dr Munir Somji’s ‘placebo lip filler’ can deliver (drmedispa.com, Essex). (Why placebo? Because you’ll notice it, but no one else will!)
Who else would I recommend? Dr Sindhu Siddiqi, (nofilterclinic.com, London) and Dr Catharine Denning, (maryleboneskin.co.uk, London). From £500.
Facelifts, deep or SMAS?
Plenty of people tell me to drop the tweakments and step up for a facelift. I would, but when I catch-up with the exceptional Mr Rajiv Grover (rajivgrover.co.uk, London), he waves me away and says, ‘Not yet.’
Who else is in the elite category? Mr George Orfaniotis (orfaniotis.co.uk, London), Mr Marc Pacifico (marcpacifico.co.uk, Kent) and Dr Tunc Tiryaki (tunctiryaki.com, London).
They all do the type of deep plane facelifts that are all the rage with celebs for their far-reaching results, though before you ask, 70-year-old Kris Jenner is understood to have had a SMAS lift, not a deep plane.
A SMAS facelift tightens the Superficial Musculo Aponeurotic System, a thin but strong layer of muscle and connective tissue that lies beneath the skin.
A deep-plane lift goes deeper, freeing and repositioning the whole face for a softer, longer-lasting result. From £25,000-£50,000.
Stay radiant at 50 
Plenty of people tell me to drop the tweakments and step up for a facelift – but I’m not ready for that yet
They may prefer different brands of polynucleotides and skin-boosters, but Dr Wassim Taktouk (drwassimtaktouk.com, London); Anna Baker (annabakeraesthetics.uk, West Sussex) and Dr Paris Acharya (theardourclinic.com, London) all know how to get radiance back into a 50-something face.
Dr Sach Mohan (revereclinics.com), meanwhile, ‘cocktails’ all the rejuvenating injectables he can lay his hands on into one treatment. I’ve tried it and found one dose gave visible skin tightening and extra clarity. From £250 to £1,200
Arms to swoon over
Dr Rita Rakus (drritarakus.co.uk) may have earned the title of ‘The London Lip Queen’ over 20 years ago, but now she’s more of a ‘machine queen’ and she’s here for arms. I’ve taken my crepey inner arms to Dr Preema (drpreema.com, London) with pleasing results, so she’s here for arms, too. From £900.
Nice threadwork
I know many people hate the idea of threads, but when done well they can make a very nice difference for people who aren’t up for a facelift.
I’ve watched Dr Leah Totton (drleah.co.uk, London) and Dr Victoria Manning (cosmeticskinclinic.com, Bournemouth, Lymington, London) whisk their way around mid-life faces to lift sagging jowls.
And I’ve seen Dr Bob Khanna (drbk.co.uk, Reading) redefine facial contours with a combination of threads, fillers and polynucleotides as part of his Dr BK Lift, which lasts for the best part of two years. From £3,000.
Perfect complexion
Menopause can wreak havoc on the skin, but you have a lot of choice of treatments.
You could see a dermatologist, like Dr Stefanie Williams (eudelo.com, London) or Dr Ariel Haus (drhausdermatology.com, London) who each have many treatment options.
In Birmingham, Dr Sajjad Rajpar (midlandskin.co.uk) specialises in lasers that help skin health, and in London, cosmetic dermatologist Dr Alexis Granite (dralexisgranite.com) has a light touch with injections that can coax skin into better health. From £300 for a consultation.
There are several options if you want to achieve that smooth, glowing, uber-hydrated Korean skincare trend that has spread west in the past few years
Then there are the aesthetic practitioners who offer all manner of tweakments but just love guiding patients to the best medical-grade skincare.
Julie Scott, (facialaesthetics.co.uk, Essex), Sara Cheeney (pureperfectionclinic.com, Wrexham) and Dr Catherine Fairris (wessexskin.com, Winchester) are particularly good at this. Consultations from £50.
Or if you want to see if you can achieve ‘glass skin’ – the smooth, glowing, uber-hydrated Korean skincare trend that has spread west in the past few years, Dr Jinah Yoo (maylinjyd.com, London) has begun importing the best Korean medi-tech devices into her West-End clinic.
Which Korean skincare to try? Dr Christine Hall (drchristinehall.com, London) can give you a steer. And once you’ve seen Dr Brendan Khong’s flawless skin, you’ll be queueing up to see what he can do for you (drbrendankhong.com, London). From £500.
Fine skin from within
Everyone in aesthetics is mad for ‘bio-revitalisation’, ‘biostimulators’ and ‘regenerative aesthetics’ just now – which translates as injectable treatments that stimulate your skin to make more collagen and elastin and generally behave like its younger self.
