In this enlightening episode, host Vicky Eldridge welcomes Dr Raj Thethi, Medical Director at Yorkshire Skin Centre, to delve into the evolving world of aesthetic training and trends. With a background deeply rooted in the NHS, Dr Thethi shares his transition into private practice and the continued passion for advancing education in aesthetics. They discuss the critical importance of ongoing professional development and the dynamic pace of aesthetic innovations which practitioners must keep up with to remain at the forefront of the industry.
Throughout the conversation, Dr Thethi emphasises the symbiotic relationship between teaching and learning, revealing how training others enhances his own understanding and keeps his practices up to date. This episode is a treasure trove of insights for anyone involved in aesthetic medicine, from seasoned professionals to those just starting their journey. Tune in to discover how to navigate the complexities of aesthetic training and stay ahead in this fast-evolving field.
Vicky Eldridge
I'm here with Dr Raj Thethi, he's the medical director of the Yorkshire Skin Centre and we're going to be chatting about the importance of training and trends in aesthetics and things like that. Welcome to the podcast. Lovely to have you here.
Dr Raj Thethi
Thank you so much for having me.
Vicky Eldridge
So training is a topic that you have been speaking about. Why is this so key in aesthetics? Why? And why are you passionate about it?
Dr Raj Thethi
So I think from the time I was in the NHS, training and helping other people to move further in their careers has always been a fundamental part of our process, of our own learning as well.
So I think, I don't think we should stop now that we're in private practise or that we've left that NHS environment. I think the passion for it has always continued in me. It's really critical, I think, because people just need to keep pushing themselves and it's very easy to become complacent, become a bit lazy. And, yeah, people can do this job for a long time, but it's moving at such a rapid pace that I think we just need to stay on top of it. And to do that, we have to have expert opinions and expert teaching.
Vicky Eldridge
So someone like yourself, who stands up on the stages, you train other people, people might think, oh, well, you know, what has he got left to learn? But I've heard you saying that it's always an ongoing process and that you also learn a lot from when you're training. Tell us about that.
Dr Raj Thethi
Absolutely. So I think it's so critical that we - It works, it works two ways, so definitely works from point of view. If I'm teaching something, I really want to know that I know my subjects inside out, and if I don't know it, then I'm going to look like a buffoon, so. And also, ultimately, you will not know certain things and that's completely fine, but it's knowing the limits of your competence that's really critical.
But also secondarily, like, it doesn't matter how far you are in your career, there is always something to learn from somebody else. So I'm actively still going on training courses now. It was one of the slides in the presentation I'm doing, it's how many training… I think I've done 74 courses since I started in 2017. So you just have to keep on going.
Vicky Eldridge
And that continued learning is really important, actually, isn't it? Anyway, for revalidation, when you're a practitioner, you've got to show that you're continually learning within your space.
Dr Raj Thethi
It's part of our kind of yearly appraisal. We have to show that we've done a certain amount of CPD, but not even that, just past that, just for our own sake, of our own sanity. I think it's just, It's really, really important for us to not work in silos and for us to have understanding of what other people are doing and how things are moving on.
Vicky Eldridge
I think the training space can be. I'm sure it could be challenging for people, can't it? Because there's so many options out there, lots of different courses. If somebody's new in aesthetics, what advice would you have for them in terms of trying to find training courses to attend, having been on lots yourself?
Dr Raj Thethi
Yeah. So I think, from my experience, and I'm not saying this is necessarily the right way to do it, I don't think I did anything in the right way at the beginning. But hindsight's a really amazing thing, isn't it? So I think you have to look and really judge, especially now, because it is flooded with courses.
And I think Lee Walker said it really well. He said “you need to look for people who are speaking from evidence rather than from eminence.” And actually, we've got to find the people who are teaching you, teaching you ideally what you need to know rather than what they think you need to know. So, it's really, really crucial to do some background digging into the company that's actually teaching you how long they've been established for their reviews.
But even the reviews, everything can be slightly skewed. They're going to show you everything skewed on the website and it's going to be. It's always the case that we have to do some extra digging, do your due diligence and go the extra mile to make sure that you're not missing anything. Look at the number of students to training ratio. Look at this, see where the venue is, whether they've got, what kind of models they have in place.
So it depends whether it's just simple injectable training or whether you're doing something more complex. So, all of those things need to - And hands on. Whether it's hands on, you'd be surprised how many times you're either just injecting, like a random plastic dummy or whether you actually got a patient. So, all those interactions are so crucial.
