Last week one of my very loyal patients told me that she had nominated Happy Face Aesthetics for a Tendring Blue Ribbon award. I was surprised to say the least, and wondered what I had done to deserve this. We chatted about it and my imposter syndrome was crushed when she reminded me of how far I have brought the business.
Happy Face Aesthetics started in January 2019 as a part time endevour I practiced from my spare room at home around my NHS job as an Advanced Nurse Practitioner. When I finally had enough patients, I left the NHS and 3 weeks later the very first lockdown began. This started a year of financial instability, uncertainty and stupid TikToks.
In January 2021 I pooled all my resources and rented a clinic room in The Mews Therapy Rooms on Connaught Avenue. I have very little money, but I did have a delusional idea that I could make the business work if I just kept trying. It did work!!!
Over the past year and a half my client group has continued to grow and I have many more loyal patients who appreciate my services, honesty and ethics. I am so grateful to attract the best type of patients who make me laugh, cry, learn and make my work a delight.
More recently, I have registered with the Care Quality Comission to ensure patient safety and continued high standards. I have continuously been adding new services to our menu, and hope to add more medical/surgical treatments over the coming year. I have also taken the front room at The Mews Therapy Rooms which has been turned into a beautiful reception area and gift shop.
The gift shop has allowed me to to work with some amazing local independent business women who supply us with beautiful Sea glass art (Susie, Sea Glass Cottage), T.H.E. Skincare (Vusi, Happiness Emporium), scented candles, waxes and diffusers (Jo, The Divine Candle Company), and crystals (Maxine, The Spiritual Worker).
Happy Face Aesthetics is always evolving and with your support, I know the future is bright.
Open afternoon to be held on Friday 1st April between 3pm and 6pm.
As some of you will know, we have been working really hard over the past couple of months to set up a welcoming reception area for our patients. As our ideas have evolved we have also decided to get some local small business people to stock the area with their hand crafted goods.
So from Friday you will be able to buy from a small range of crafts, skincare, crystals and candles. These products are already much loved by myself and I am honoured that the business owners have decided to sell their products through us. Available will be:
* T.H.E Skincare from The Happiness Emporium * Sea glass art by Seaglass Cottage * Crystals and metaphysical items from The Spiritual Worker * Scented candles, wax melts and diffusers from Divine Candle Company
On Friday 1st April we will be holding an open afternoon with wine, nibbles and freebies for visitors and an opportunity to meet the people who have created these wonderful products.
We hope you can join us on Friday, but if not we look forward to seeing you soon.
As you may remember, we became CQC registered at the end of last year. This means that I can take the clinic from offering exclusively cosmetic treatments, to offering medical treatments as well.
So what’s new?
First off, we have the wonderful Sarah Appleton joining us to offer ear irrigation services.
Sarah is an NMC registered Nurse with over 30 years experience. More recently she has been working in General Practice and at the vaccination centres. She is fully qualified in ear irrigation and has a wealth of experience and knowledge on the subject.
Ear irrigation (or syringing) used to be offered in General Practice, but this NHS service stopped when the funding was withdrawn. It is often recommended prior to having hearing tests and hearing aid fittings, and it is also used when there is a large stubborn build up of wax in the ear.
This service with take place on Wednesdays in our CQC registered clinic in Frinton on Sea and costs £80.
I will be starting Rosacea clinics, where you can get individual support and treatment for any problems you may be having with Rosacea.
Rosacea is one of those conditions that is often ignored, suffered or mistaken for acne. Whilst there is no cure, a thorough assessment and excellent management plan can keep any signs and symptoms under control.
Following on from this, I am offering an Acne management clinic for all ages.
90% of teens suffer from acne and I believe that it is generally poorly managed. From my experience in General Practice I have found that there is little understanding from patients and clinicians alike on the best methods of treatment and maintenance.
For this reason I’m really excited to be offering this service so that I can help people who have slipped through the net.
Finally, I’ll be training in thread vein treatment and I’m requesting some models to have sclerotherpay at half the price of usual treatment.
