The Eight 'Cs' of Aesthetic Practice: A Practitioner's Guide

By Dr (Mr) Niroshan Sivathasan / 07 Apr 2016

Dr Niroshan Sivathasan advises how to get the most out of your practice

The five ‘Cs’ of diamonds are well known: carat weight, clarity, colour, cut, and certification. When assessing and grading a diamond, these properties are fundamental. Like diamonds, I believe there are several ‘Cs’ to aesthetic practice, and if we fulfil each of these ‘Cs’, we can create a successful business that our patients will love. Just as the astute diamond patron assesses the skill of the artisan, the reputation of the institution, and the qualities of the transaction using a series of ‘Cs’, the discerning aesthetic patient is also aware of the need for careful evaluation. So what should aesthetic practitioners consider in order to put their services at the top of the pile?

The ‘Eight Cs’ of cosmetics

Everyone should understand that both medicine and nursing are arts based on science, and that no intervention may be guaranteed to produce the desired result without a potential side effect and/or complication. Indeed, this is where the skill of the practitioner and the features of a clinic, including its cleanliness and calibre of its staff, really kick-in to counteract or mitigate an adverse situation.


Arguably, the clinician is the most important variable for people seeking elective services. A point worth considering is: do I, as a practitioner, make the patient feel confident with my demeanour and advice? Trust is intangible, yet pivotal to successful treatment, and many people are able to tell when somebody is talking beyond their limits of knowledge or capability.


The clinic should be fit for purpose and appropriately equipped. Would you be impressed if you were to enter your practice? And does it compare well with the offices of your local competitors? The appearance and decoration is one thing, but does your clinic have provisions for emergency care and access, as required?


Certification of the practitioner (level of training and the direct relevance of any attained skills) and clinic (recent accreditation) should serve to reassure the end-user. Also consider, is your training formally accredited, and, if so, does it attract any discounts from your indemnity-provider?


This includes a transparent discussion in simple language and forms the basis of consent. Contrary to widespread belief, consent does not always have to be written and can just be verbal. However, there are instances where written consent is absolutely necessary. For more information see the Department of Health document: Reference guide to consent for examination or treatment.1 The consultation should also allow for adequate time for patients to thoroughly consider their options. This shall also allow you to refuse treating some patients and dodge likely disasters. Of course, some practices are run like fast food joints, but I believe that patients are best served when the clock is secondary to the care and consideration afforded during the consultation, which shall, in return, reduce the risk of medicolegal-comeback. If your business employs a model of ‘very low price with high turnover’ or ‘pile ‘em high, and see ‘em quickly’, then periodically consider if you have engaged in the optimal strategy.


Competition has greater bearing in the absence of word-of-mouth referrals and ‘genuine’ testimonials, and this is particularly true for surgical endeavours. Be aware that some potential patients serially ‘window shop’ and that a clinician’s time has inherent value, so do not devalue your brand or your services, which has involved a varying degree of personal sacrifice, by offering free consultations with no qualifiers. Impress upon all patients that miracles cannot be promised and do not jump on the bandwagon of unsafe practice just to remain competitive.


A cooling-off period is not necessary for all procedures. For instance, I believe it is okay to administer soft tissue fillers during the same sitting, but procedures such as breast augmentation need some time for reflection. Of course patients must take responsibility for their well-informed choices, but you must stay abreast of regulatory changes pertaining to this matter.


Care in the post-treatment period includes the provision for contacting the clinic easily, reviewing plans as needed, and the ability to deal with complications successfully.


As I conclude, this final ‘C’ must always be kept in mind – change. Think about what the patient wants to change, and why. Does the patient have realistic expectations, does their wish fall within their budget, and are you able to honestly deliver within the individual’s constraints? The internet is teeming with inaccuracies, laymen masquerading as experts and expressing conjecture as fact, so do not be bullied into agreeing to do things that you are not certain of or have reservations about.


Cosmetic standards and regulations vary significantly around the world, and navigating the potential pitfalls is critical for all stakeholders. We talk about pearls and stars, but perhaps analogising with diamonds is the easiest way to remember the key concepts. If in doubt, err on the side of caution and remember that individuals are exactly that: one size does ‘not’ fit all, and people should be considered in a bespoke fashion. 

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