Vicky Eldridge
Yeah. And that learning goes on afterwards, doesn't it? Because, of course, you know, you might go on a course where you're learning how to do a certain injectable technique. And then you've got to go away and do that on live patients. How do you feel like mentoring comes into all of this? Is that something you've, you do or you've done?
Dr Raj Thethi
Yeah, I have, yeah, absolutely. So, I think it's really crucial because we, we have a, especially if someone's brand new to the industry and they're coming from an NHS role or they're, you know, they're starting out, they're quite junior in their career. Once you've done a course, that does not mean that you are competent. It just means that you have had the basic training requirement in order to pass a course.
You know, sometimes I've been on courses where they've just given me a certificate of attendance rather than of completion. So, it doesn't necessarily mean that you are now okay to do that skill. Ultimately, it's about the longer term gains that you're going to get. You learn more about the skill when you start doing it yourself and slowly you will cock up, you'll have some mistakes. And that's part of the process, it's part of the learning process.
And from those mistakes, the mentoring really comes into play. Because having somebody over your shoulder that's going to potentially help guide you, who's already been through those tribulations, already been through those problems before, and is able to give you some guidance at the time you need it is invaluable.
Vicky Eldridge
Yeah. And you're somebody who speaks at lots of clinical conferences, you're sharing your expertise and obviously Hamilton Fraser’s Aesthetic Business Conference is a business focused event. And I know that you do business focused talks as well. What's the value of attending these types of events and these types of talks that are focused on the business side of aesthetics?
Dr Raj Thethi
Sure. I think the business side is normally neglected. Naturally, we are clinicians and we tend to err on that side. Naturally, we just lean that way, which is just the way that we are. So you have to make a conscious effort to step out of your comfort zone and enter the mindset that you're actually not just a clinician, but you now are also a business owner. And that's something that I really struggled with right at the beginning.
I think it was really hard to kind of get my mind around it. I felt guilty, I felt nauseous every time I told a patient a price and, you know, and taking money from some, I didn't think I was worth anybody paying me for anything, you know. But I think it's just the mindset that changes. I think really something really helpful for me was obviously these kind of conferences are great and you're going to see a wide variety of people talking about different aspects of business but also just doing your own self directed learning is so critical.
I just read, well not read, I listened to mainly, in the car, audiobooks, business audiobooks. Just learning about the background basics. And yet again I still don't think I'm anywhere further forward. I wouldn't class myself as successful. It's just case that I know I'm on a journey.
Vicky Eldridge
For doctors who are thinking about coming into aesthetics from a business perspective, what advice would you give them? If you could go back and give yourself advice when you first started is there any tips that you would give?
Dr Raj Thethi
Give myself a hug from like 2015. So I think it's definitely harder than you think at the time. We've all got this kind of, especially in this kind of field, we are all wired to be quite high flyers. You've always tried to do well and it's the understanding that no matter how much you try there are certain sets of processes within the kind of this within the business space that you, there's certain factors you just not going to be able to control.
And you can have to come to terms with the fact that time is going to be your friend. And if you stick at something for long enough, eventually something will stick. I found that really hard at the beginning because we're wired to revise for an exam and then do an exam. Revise for an exam and then do an exam.
Once you've done your exam you get a mark and then that's the end of it. And then you work on to the next one. And actually in business it's not like that. It's about the longer term game and that's really hard to get your head around. It's about understanding that there's brand awareness, there are different aspects of even the financial stuff in the background. I fundamentally had my head in the sand for many years. I'm not going to lie about that but. And I probably still do on some fronts despite this conversation. So, I think it's an ongoing mission. But definitely, it's going to take longer than you think.
I think there's a magic number about three years where after three years of doing something like this you eventually have seen enough people on the premise that you're good at your job. Good luck. But if you're good at your job. You didn't for three years. You'll have seen hopefully enough people that they will have told other people.
And then there's a kind of a snowball thing that happens. It then eventually just kind of goes out of your control. So right at the beginning, when you're actually looking for people and you're trying to find patients, I mean, you're still trying to find patients now because you've got to keep feeding the beast that you make, but the problems are different. So I think that definitely comes into play.
