Mainly as part of my job as a beauty journalist and co-founder of Future Health and Beauty – though sometimes not – I’ve tried virtually every tweakment, laser, filler, radiofrequency device and injectable on the market.

Sometimes they’ve had transformative results, occasionally there’s been genuinely terrible ones.

My experiences have led me to launch Ireland’s first independent aesthetic concierge service, providing one-to-one consultations advising on everything from injectables to cosmetic surgery, alongside non-biased clinic and practitioner recommendations across Ireland and Europe.

This is the stuff I wish someone had told me before I over-treated my skin into fragility, said yes to procedures that were never right for me or learned the hard way that the most Instagrammed clinic in the country is not always the one you want near your face.

White coats and titles mean very different things – and the system lets everyone blur the lines.

A consultant plastic surgeon has spent up to 20 additional years earning that title beyond their medical degree. A consultant dermatologist similarly.

Yet in the aesthetics world, they can appear in the same Instagram feed alongside a nurse running a Botox clinic from a converted premises after a prescribing course. I am not dismissing the skill of excellent aesthetic nurses – many are exceptional. But the hierarchy is genuinely opaque and the lay person has almost no way to navigate it without insider knowledge. Word of mouth, again, is everything.

Here’s my top ten hard-learned lessons from my 20 years at the coalface of cosmetic industry...

1. Most tweakments over-sell and underdeliver – and are often sold to the wrong person entirely

If a treatment truly did everything it claimed in the brochure, the aesthetics industry would have cured ageing by now. The reality is that the majority of tweakments overpromise, underdeliver and are routinely sold to people they are not actually suitable for.

Not because every practitioner is dishonest but because the commercial pressure is enormous and the incentive to say yes is baked into the system.

2. The best doctors and surgeons are not on Instagram

One of the stranger distortions of the social media era is that visibility has become mistaken for expertise. The truly excellent medics – the ones you actually want – are in surgery, in training rooms, at medical conferences and have waiting lists six months long.

They don’t need 10,000 likes. They don’t have time to film content in their clinics. The only way to find them is by word of mouth and insider knowledge.

3. Before and after photos should come with a health warning

They are useful as a rough gauge of change, I’ll give them that, but they are so unreliable it borders on misleading. Different lighting, different make-up, different angles, filters and then there’s the biology nobody talks about: after almost any procedure, there will be swelling, inflammation and water retention that temporarily makes skin look plumper and tighter.

It can look extraordinary at two weeks but a year later, when the inflammation has completely resolved and the real structural result is visible, is a very different story. We need a far better methodology for judging long-term results. In the meantime, take every before and after you see online with an entire teaspoon of salt.

4. Walking into a clinic is like walking into a fashion boutique that only stocks one brand

Imagine you walk into a boutique looking for a wedding outfit and the staff tell you honestly: ‘We don’t really cater for your colouring and shape – you’d be better served in the shop across the road.’ That does not happen and it’s the same in aesthetics.

A clinic invests potentially hundreds of thousands of euro in a device – some of these machines cost the price of a Dublin semi-D – and they need to recoup that.

So even if their laser is not the right tool for your concern, there is a very good chance you’ll leave with a €2,000 treatment plan and a very convincing explanation for why it is your best route.

5. I destroyed my skin by doing too much

This one is personal and professionally mortifying. Think of what happens when you let a child loose in a sweet shop – that was me with editorial access to treatments. Surely if you keep doing lasers and radiofrequency and collagen-stimulating procedures, it just keeps getting better? Wrong.

My skin has gone from being as tough as a rhinoceros – able to tolerate anything I threw at it – to being as fragile as a butterfly’s wing, intolerant of 95 per cent of skincare and make-up products.

Perimenopause has a role to play, absolutely, but I genuinely believe I have sandpapered down my skin barrier through years of over-treating in the name of professional curiosity. The irony of having access to every treatment going, only to end up with skin more compromised than when I started is not lost on me.

6. For surgery, seek out specialists – a jack of all trades is not the answer

Whether you’re contemplating a blepharoplasty or a breast reduction, a rhinoplasty or ear pinning, focus on surgeons who perform that procedure day in, day out.

They are not just faster or more confident in the operating room, they also understand intimately how their work settles over years, and how results shift and evolve on different bone structures, different skin thicknesses, different physiologies.