This will be really useful for me to be able to market the treatment and show how it works. If you know anyone, or you yourself may be interested drop me a message.And I have one request. You have all been amazing at filling in your Pabau review forms, but I would be very very appreciative if you could each leave me one Google review.
Keeping the business at the top of the search engine and providing Google reviews will be essential for our growth and continuation over the coming year. It would mean so much to me.
Thank you again for all of your continued support. I am so grateful.
Hello to my lovely patients, and thank you for your continued support. As we are coming up to Happy Face Aesthetics 3rd birthday I am delighted to announce that I am now registered as a provider with the Care Quality Comission.
I have been working very hard on countless policies, risk assessments and service improvement measures to ensure that the clinic is as safe, effective, caring, responsive and well led. After a long interview and an inspection I am so proud that I am registered.
For you this means that you can rest assured that you are being cared for to a high standard and that I will be inspected and graded accordingly. For the clinic it means that I can diagnose and treat people for certain medical conditions within the scope of the clinic services. In the future I am hoping to extend my registration to incorporate minor surgery activities and diversify the clinic practice.
I would like to end by thanking you again for being marvellous. I am so fortunate to serve such a wonderful population of people, and I hope you will continue to join me as we look forward to an even brighter future.
You may have seen a few a weeks ago that I posted some content about an 18-year-old woman who I saw as an emergency after she had lip fillers. This patient has been very brave and has allowed me to share her story as a lesson to others and as a learning point for myself and other practitioners. The following account is based on the patients’ and my experience of treating her.
I had scheduled a weekend off to prepare Ena for school, and we were both mooching around the house in our pjs. I received a phone call from an anxious mum who told me her daughter (who we will call K) had spent the night in A&E after having lip fillers with another practitioner. A&E could only give her antihistamines. She told me that they had contacted the original practitioner who, K tells me, told her that her swelling, and pain was normal. They also told me they had contacted various other practitioners who advised that she be seen by the original practitioner or someone who is a registered healthcare professional.
I asked mum to get K to send me some pictures. What I saw was some very swollen lips with a dusky looking area at the right Glogau-Klein point (GKP). I could see that K needed to be reviewed quickly and dragged my behind out of the house.
I met K, who is a lovely, articulate, and beautiful 18-year-old. Her mum joined us soon after to support her. I took a detailed history, here is some of what she told me:
She had found the practitioner through social media and liked her work and appearance.
The practitioner was a non-healthcare professional and worked in a local salon as well as offering injections in her own home.
The patient went to the practitioners’ home and paid £100 for 1ml of injectable dermal filler.
K said that the treatment was very painful and continued to be painful for the whole day and night.
Her lips swelled to the point that she couldn’t close her mouth, eat, or drink.
K says that she contacted the practitioner who told her there was nothing to worry about.
She eventually went to A&E and was discharged in the morning with some antihistamines.
Her mum spent the morning calling other practitioners who were not available to see the patient or were too far away. One Harley Street doctor advised that K be seen immediately.
I then performed a physical examination that included feeling for lumps and checking blood flow. I could feel two large masses of filler in the top lip and one large mass in the bottom lip. Blood flow was appropriate in most of the lip, but blood return to the GKP and surrounding area slow and sluggish. On the inside of this part of the lip there was a large haematoma with an area that looked macerated, and I could not discern if this was caused by trauma created by the lip rubbing on the teeth or by small blisters (often present with vascular occlusion).
After a discussion with K and her mum, I felt it was appropriate to dissolve the filler as an emergency. I believed that that K had a compression occlusion, whereby the filler was squeezing the artery so that blood and oxygen could not perfuse an area of tissue. Without an ultrasound it was difficult to determine what kind of occlusion it was, but I felt the risk of not dissolving immediately outweighed the risk of dissolving. Also, K was still in pain, and that itself was a good reason to dissolve.