Vicky Eldridge
And what about social media? Because you're someone you know, from my perspective, you're great on social media. Your social media is really good. And that's something that obviously people struggle with a little bit, putting themselves out there, doing videos, doing things like that, and striking that balance between your professionalism, your reputation, and then doing, you know, attracting patients via social media. How have you struck that balance?
Dr Raj Thethi
You clearly do not know me. I am not professional at all.
Vicky Eldridge
Your social media is great.
Dr Raj Thethi
It's awful. So, I have always been slightly out there and I don't easily conform to the, to like the restricted norm that I see. So, I've always pushed myself to try to do something a bit quirky, and I think that resonates really well. Lots of my patients have come to me and said that they've been following me on socials for like three years before they've managed to pick up the phone. So, you've got to find people that you relate to if you are going to be, and you're completely fine to be completely professional, and loads of people are, and they're great, they've got great businesses and that's good.
Ultimately, it's about being yourself. That's what it's down to. If you're a serious person and you do serious things, then be serious. Don't pretend to be something you're not.
Vicky Eldridge
No, not everybody's comfortable with some of those.
Dr Raj Thethi
So just being comfortable in yourself and in your own skin, ultimately, if you try to put on a front, which I have done, I've tried to be serious many times, but it doesn't work. Ultimately, you'll get found out very quickly because you can't keep it up. So, your ultimate, your true personality will come out.
So it's difficult to not be yourself, but to let go a little bit and actually just give yourself the space to make a mistake and understand that it's not life and death. It's ultimately the case that you've made a mistake.
But you move on, you build on it, you keep on getting better slowly. That's a really hard mindset to, to adjust to and I think it takes a long time, but you basically just got to get your hands dirty.
Vicky Eldridge
Yeah, absolutely. And not worry so much about what other people are doing. I think we've, you know, I've had a lot of people who run successful businesses saying actually what they do is they don't focus on what everyone else is doing, they just do what's authentic for them and what feels right for them.
Dr Raj Thethi
I think it's really easy to compare yourself to other people. And I've done this myself, where you look to somebody who's maybe like five years ahead of you in the career and you can see everything they're doing. You're like, oh, my God, I'm not doing that, I'm not in that. But if I look back now where I am about seven and a half years in and I mean, I remember when I first met you were talking about, like I was a complete noob and someone that we know mutually, Pam introduced myself, introduced you to me and me to you.
But at that time, had I known what I know now, you know, it's a completely different situation, isn’t it? So, you built from all of your experiences that you have and I think it's, it's just knowing that you've just got to be a bit out there, you've got to give yourself some space and understand that you're going to make some mistakes.
Vicky Eldridge
Yeah, absolutely. That makes a lot of sense. In terms of the treatment, the market for male treatments is something I'm interested in asking you about. Have you seen any trends, have you got a demand or an increased demand within your clinic for treatments that men are interested in? And have you seen any shifts in that market, any trends in that market?
Dr Raj Thethi
Yeah. So, I think men are a completely different kettle of fish. They're very, I'm going to be highly sexist now, so, we are much better at making decisions and we're far more decisive. So, I've got female patients who will spend a long time, which is completely fine, trying to understand, weigh up decisions and do... Men tend to, on average, I'm pretty sure it's a massive stereotype, they sometimes are a little bit more decisive and they just kind of, they make a decision and go with it, which is a very different dynamic when you're in the consultation room.
So, if somebody's not used to seeing many men in the consultation room, it can feel a bit awkward, slightly jarring. So, they tend to be a lot more subtle and a lot more, they don't want to be in the public light normally. But saying that, there's definitely been a shift in the last seven or eight years, even though I've been doing it, I'm seeing more and more men, probably because I'm a male doctor, so it probably helps.
But ultimately I'm a firm believer that whatever you push out in terms of your advertising, your marketing, that's what's going to come back in. So, if you, and I'm fortunate enough, I've tried to push that market because I know that it's a really, really, it's a market that needs our help and unfortunately sometimes they just feel like it's slightly, there's some barriers to entry. So actually being able to market specifically for them has meant that I'm then attaining those patients as, you know, paying patients, which is fantastic.
But it takes time because you've got to understand the artistry behind how a male face or male treatments are going to fundamentally, how they're different from female ones and even a younger or middle age.. I've just done a talk at, what was it, a Wigmore conference about the maturing male patient and how their needs are different from a younger male because masculinisation or kind of like making sharp angles and squiggly things, you know, sometimes a middle aged man does not want those things. So, it's dealing with those problems as they come in.
