*Sponsored post: Dr Alek Nikolic Aesthetic Medicine Clinic*
Choosing an aesthetic treatment begins well before the appointment itself. Cape Town aesthetic medical practitioner Dr Alek Nikolic explains why a thorough assessment, realistic expectations and a long-term plan matter. He shares the questions patients should consider before choosing a doctor or committing to treatment.
Twenty years of consultations have taught me that the decisions patients make before their first treatment matter more than any single procedure. Here is what he wishes every prospective patient knew.
Most people who walk into an aesthetic practice for the first time have already decided what they want. They have seen a treatment on social media, a friend has had it, or a magazine has declared it the thing to have this season. Very few arrive asking the question that actually matters: what would improve my face, and what would not?
The purpose of this guide is to help you choose a doctor, a direction and a plan that you will still be happy with in five years, based on what I have observed over the years in my own practice.
Start with a conversation, not a treatment
The first thing to look for in a doctor is not a treatment list. It is whether they assess before they recommend. A good first appointment takes time, involves looking at your whole face rather than the one area you came in about and what you feel needs to be treated, and should leave you understanding why something is being suggested, not just what. “Ask what the doctor would not do for you. The answer tells you far more than any list of what they would.”
In our practice, every new patient is booked for a 45-to-60-minute assessment, even if they have come for something as routine as frown botulinum toxin. That appointment may include a VISIA skin analysis if necessary and, where injectables are being considered, ultrasound mapping of the underlying anatomy when appropriate.
Decide what “better” means to you
Aesthetic ideals are not universal. Proportion, balance and harmony matter more than any single feature, and the version of you that looks rested and refreshed is usually your own face with its structure supported.
Spend some time deciding whether you want to look like yourself on a good day, or whether you want a specific look you have seen elsewhere. Both are legitimate choices. They lead to different doctors and different plans, and it helps to know which road you are on before you start.
Our approach is a more natural enhancement. “If a patient wants a look that we believe would not suit their anatomy, we say so, and we explain why.”
No treatment is the whole answer
Every year a different treatment dominates the headlines. Biostimulators, skin boosters, threads, a new device. The pattern is always the same: the treatment is presented as if it replaces everything that came before it.
It never does.
Each treatment does one job. Biostimulators build collagen and firmness over months. Soft tissue dermal fillers restore lost structure and support. Botulinum toxin addresses lines caused by muscle movement. Skin boosters improve hydration and skin quality. Peels, Dermapen 4 microneedling, IPL and skin tightening technologies each work on the skin itself in different ways. They are designed to work alongside one another, and the treatment currently getting the most attention is not always the one you need most.
Our approach is to plan in combinations and in sequence. A patient with early jowling, for example, may need upper and lower-face structure restored with soft tissue filler before any tightening treatment can show its full effect.
Sometimes the honest answer is surgery, or nothing
Non-surgical medicine has limits. Significant skin laxity, heavy eyelids and some structural changes are better served by a surgeon, and a good aesthetic doctor will tell you that rather than keep treating around the problem. Equally, some patients are advised that the best course is to do nothing for now and revisit in a year.
We refer to plastic surgeons regularly, and we regularly advise against treatments patients have come in requesting. We do not provide a treatment that will not improve the outcome, and every recommendation comes with the reasoning behind it.
Think in years, not appointments
Aesthetic medicine works best as a long-term relationship with one doctor who knows your face and how it has changed. Results build gradually, maintenance is planned rather than responsive to a new facial change, and one should invest in treatments that make the most long-term difference. The patients who are happiest a decade on are almost never the ones who chased each new treatment as it arrived.
Choose your doctor for how they think, their approach, and what they stand for aesthetically. The right one will guide you with reason, guide you when no is the correct answer, and still be the person you trust when the next trend has come and gone.
Schedule an appointment
For patients considering aesthetic treatment, a consultation is an opportunity to discuss their concerns, understand the available options and consider a plan suited to their individual needs. To schedule an assessment at Dr Alek Nikolic’s Cape Town practice, contact the team using the details below or complete the online appointment enquiry. Consultations are by appointment only.
- Website: www.dralek.co.za
- Email: dralek@mweb.co.za
- Phone: +27 21 797 0960
- Address: 33 Piers Road, Chelsea Village, Wynberg, Cape Town, South Africa
- Instagram: @dralek.nikolic
- Facebook: Dr Alek Nikolic
- YouTube: youtube.com/@draleknikolic
About Dr Alek Nikolic and the clinic
Dr Alek Nikolic is a medical practitioner with a special interest in aesthetic medicine. His qualifications include MBBCh (Wits), ATLS (ACS) and MBA (UCT), and he trains medical practitioners in facial aesthetic treatments in South Africa and internationally.
Situated in Chelsea Village, Wynberg, his Cape Town practice offers non-surgical aesthetic treatments, skin assessments, skincare advice, chemical peels, microneedling and laser treatments. The clinic provides a private setting with secure parking, with an approach centred on individual assessment, natural-looking enhancement and long-term treatment planning. View their full procedure and treatment list.
About the author
MBBCh (WITS) ATLS (ACS) MBA (UCT)
Dr Alek Nikolic is a doctor with a special interest in aesthetic medicine and is at the forefront of the latest developments in his field. With a focus on skin care, skin ingredients, and cosmetic dermatology treatments such as lasers, chemical peels, Botulinum toxin, and Dermal Fillers, he has performed over 20 000 procedures to date and is responsible for training many medical practitioners both locally and internationally. After receiving his MBBCh from the University of the Witwatersrand (1992) he went on to do an MBA at the University of Cape Town (2000). With over 24 years in private practice, he has lectured and performed live demonstrations across the globe, including Bangkok, Rome, Paris, Monte Carlo, Prague, and Warsaw.
Some of his accolades include: Owner of Aesthetic Facial Enhancement, Owner of online skincare store SkinMiles.com, Owner and formulator of Skin Ingredients (sk.in): www.skiningredients.com, Founding member of the South African Allergan Medical Aesthetic Academy, Advisor to Allergan Local Country Mentor in Facial Aesthetics, EXCO Member of the Aesthetic and Anti-Aging Medicine Society of South Africa (AAMSSA), and is an Associate Member of the American Society of Laser Medicine and Surgery (ASLMS).