As a cosmetic doctor – and as a woman – it intrigues me how cross people can get, especially on social media, about those having procedures to improve their looks.
At heart, I think it’s fantastic that if you don’t like something about yourself, you can just change it. And why wouldn’t you?
It levels the playing field, though of course only if you can afford it. Someone once said there’s no such thing as being ugly, just poor. While that’s not strictly correct, you have to acknowledge there is definitely truth in it.
I had my first tweakment at 26. And now at 43, if you totted up everything I’ve had – and if I’d actually paid for it rather than being an industry insider who doesn’t always have to – the bill would come to £170,000.
Eye-popping costs are why some people go to cheaper, unqualified practitioners – and though I don’t condone it, I totally understand it. Patients realise how much better they could look, and try to make their budgets stretch accordingly.
I’m from solid working-class stock in Castleford, West Yorkshire, and I work hard with patients to make choices that will benefit them most, without risking penury. Many of my clients don’t have unlimited funds. They may be climbing the first rungs of a career or spending money on themselves for the first time in years, keen to see what a treatment can do for them. I have every sympathy.
My own confidence levels were once low, too. As a teenager, I was a bit chubby when waifs were all the rage. I was a size 12-14, but as a teen you feel that stuff a lot more. Boys asked out my pretty friends and ignored my average looks.
I was fine with the way I looked as I went out into the world, progressing through university – studying at Newcastle, Queen Mary in London, UCL and George Washington in Washington DC – and beginning my career as a dentist. However, by the time I was 26, cosmetic injectables were just going mainstream – and it felt like a game-changer.
Dr Sarah Tonks has undergone £170,000 worth of ‘tweakments’
Dr Tonks at 18 years old. It would be another eight years before she received her first cosmetic treatment
Here she is aged 22. Dr Tonks grew up in Castleford, West Yorkshire, before going on to study at several universities
When a dentist friend suggested we go on a Botox-and-filler-course, it made total sense – if this was the coming trend, why not learn how to do it myself? Not long after that, I went back to medical school with the aim of becoming a maxillofacial surgeon and going into facial reconstruction – but I didn’t get very far.
Frankly, I had started building up a clientele for cosmetic injectables and it looked too much of a promising career to give up.
Not that I would wish to emulate the results of my own first fillers in 2007. Back then, the quality expected was very different to what we expect now. In fact, it was play school at the beginning – the knowledge and products for achieving imperceptible results just weren’t there.
It amazes me how fearlessly we self-experimented (my friend injected me) and how pleased I was with my full face of lumpy fillers. They were so obvious! Today, I would be horrified by that result – thank goodness they dissolve over time.
From that point on, however, I never stopped training, investigating and having new treatments and techniques. Some, such as mesotherapy (vitamin injections), I rated less than others. And some, such as bio-stimulating injections and laser treatments, I still have to this day.
I think it’s only fair that I experience what I subject my patients to, and have first-hand knowledge of how everything feels – and how good the results are.
How many procedures have I had? Off the top of my head, I’ve been having toxin (such as Botox) and filler injections (which you need every few months) in my face, lips and neck for 17 years, and hydrating and regenerating injectable skin boosters – such as Profhilo – in my face, neck, hands, tummy, bottom and arms for more than a decade.
I’ve had the full gamut of other minimally invasive treatments – skin tone and texture-refining laser and intense pulsed light (IPL); firming ultrasound and radiofrequency; thread lifts to lift parts of the face; mesotherapy for a healthy glow; carboxytherapy (carbon dioxide injections) to tighten skin on the face and body; fat melting injections, lip and eyebrow tattooing, and exosomes (skin-regenerating molecules that are microneedled into the face).
I’ve even had labia fillers which, well, sound exactly like what they actually are. You get a hyaluronic acid-based filler approved for the intimate area injected into your labia to restore volume and lubrication – and, yup, it works.
I’ve also had cosmetic surgery. Ten years ago, I had a boob job – not to go up a cup size, but to restore fullness in the upper part of my breasts.
Technologies have improved, however, and I’m going to have my implants removed and a more modern uplift performed soon.