Vicky Eldridge
Interesting. Are there any particular treatments that you find that men are more interested in or.. I've been reading about the jawline treatments and things like that. Have you noticed any particular treatments that are trending?
Dr Raj Thethi
So I think, I think trending is hard because trends come and go and what you don't want to do is left with a trend that is no longer a trend. So, I think I tend to aspire to a more natural aesthetic and those things are quite classical and people come back again and again for those things.
So, I see a lot of men who have, normally, kind of signs of ageing. So, I do a lot of neck work and lower face and neck. So definitely jawlines are really critical. People feel like they kind of have like little ‘turkey necks’ or they feel like their jowls are sagging or, you know, so. But those are the kinds of things men tend to get bothered about rather than little tiny fine lines and wrinkles and stuff. Other thing around the men, men, you know, the eyes are really important.
So, we do a of stuff, periorbital stuff. So periorbital and then kind of lower face and neck tend to be the kind of bits where I treat the most men for, for those particular indications.
Vicky Eldridge
And what about looking forward to 2025? Is there anything that you are excited about for the market in the future and things that you are, you think are going to develop more and anything for both men and women?
Dr Raj Thethi
It's really hard because every time we make any of these kinds of predictions we get completely proven wrong every single time.
I think there has been a big swing away from dermal fillers. I think that's internationally been the case. We're all about collagen banking and improving your own, your own body's ability to regenerate. And the regenerative medicine side is really coming through.
We've taken that on board in my clinic and you know, we're pulling in aspects of regenerative medicine into areas that were traditionally very, very quite, not closed minded but very traditional. There was a set way to do things. For instance, I've got in my clinic we have an oculoplastic surgeon who does blepharoplasty, which has been done forever and a day.
But now we're incorporating things like laser technology or PRP or polynucleotides, exosomes. We're incorporating those things into our treatments of a blepharoplasty to help further improve the quality of the outcome and make the patient have less downtime, less scarring, improve the longer term maintenance of the results.
So, all of those things are, I think we're just changing up the way that we're doing things. We can see the potential of how we're just not letting the body do what it needs to do. And I think we're holding it back.
Vicky Eldridge
Yeah. And finally, really from a training perspective, how do you think, because a lot of them, we see training courses where everything's separate, don't we? And with the industry moving in that direction. I was just reading a report actually about combination therapies and someone used the term treatment stacking or you know, that if we're moving in that direction, where all of these modalities are working together, what role do you think training plays there when we've got separate courses?
Dr Raj Thethi
I think the problem is that there's lots of different companies that will be selling their individual stuff. But from my experience and what I find, I'm sure many colleagues will agree is that if you've got a multi focal problem, you'll need multimodality solutions.
And you're completely right. There isn't anything that's unifying all of these different aspects of the sector together. And I think that's a massive gap in the market, to be honest.
So **** it, I'm going to fill that right now. No, I think, I think there's definitely a gap in the market and there's things that there's one machine that I do that I have which will do really well, but it won't do the other XYZ very well and vice versa, there'll be another one that does something different.
So not just machines, but generally techniques or products or whatever it is, being able to kind amalgamate those things together and bring them together in a way that they're going to become cohesive and something that you can potentially have longer term, it would be great.
There are fundamentally flaws with that plan ultimately because standardisation is so difficult even if with one machine. Standardisation is hard if you've got multiple things going on.
The concept of trying to have evidence based medicine with something that's going to be standardised, that's really tricky.
Vicky Eldridge
Really tricky, isn't it? Because obviously we want a personalised approach.
Dr Raj Thethi
Absolutely.
Vicky Eldridge
But then that means..
Dr Raj Thethi
Which is kind of conflicting, kind of conflicting with the standardisation and even personalized approach. The way that I would do a personalised approach, somebody is going to be completely different to the way somebody else would do a personalised approach, simply. So, it's my personalisation on your personalisation and then there's another level of complexity, so.
And also, I mean, I'm very, very fickle. I think my opinion on Monday is different to my opinion on a Wednesday. So, you might get two different treatments depending on which day you see me. So, I think, yeah, I think that was really critical, but I think there's a long, there's a long time coming.
Vicky Eldridge
Amazing. Raj, thank you so much. Pleasure talking to you as always.
Dr Raj Thethi
Appreciate it. Thank you so much.