Who’s particularly good at this? Dr MJ Rowland Warmann (smileworks.co.uk, Liverpool) and Dr Ash Soni (thesoniclinic.com, Ascot) who both use huge amounts of Sculptra; Amy Bird (kastaesthetics.co.uk, Cheshire) who has taken up with Julaine (think of this as Sculptra’s younger, sexier, though less well-tested cousin).
Dr Apul Parikh (apulparikh.co.uk, London) who loves the hybrid injectable biostimulator HarmonyCa (Inspire’s fellow beauty supremo Inge van Lotringen loves her results with this).
And then there is Dr Olivier Amar (olivieramar.co.uk, London). He has patented a method for extracting some of your fat, processing it into a fluid full of regenerating growth factors, then reinjecting it to supercharge your skin. From £600 to £7,000.
For sleek necks…
A 50-plus neck often needs a combination of tweaks to smooth and tighten the skin. Dr Sabika Karim (skinmedical.com, London) has a box of tricks at her disposal, and puts together treatment programmes depending on what patients need. From £500.
…and youthful hands
I get far more anxious about having my hands injected than my face – so many nerves and tendons to avoid!
But I can vouch for Dr Lorenzo Garagnani, (se1medicalaesthetics.com, London) and Dr Priya Chada (amerclinic.com, London). Both are hand surgeons who have brought their skills to making hands look younger with fillers, skin boosters and polynucleotides. From £300-£1,200.
Clearing age-spots
By our 50s, our sunbathing sins are showing up in our faces. Lasers and Intense Pulsed Light (IPL) which use light to break up the pigment that clusters into age spots, are the tools of choice for dealing with these – and with tiny spider veins.
If your rosacea is getting worse Dr David Jack (drdavidjack.com, London and Edinburgh) could help with his Lumecca device.
For age spots, Debbie Thomas, London (dthomas.com, London) and Kerry Belba (laserskinsolutions.co.uk, Bournemouth) will see you right.
Or maybe it’s wider pigmentation patches on your face and body, which Dr Tanja Philips (tanjaphillips.com, Reading and London) will happily tackle.
Dr Darren McKeown (drdarrenmckeown.com, Glasgow) offers every laser treatment available, including full resurfacing of the skin. From £300 to £5,000.
Jowls begone
Jowls are the bane of many a 50-plus face. What’s effective? For fat-busting, Dr Saleena Zimri has a special ‘Jawtite’ procedure (skindoctorclinics.co.uk, Leeds, Manchester and London).
Endolift is a non-surgical laser treatment that uses a fine fibre optic wire to deliver energy just beneath the skin, stimulating collagen production for skin tightening and liftin
Dr Priya Verma is the go-to expert for Endolift, which melts fat within jowls and tightens skin (drpriyaverma.com, London).
Dr Raj Thethi (yorkshireskincentre.co.uk, Leeds) offers a combination of fat-reducing FaceTite, micro-liposuction and threads to counteract that sag. From £3,000.
Celeb laser pros
The other thing to know about lasers is that they can be used on a light-but-effective setting to give a red-carpet-ready glow.
Who does this beautifully? Dr Nina Bal, (facialsculpting.co.uk, London), Amanda Azzopardi, (amandaazzopardi.co.uk, Liverpool) and Teresa Tarmey (teresatarmey.com, London). From £500.
Body sculpting
For non-surgical sleekening of bum, tum and legs, Dr Galyna Selezneva (drgalyna.com, London) has every device that could help.
If you’re thinking of the newest form of liposuction, Mr Omar Tillo makes delicate work of serious fat removal (uk.elitebodysculpture.com, London). From £400-£8,000.
Intimate renewal
It still feels like a taboo, but practitioners like Dr Shirin Lakhani (drshirinlakhani.co.uk, Kent and London) and gynaecologist Dr Tania Adib (adib.org.uk, London) are opening up the conversation about the benefits of vaginal rejuvenation for women in their 50s. The treatments are done using laser or radiofrequency probes and, surprisingly, are not painful. From £800.
FYI: Friends say that these options have improved their sex lives.
Skin tightening
There’s been a fair bit of fearmongering that ultrasound technology may ‘melt’ fat in the face.
But in the best hands – Dr John Quinn (quinnclinics.co.uk, Bristol), or Dr Julia Sevi (aesthetichealth.co.uk, Leeds and London) – it gives a face a lovely bit of tightening and a smidge of lift.
As does Sofwave, another form of ultrasound tech which is what Dr Dev Patel prefers – and his patients love the results (perfectskinsolutions.co.uk, Portsmouth). From £500-£3,000.
Find these practitioners and many more based around the country on thetweakmentsguide.com/practitioners
For specialist practitioners, check the British College of Aesthetic Medicine (bcam.ac.uk), the British Association of Medical Aesthetic Nurses (baman.org.uk) and the British Association of Aesthetic Plastic Surgeons (baaps.org.uk)