The importance of the consultation in aesthetic procedures: A Q&A with Nick Miedzianowski-Sinclair

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Nick Miedzianowski-Sinclair will be speaking at The Aesthetics Business Conference on the importance of the consultation in aesthetic procedures.

Nick has operated in the international healthcare market for more than 35 years. He is the founder and CEO of Surface Imaging Solutions, which has, since 2004, been the exclusive distribution partner for Canfield Scientific in the UK and Ireland. Through the SIS 3D imaging services, Nick has imaged and consulted with over 2,900 people referred to him by consultant surgeons and aesthetic practitioners in the past 17 years.

He believes consultation is an essential part of any journey in aesthetic medicine. We caught up with him to find out more.

Hamilton Fraser: What will you be covering in your talk at the Aesthetics Business Conference?

Nicolas Miedzianowski-Sinclair: I’ll be focusing on the crucial components of the consultation process in aesthetic medicine. I often quote Warren Buffett: “Somebody is sitting in the shade today because someone planted a tree a long time ago.” This encapsulates the essence of a consultation – it’s about planting that initial seed for a patient’s journey, ensuring a thorough understanding and setting the foundation for long-term outcomes. It's not just about flashy technology or quick sales; it's the start of a careful, considered journey toward the patient's goals. As Confucious says, ‘A thousand-mile journey begins with a small step.’

Hamilton Fraser: Can you begin by explaining why the consultation process is so pivotal in aesthetic medicine?

NMS: Absolutely. For me, the consultation is a lifetime engagement. It is the cornerstone of patient care – it's where we set expectations, understand patient needs, and plan treatments. The reason for a consultation is an exchange of information. It's about working towards a goal and being able to measure, manage, and understand that it's not a once-off; it's not a bit of smoke and mirrors or a blinding flash of light or a great big AI pyrotechnic show. It's the start of a journey. It is essential to continuously monitor and adjust the plan based on evidence. Aesthetics is not just about enhancing appearance; it involves serious medical procedures that can have lasting effects, making the consultation a critical safety step across the continuum of care.

Hamilton Fraser: In your talk, you draw an analogy between crossing the road carefully and conducting a consultation. Can you expand on how this analogy applies to patient safety and satisfaction?

NMS: Of course. Just as the Highway Code helps prevent accidents on the road by setting guidelines and rules, a good consultation process sets the framework for patient safety and satisfaction in aesthetics. The Highway Code is there to stop people from injuring themselves. It's there to help people go from A to B in a safe and easy manner. And we all get speeding fines, parking tickets and so on and so forth when we don't do it. So, there are consequences. You wouldn’t just open your door and walk straight across the road without following the highway code to make sure you go from one side of the road to the other without being injured - You look left, look right, look left again, and when all clear you cross. When you come to a junction, look left, look right, and left again and may repeat that many times until you are ready to proceed. You cannot come to a junction and pull out. If we all follow the highway code, however boring it might be, the chances of us being safe and arriving safely are increased.

It is about careful planning, double-checking, and always ensuring safety first – proceed with caution. In aesthetic medicine, it is outcomes management. Ignoring traffic signals will cause accidents.

Hamilton Fraser: With over three decades in the international healthcare market, how have you seen the consultation process evolve in aesthetic medicine?

NMS: There’s been a positive shift towards technology-enhanced consultations and evidence-based medicine, which I wholly embrace, with an increased richness in digital imaging solutions, both 2D & 3D. Advances in Cosmeceuticals and devices have changed what is available to medical practitioners and their patients. Yet, I see a tendency to compromise on the scale and timing when it comes to engaging and investing in imaging solutions when it should be one of the essential investments within any aesthetic clinic. The COVID experience will have contributed to that. Also, Smartphone/iPad apps and AI-based apps influence the nature of the consultation. The essence of truly listening and understanding patient concerns must remain central. Technology is there to enhance, not replace, the human element of consultations. I often say, ‘There is nothing virtual about our reality!’

Hamilton Fraser: What are some common misconceptions patients might have about aesthetic procedures that a thorough consultation can clarify?

NMS: Over the years, my clients have shared with me that many patients come with unrealistic expectations or misunderstandings about the efficacy and safety of procedures and are increasingly influenced by social media and media personalities. A thorough consultation helps us address these by providing clear, realistic expectations about outcomes, potential risks, and the recovery process. It's also an opportunity to debunk myths and provide education, which is crucial in an era where misinformation abounds or is generated.

Hamilton Fraser: Can you share how Surface Imaging Solutions’ technology, like VISIA® and VECTRA®, enhances the consultation process?

NMS: These technologies are transformative – they allow for a detailed analysis of the patient’s skin or body that both the practitioner and patient can review together. For example, VISIA captures medical-grade images of the skin, aiding in a comprehensive assessment and continuous monitoring. In a consultation, we are facing each other. I’m looking at you, and you’re looking at me. A mirror is used and then taken away. The lighting is different. We don't necessarily have a common view, and it's important to have a common view so that I can understand what you might think is your target. It is about providing a common visual ground for discussions, which helps in setting accurate treatment goals and expectations.

Hamilton Fraser: How do these technologies help in setting realistic expectations for patients before undergoing an aesthetic procedure?

NMS: By providing precise, standardised images, VISIA and VECTRA allow patients to see a clear, unbiased view of their current condition and potential results. This visual tool helps manage expectations and shows achievable outcomes rather than transformations. It aligns the patient's expectations with what is clinically possible, reducing the risk of dissatisfaction across the continuum of care.

Hamilton Fraser: What are some of the key components of an effective consultation?

NMS: Listening is paramount – thoroughly understand the patient’s desires and concerns. It is also crucial to manage expectations and provide a clear, realistic picture of outcomes and risks. I stress the importance of continuous engagement; it is not a 10-minute consultation, and that is it. We will never chat again. We will continuously come back. The consultation does not end when the patient leaves the room – it is an ongoing conversation that adapts as the treatment plan progresses, year after year.

Hamilton Fraser: Looking towards the future, how do you see the role of technology in consultations evolving in aesthetic medicine?

NMS: Over the past 20 years of working with Canfield, and even prior to that in the mid-nineties within three-dimensional imaging, I have seen technology become increasingly essential in consultations and planning. AI is becoming more embedded in applications; however, advancements in artificial intelligence, which may also be described as advanced machine learning, lack original thought; it can only know what it knows and what we have taught it. It cannot think outside of the box. It is proving more valuable in assisting medical practitioners in their decision-making, outcomes management and planning.

For me, the challenge will be to continue to balance technological advancements with personalised care – ensuring that technology supports, rather than overshadows, the human aspect of patient interaction.

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