Injecting integrity

Editor Anna Dobbie asks Aesthetic Medicine’s Nurse Practitioner of the Year Alexandra Mills about her new BAMAN board role and how she incorporates surgical precision into her aesthetic practice

From the intensive care wards of Belfast to London’s refined aesthetics scene, Alexandra Mills has a career rooted in surgical experience, unwavering ethics, and a passion for patient-centred care. After 12 years in a regional head and neck unit, Mills transitioned from NHS nurse practitioner and clinical educator to one of the UK’s most respected voices in aesthetic nursing.

“I didn’t choose aesthetics, aesthetic medicine chose me,” she says, reflecting on a career that started in the rigours of reconstructive care.

Mills’ clinical journey began as one of the earliest graduates in nursing, later returning to general medicine before aesthetics beckoned. After helping set up a clinic for plastic surgeons, she eventually took it over, growing it into a successful chain of eight clinics across Northern Ireland. Seven years ago, she sold the business and relocated to London, a move spurred by family and new opportunity.

In London, Mills’ core values remain unchanged: skill, education, and integrity. “Word of mouth has been my biggest marketing tool. It’s slower, but it’s the best compliment.”

She splits her practice between Until, a boutique CQC-rated clinical space, and 10 Harley Street, where she maintains a long-standing contract alongside her husband, Prof Syed Haq. Though she once vowed never to manage staff again, she now mentors a fellow nurse, nurturing the next generation with the same high standards to which she was trained.

CHANGING FACES

A prolific contributor to the Journal of Aesthetic Nursing, where she sits on the editorial board, Mills continues to publish regularly – often five or six times a year. She remains committed to clinical excellence, regularly attending cadaveric dissections and anatomical masterclasses to refine her practice. “No two faces are the same,” she explains, emphasising the critical importance of understanding anatomy in her work.

“You can’t train hands,” she recalls mentor Dr John Curran telling her. “There’s an artistic element that not everyone will get, and that’s okay.”

Mills is a vocal advocate for professional regulation and transparency in aesthetic medicine. As the recently-appointed vice chair of the British Association of Medical Aesthetic Nurses (BAMAN), she’s part of the ongoing battle to protect the “nurse” title and ensure professional standards in an increasingly crowded field.

SAYING NO

In her practice, Mills champions subtlety, patient safety and bespoke treatment journeys. “I’ll never over-treat, that’s just not in me. My goal is to not harm, and that means sometimes saying no.”

She currently works as KOL for Croma Pharmacy, a highly respected manufacturer and distributor known for its patient safety focus. She praises their educational support and professionalism: “They’ve helped shape my practice, and they genuinely care.”

On the skincare front, Mills collaborates with L’Oréal’s blue-label range, choosing evidence-based formulations that suit diverse budgets. “Good skincare doesn’t have to cost the earth,” she adds, citing the range’s B5 cream and hydrating cleanser as staples.

While she currently does not use large-scale devices, Mills has experience with IPL and Neogen and is considering adding more skin-based technologies as she explores the potential for new, dedicated premises in central London.

Despite her accolades, Mills remains grounded. “I’ve survived all climates,” she says. “If you’re good – genuinely good – people will come back, but it takes hard work, sometimes losing money, and always putting patients first.”

REGULATION, STRUCTURE AND SUPPORT

With more than 1,600 members in BAMAN, the majority of them women, Mills is pushing for a more structured, regulated, and supportive environment for her peers, with authenticity and humility.

“We’re looking at registration, title legislation, and just growing our community,” she says. “Over 70% of our members are prescribers, but we want to get that number up.”

To help achieve this, she and her team are offering bursaries for nurses who want to become prescribers, with just a few requirements: two years of membership and a Designated Medical Practitioner (DMP) to supervise them during training. Anna Becker, chair of the Education Committee, is leading the charge in organising a national list of potential DMPs ahead of the next academic intake in September.

THE PERSONAL SIDE

While her professional agenda is packed – overseeing education, managing strategic growth and sitting on editorial boards – there’s a deeply human element to her story. She’s also a mother to a six-year-old, married to a fellow aesthetics professional, and openly acknowledges the juggling act that comes with it all.

“We’re both in aesthetics. It wasn’t intentional,” she laughs. “It’s good and bad – you never really get away from it.”

That authenticity carries into her views on industry ethics and patient safety. She’s been vocal about the need for aesthetics to be treated as a medical subspecialty, pushing back against over-simplified training and emphasising the value of multidisciplinary experience.

“One-day courses don’t cut it,” she says. “Even doctors and dentists should be part of a membership organisation if they’re serious about practising safely. It’s not just about injecting – it’s about understanding tissue, healing, patient care.”

FROM COFFEE MEETUPS TO NATIONAL STRATEGY

Her leadership trajectory has been organic. She once led London’s branch of BAMAN from the ground up, turning it into one of the busiest regions through simple meetups and strong community bonds. Now, as vice chair of BAMAN, she wants to bring that same grassroots ethos to a national level.

“Whether you’re brand new or struggling to find a clinic role, we want to be that hand to hold,” she says. “I’ve been there, we all have.”

She’s also quick to point out the clinical discipline that underpins her work. From advising patients on bruising and swelling to providing written aftercare, nothing is left to chance.

“You are having a medical treatment,” she emphasises. “I always give my patients something – a product, a supplement – just so they know to take care.”

Even in lip augmentation procedures, her method is cautious and calculated. She avoids the overfilled “Russian lip” look, never injects into the border, and sticks to subtle corrections using high-quality products.

“Touch wood, I’ve never had any problems with migration in 16 years,” she says.

WHAT COMES NEXT

With the Scottish government preparing to legislate, all eyes are on how regulation will roll out across the UK. She’s cautiously optimistic – but wary of missteps.

“My fear is that we regulate the regulated and leave the unregulated to continue unchecked,” she said. “That’s where the real risk lies. It’s a scary place to come out as a newly qualified nurse in aesthetics,” she says, “but it doesn’t have to be.”

Still, her focus remains steady: advancing education, supporting new practitioners, and ensuring the aesthetic nursing sector continues to evolve with care, competence and community at its core.