We discussed the procedure, the contraindications to using hyalase, went through the consent forms together, took pictures and made a video consent also. It was important for K to understand how Hyalase works by turning the dermal filler from a polymer into a monomer, allowing us to massage out and away. There are also undesirable effects and risks to using hyalase. Hyalase dissolves your own hyaluronic acid meaning you can have a period of loss of natural volume; it can be sore to have the treatment; there is often bruising associated. However, the most concerning thing is that there is a 1 in 2000 chance of allergic reaction to hyalase. Like anything in medicine, treatments are rarely simple, so in case of anaphylaxis I had my emergency adrenaline ready, and my emergency protocol open on my desk.
K had no prior history of any allergy and as this was an emergency treatment, we did not perform a skin test. I reconstituted with lidocaine and injected directly into the mounds of filler starting with the area of concern. Almost immediately to flooding the area massaging, it became pink and well perfused. The hyalase itself caused swelling and bruising, but capillary refill time was less than two seconds, and I was satisfied that we had succeeded. After 30-minute rest and some more pictures, I discharged K with some prophylactic antibiotics and a follow up appointment. We kept in touch for the next few days and K’s lips returned to normal over the next 2 weeks.
What had originally cost K £100 ended up costing her a further £200 for me to dissolve, plus the cost of a private prescription for antibiotics. However, the pain and the time it took K to put her condition right cannot be equated to money.
How can we stop situations like this happening again? It’s true that even the most experienced medical aesthetic practitioner will have complications in their patients resulting from their treatments, but a good practitioner will recognise this and treat it as soon as possible. The government need to define minimum training and practice requirements for all of us and regulate the industry rigorously so that we are 1. Trained to the highest standards; 2. That non healthcare professionals work closely with a prescribing clinician; 3. That those who meet the standards are registered under a governing body. Until then it is up to the patients to be informed enough to decide who they go to for treatment, so here are some red flags for you to look out for.
Cheap prices – they are using the cheapest products.
Time limited offers on injectables – this is coercive and makes a quick buck
Bundle deals on injectables e.g., ‘6ml of filler for a low price’– coercive, enticing you to have treatments you don’t need or want.
They treat you in their kitchen or lounge – if they treat you from home, they should have a specific clinic room.
Use hashtags on their social media like #medicalaesthetics #nurseinjector #doctor, but you can find no evidence of them ever being registered with the GMC or NMC or any other professional regulator, or they are no longer registered.
When you ask to see their medical director or supervisor, they are not available, or things start getting a bit shady.
They don’t offer consultations.
If they do offer consultations, they do not complete and full medical and facial assessment.
If they do not allow you time ask question, they do not tell you risks and do not allow you to read and sign a consent form.
If they are not going to be available for the two weeks after your treatment, or they cannot provide contact details for another practitioner e.g., Going on holiday.
They can provide no evidence of complications training and do not have a healthcare professional on call to help them deal with complications.
They do not have quick access to emergency drugs and do not have protocols to deal with emergencies.
They have had 1-2 days training in injectables with no previous medical/nursing experience – a good practitioner will pay to shadow another experienced practitioner and have some mentoring sessions.
It is not the responsibility of other practitioners to fix the problems of our patients. This only happens if you are not qualified to deal with the results of your work, or the patients has lost trust in you for various reasons (for example, you haven’t listened, or you have dismissed their concerns).
It is not the responsibility of the NHS to fix the problems aesthetic practitioners create. The NHS and its’ staff are on their knees. Resources should be saved for patients with actual life limiting health problems. Unless our patients suffer from life threatening complications like anaphylaxis, we should not be burdening the NHS. It is ours and our patients’ responsibility to manage and pay for any undesirable effects.
Furthermore, healthcare professionals who are not trained in medical aesthetics will not have the knowledge or resources to deal with complications from aesthetic injectables. For example, in the case of a vascular occlusion that is affecting a patient’s vision, the practitioner should accompany the patient with their own emergency drugs to the ophthalmologist if they are not trained to deliver retrobulbar injections.
I want to end this by stating that I do not think that all beauty therapist aesthetic practitioners are bad at their job. Equally I do not believe that some medical/nursing aesthetic practitioners practice ethically and safely. I do not think the beauty therapist in this case is to blame for the following events. I do however blame training academies who do not prepare their trainees to deal with adverse events, and I do blame the government for not having regulations and standards in place that protect our patients from all of us (no matter our profession).