Next, I got a nose job – my nose was fine, just a bit less perfect than it is now – and liposuction to correct a double chin I didn’t like.
Then a few years ago, I had a ‘Brazilian bum lift’, which also involved liposuction on the waist and back to harvest fat that was then injected into the bum area. I ended up with a complication called a seroma (a pocket of blood plasma fluid) so I had to go have it fixed and re-done.
That was unpleasant. You can’t bend over for a few months because they cut the gluteal muscle to get the implant in, and you can’t sit on a hard chair for weeks either. I’m not sure I’d do that one again.
And while it’s certainly not a ‘tweakment’, I’ll throw in the fact I use the weight loss drug Wegovy. I qualified for it medically, owing to my post-baby weight – I had my child three years ago and have lost maybe 27kg. I’m still on a maintenance dose of the jabs because I don’t want to regain the weight.
In all, when you break down the total cost of my treatments and divide it over the years, that’s an annual budget approaching £10,000 – and I have to say that kind of spend is not unheard of among my better-off patients.
While some people may be shocked at the amount of work I’ve had done, I try to keep things balanced and subtle. I’ve recently opened a clinic in Knightsbridge and am very aware that a cosmetic doctor’s face is her calling card.
People come to you because they like your aesthetic and your approach, which in my case is relatively minimal. Well, that’s what it looks like at any rate.
An aura of polish is the aim. I do it, as do my patients, because looking good gives you the edge. It’s well-known – and plenty of studies have proved it – that if you are attractive and perceived as looking ‘put together’, you have more advantages in life.
And I’m afraid it’s also been shown that if women – and this is specific to women, which is galling – are slimmer, they are perceived to be ‘more professional’ too.
These are social signifiers, for better or worse. In my business as in any business, if I look well turned-out – as opposed to exhausted, with split ends and a crumpled shirt – the expectation will be that I’ve got my life together and people will want me as their cosmetic doctor. Of course I want that advantage.
I compare it to having your hair professionally straightened so you don’t have to flatiron it in the morning. Some of these procedures tweak your skin and your features to a point where you can just get out of bed and go, with minimal make-up and fuss. That seems to be what my patients want too. People really don’t know what’s going on in most cosmetic clinics.
They think it’s a parade of desperately vain crazies demanding to look 25 years younger and hoping to be photo-shopped in real life by unscrupulous doctors.
The reality is that what the vast majority want is just to look less tired, fresher, more ‘like myself again’.
Yes, I’m afraid you do occasionally get deluded, difficult patients who want over-filled cheeks or a pentagonal-shaped head (men favour angular, Clark Kent jawlines) like they’ve seen on TikTok. And they can get pretty nasty if you say ‘no’. It’s a lot of responsibility and it makes life difficult.
I would definitely have tweakments even if I wasn’t in the position I’m in. But I would never spend money I couldn’t afford, and neither should anyone.
Good skincare is the first thing I talk about with patients on a strict budget as it can make a significant difference.
I would spend limited treatment funds on regular laser or IPL sessions – they really refine the skin – and bespoke muscle and wrinkle-relaxing Botox all over the neck and face – you can get really nice results from that if your doctor knows what they’re doing. Those two options probably give you the most bang for your buck – maybe £2,000 a year.
If you had a bit more money, I would do regular skin boosters such as Profhilo. I often advise patients who’ve travelled from out of town to see me to get those from a reputable doctor or nurse locally, as it’s not complicated and will be a lot cheaper outside of London’s fancy postcodes.
Whatever you do or don’t do, people will have vehement opinions about anyone having these procedures – and I’ll never quite understand why.
My looks are often insulted, either for having had too much work done or not enough.
My favourite insult on social media was ‘you look like you fry chips for a living’.
Given the fact my great-grandma did work in a chip shop, they weren’t far wrong!
Maybe they don’t like it because having a tweakment is like tricking them – it’s seen as cheating nature.
But if that’s accessible to you and it makes you feel good, who are others to judge?
Dr Sarah Tonks is at The Lovely Clinic (thelovelyclinic.co.uk), 8 Beauchamp Place, London, SW3
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