KAMBIZ GOLCHIN

5 MINUTES WITH… KAMBIZ GOLCHIN

Connie Cooper speaks with facial plastic surgeon at Rakus Clinic, – Kambiz Golchin, about the evolving landscape of facial aesthetics

WHAT INSPIRED YOUR INTEREST IN FACIAL AESTHETICS??

I trained as an ear, nose and throat consultant, and I had a fascination with noses. I wanted to learn about rhinoplasty and nasal surgery, so I did a fellowship.

In my fellowship year I was exposed to a lot of non-surgical treatments for the face. That’s where I learned about injectables, botulinum toxin, fillers and lasers, and that really captured my attention. I had this fascination with noses. I just thought anatomically they were really complicated, so that’s why I decided to get into it.

WHAT HAS BEEN THE MOST TRANSFORMATIVE MOMENT IN YOUR CAREER SO FAR?

The truly transformative moments are when you carry out procedures that are genuinely life-changing for patients.

When you realise you’ve had a positive impact on someone’s life, it gives you an incredible feeling. At the same time it’s very humbling, because you recognise the responsibility that comes with.

WHAT FIRST SPARKED YOUR INITIAL INTEREST IN REGENERATIVE MEDICINE?

My first exposure was through PRP in 2010, at that time I was doing a lot of teaching around botulinum toxin and fillers. But when I discovered the potential of PRP, that’s when my interest in biologics grew. From there I moved into working with stem cells, using the patient’s own cells derived from fat and my interest expanded into a broader interest in regenerative approaches.

I think the next big thing is going to be some form of signalling.

It will be a combination of stem cells and exosomes, but not in the way they are being used at the moment.

Most of the exosomes that are on the market, are not fully understood. The ultimate goal would be that we have a way to signal the cells to do what we want them to do.

HOW IMPORTANT IS THE RELATIONSHIP BETWEEN PRACTITIONER AND PATIENT IN ACHIEVING AESTHETIC OUTCOMES?

It’s fundamental because without that relationship nothing can be done. It’s not going to be based on a solid foundation.

You really do need to have that rapport with the patient and have a deep understanding of how they feel about themselves, how they see the world, where they are in their life and where they want to go.

You also need to understand what the motivation is behind what they are looking for.

That understanding is key, and then it’s the job of the practitioner to guide them safely.

There is so much out there in terms of procedures and techniques and offerings that it’s actually pretty confusing. It’s confusing for practitioners, never mind the patient.

It’s difficult for most people to choose wisely in terms of what they should have.

For larger or surgical procedures, it can be beneficial to have more than one consultation. Bringing the patient back allows them to absorb the information and make an informed decision. The process shouldn’t be rushed, and patients need to fully understand their options.

HOW DO YOU MANAGE PATIENT EXPECTATIONS WITH SOCIAL MEDIA, FILTERS AND AI?

It’s a real challenge. We’re surrounded by filtered images and AI-generated visuals, and many of them simply aren’t achievable in real life.

A lot of my time is spent educating patients. Many of the images people see online are heavily edited and unattainable without the same filters or apps.

I think there should be regulation, particularly in advertising and promotional imagery.

Before-and-after images, for example, should represent genuine results. Using manipulated imagery to attract patients is misleading.

HAVE YOU NOTICED CHANGES IN PATIENT DEMOGRAPHICS IN RECENT YEARS?

Yes, particularly when it comes to male patients. It shows that men are just as conscious of their appearance and wellbeing as women. In many ways they can be just as vulnerable to the same pressures.

I think the stigma is dropping, and there are also wider social factors that may be contributing to this shift. Changes in relationships, more competitive job markets and broader cultural shifts all contribute to why more men are seeking aesthetic treatments.

HOW ARE GLP-1 WEIGHT LOSS MEDICATIONS AFFECTING AESTHETIC PATIENTS?

Many people that are on GLP-1s should not be.

It’s not just the dramatic weight loss, it is associated with premature ageing, skin changes, muscle atrophy and bone density. There are also a lot of unintended consequences that people will have to address at a later stage and it’s not really talked about.

It’s a constant battle that I have in the clinic. For the patients who genuinely need GLP-1 medications, they are life-saving. But many people take them simply to lose a few kilos, and once they start they continue and sometimes become underweight.

That becomes a serious problem. It’s also not correct to simply replace lost volume with dermal fillers. That can actually contribute to the problem rather than solving it.

WHAT MAJOR TRENDS ARE SHAPING THE FUTURE OF FACIAL AESTHETICS?

The biggest shift over the past few years has been toward minimally invasive or non-invasive procedures.

There are also trending surgical procedures, like deep plane facelifts, which have become popular due to celebrities.

But overall, the trend is toward non-surgical treatments, regenerative approaches, biostimulator injectables and light-based devices. There have also been significant advances in skin-tightening devices and laser technologies in recent years..

There will always be a need for surgery. That isn’t going away anytime soon. But as technology advances, there will be more devices and more minimally invasive or non-invasive procedures available.

HOW DO YOU EVALUATE WHETHER A NEW DEVICE OR TREATMENT IS GENUINELY EFFECTIVE OR JUST A MARKETING HYPE?

Experience plays a big role. When you have been working with devices and technologies for a long time, it becomes easier to judge whether something is worthwhile.

Often you still need to try it and see whether it performs as claimed. Reputable manufacturers usually go through proper research and development processes and provide good clinical data.

WHAT TRENDS DO YOU THINK WILL DEFINE FACIAL AESTHETICS IN THE COMING YEARS?

I think there will be more minimally invasive treatments aimed at improving skin quality and glow.

This will include both light- or energy-based devices, such as lasers, and injectable treatments. We are already seeing things like polynucleotides and biostimulator fillers, and I think there will be further advances in those areas.

There will also be developments like topical botulinum toxin and possibly gene-based approaches.

There are several innovations coming that will be quite exciting.