From Botox to fillers and deep cleansing Hydrafacials, these are the ‘tweakments’ and treatments the cosmetic doctor rates for tackling signs of fatigue, crepiness and loss of firmness

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Everyone’s skincare journey is personal and wholly unique. A point proven by our ‘What would a skin expert do’ series. From dermatologists such as Dr Justine Kluk  and Dr Anjali Mahto , to cosmetic doctor Dr Sabrina Shah-Desai , the pros that we’ve featured so far have been wonderfully honest about their experiences, as well as the treatments and ‘tweakments’ they book in for too. This time round, it’s the turn of Medicetics  co-founder  Dr Vicky Dondos , whose focus on subtlety, approachable demeanour, and emphasis on the long rather than the short-term, has seen her become one of the premier names in the world of aesthetics.

For her, tackling the signs of fatigue is her main skincare priority what with having three children, running a busy practice and expanding and building the Medicetics team. “There’s a lot of pressure and I thrive off the fast pace, but I’m aware of the impact that has on my skin and the fact that it needs support,” she tells us. Now in her mid-forties, she’s also looking to address crepiness, sagging skin, loss of firmness in the neck area and redness. A combination of lifestyle adjustments, high-performance actives and injectables help her meet the changing needs of her skin as life has gotten more stressful. We caught up with her to find out more.

What’s your skin philosophy?

‘Do no harm.’ It’s the philosophy that we go by at Medicetics too - being effective but gentle. I always weigh up the long-term benefits of something and ask myself how it will actually help my skin do its job, and how best to maintain its health and any improvements I achieve. It’s important to be responsive with your skin and understand and read how it changes with different stressors and different seasons.

I like the idea of programming in a fallow period within an annual plan - a break where I let my skin just be, after an intensive treatment. It doesn’t mean that I won’t do anything to my skin. I’ll just take my foot off the pedal a little bit once I’ve achieved the results that I want, using basic actives in my skincare to support skin function, and sustain and maintain it after rebooting it with say, a course of peels or microneedling .

What non-surgical treatments do you have?

I have Express Hydrafacials every four to six weeks. It’s the cornerstone to all of my other treatments. It gives you an incredibly good cleanse - I’m shocked at much dirt comes off despite the fact that I cleanse my skin really well using good products. It gives you a glow afterwards, but it also means that any ingredients in your skincare penetrate that much more.

I also do light peels. Epionce does a three-step programme of peels using salicylic and malic acids - which I combine with IPL. I also love mesotherapy  and have a course of Dermapen every 18 months.

Every six months, I’ll also have Excel V, a type of laser that addresses the red vessels around my nose.

Any injectables?

I’ve been having regular Botox  over the last 10 years. I call it ‘Smart Botox,’ because I use it to make my face look more rested rather than completely wrinkle-free. As I have had it done regularly, I don’t need high doses and because it’s had a cumulative effect, I can go longer between treatments. I use it for a little brow lift (on the tails of my brows), the downturned corners of my lips, and for firming up my lower face and neck too.

I also have fillers along my mid-face and temples to contour. It’s made a huge difference.

I also love Profhilo . If positioned correctly within a regime, it can really help with crepey skin. I have it done on my face and neck and am currently also trialling it on my décolleté too.

MORE GLOSS: All you need to know about the latest fillers and Botox - and keeping it subtle

Any surgical procedures?

I had a rhinoplasty 10 years ago. I was quite self-conscious about my profile up until then; the procedure made that niggle a non-issue for me, a little confidence boost, which is something that I try to do for my patients too.

Are there any procedures that you’d like to bring into your clinic?

We’d like to offer more body treatments as we’re noticing a real demand for them among those in their late ‘40s. I’m particularly interested in Cellfina , which is a non-surgical cellulite treatment. From what I’ve seen so far, it really stands out: not too aggressive or damaging, but powerful and effective enough to make a difference. It’s not for everyone, patient selection is key like with everything else, but it does offer long-lasting results.

What would you never go near?

I would never say never...but maybe over-the-counter potions that cost more than £150?

Who do you go to for treatments?

The practitioners in my clinic. If I’m having something done, I want my clients to have access to it too. It’s hard to pass on control, being on the other side has been a big learning experience for me, but I feel that it’s really important for every practitioner to have some experience of that. There are five doctors and three aestheticians in the team and it forms an important part of our training to put ourselves in someone else’s chair and hear how someone else would assess your face and approach your specific concerns.

What’s the best lifestyle habit that works for you for great skin?

Sleep, followed by stress management, diet and exercise - the four pillars. There’s only so much creams and injections will do if there are problems going on elsewhere. The difference I’ve seen after making an effort to sleep for eight hours every night for the last year has been insane.

MORE GLOSS: Night time anxiety - how to stop worry from wrecking your sleep

Which treatment or regime do you think gives women most bang for their buck?

It’ll be the one that fits within a programme created by a practitioner that’s on the same page as you.

A pyramid-style approach is best in my experience, one that takes into account the amount of time and money that you have available. At the base is your mindset. It’s really important to spend time with a practitioner deciding what’s right for you, your motivations, expectations and concerns.

The second layer is lifestyle and at the top, are the two levels of aesthetic treatments. The first includes ones that are about maintenance and regeneration, e.g. Hydrafacials, LED, and short courses of more intensive options such as Dermapen and radiofrequency . At the top, are your corrective ones, such as injectables and lasers. You need all parts of the pyramid to see long-term effects.

How does your skincare routine tackle your specific concerns?

I’m a huge fan of Julia T. Hunter MD’s  products. She’s a Beverly Hills dermatologist whose products are active and effective but don’t include stressors that cause inflammation. We stock her products in Medicetics.

She does a fantastic cleanser , it’s the only one that I can use on my eye areas without it causing sensitivity.

In the morning after cleansing, I’ll mix together her serum , Vitamin C Plus  powder, Cell Optimizer Cream  and Wrinkle Filler  and apply it all in one go. You don’t have to wait and layer them up - you can mix and match them to suit your needs. I’ll then follow this with ELTAMD Skincare UV Clear SPF46, £27.

In the evening, I apply a retinoid  after cleansing. I usually use a prescription strength one (tretinoin), but I’m currently using a cosmeceutical one from the Julia Hunter MD line (called Vitamin A Plus ) as my skin can be a little tricky at this time of year. I might also use an exfoliating treatment a couple of times a week too - either the one from Julia Hunter MD’s line, or Epionce’s Lytic Lotion , £54.50, which contains salicylic acid and azelaic acid . It’s a great entry-level exfoliating acid  and I even recommend it to my rosacea patients. I then apply Julia Hunter MD’s Night Regeneration Cream  on top to boost overnight repair.

If I’m having a fallow period though, I use Epionce’s Intense Defense Serum , £129.50, and Renewal Lotion , £77.50, for antioxidant protection after cleansing, to simply support the skin barrier repair processes overnight.