That depth of pattern recognition comes only from repeatedly performing a given procedure over time.

The surgeon doing a bit of everything simply cannot accumulate it in the same way.

The problem in Ireland is that demand has not yet reached the point where most plastic surgeons can sustain a practice on one procedure alone, so many have to cover a broad range, which makes finding a true specialist genuinely difficult. That is changing as the market grows, and you can increasingly see surgeons and clinics zoning in on specific areas.

But for now it requires a bit of homework.

Look beyond the website, look for surgeons who are presenting their techniques at international conferences, publishing and training others in their specific area – because that is where peer recognition actually lives, and it has nothing to do with how good their Instagram grid looks.

7. Aesthetics is one area of life you want to be last on the trend, not first

I have been the industry guinea pig more times than I care to count, and I have the scars – metaphorical and occasionally literal – to prove it.

Macrolane, an injectable breast filler I tried 18 years ago through work, caused years of cysts and was pulled from the market. A cellulite treatment left me with hollows worse than what I started with – also subsequently withdrawn. Last year I tried a new injectable skin booster from one of the most reputable aesthetic brands on the planet, and my body encapsulated it, leaving me with boil-like capsules around my chin and mouth that looked, frankly, medieval. They had to be dissolved, with thermal treatments to break everything down and months of recovery.

The moral: let a treatment exist for at least a few years before you try it. The only way to truly know if something works – or causes harm – is time and volume of patients to have tried it before you. So give it time.

8. Treat your face like a home renovation – and never hire a decorator before you’ve found the architect

Think about the worst approach to renovating a tired, ageing room. A lick of paint on one wall, a lean-to extension that doesn’t quite match, a rug you spotted on sale that seemed like a good idea at the time.

The result is higgledy-piggledy, mismatched and somehow worse than what you started with.

That is exactly what happens when people approach their face with a piecemeal attitude – a jab of filler before a wedding here, a laser special offer there, a bit of Botox because someone recommended it.

Individual decisions that made sense in isolation, but nobody was looking at the whole picture.

The far smarter approach is to treat it like a considered, long-term renovation with a good architect at the helm.

Sit down with a reputable aesthetic doctor or clinic and tell them not what you want next month – but what you want your face to look like in ten years.

A good practitioner will map out a plan that works holistically, that makes sense for your bone structure, your skin, your lifestyle and your age, and that will evolve gracefully rather than look increasingly odd as time goes on.

Like those home renovation shows on which a brilliant architect and designer finally get their hands on a space – the result is coherent, considered and functional. It looks pulled together because someone thought it all the way through from the start.

This approach is not cheap and it is not instant gratification but it will age infinitely better than the accumulation of quick fixes.

If you genuinely can’t afford to do it this way yet, do nothing and save up until you can. An empty room is always better than one furnished in a panic.

9. Laser devices are not all created equal – and the gap between them is the gap between a Vespa and a NASA rocket

Yet they are marketed in virtually identical language, as if they do roughly the same thing. What most consumers also don’t know is that the glass head on a laser device – the part that actually does the work – wears out, like a lightbulb, and needs to be replaced. Replacements can cost up to €50,000 so clinics sometimes keep treating patients with a head that is well past its best. You can ask but you’re relying on the honour system.

Your best protection is going to a reputable clinic in which laser is the primary focus – chains, counterintuitively, can be better for device maintenance than a boutique clinic running a single machine on the side.

10. If going abroad for treatment, stay within the EU

The appeal of going overseas is obvious – lower costs, sometimes more specialised surgeons and, in certain cases, genuinely excellent care. But the hidden costs are real too – hotels, transfers, the psychological toll of recovering away from home.

Complications after cosmetic procedures are more common than the industry likes to admit, and if something goes wrong on the flight home, an A&E here will treat an infection but cannot address a result you’re unhappy with.

If you do go, go EU. At minimum you have some protection under the European Health Insurance framework. Have a contingency plan and know exactly who you’ll call.

For one-to-one independent aesthetic consultations with Liz visit aestheticadvice.com

The Ten Questions I Get Asked Most — And Why There's No Simple Answer

These land in my inbox every single day. I can't answer any of them in a line — and anyone who tells you they can is already doing you a disservice. The right answer depends on your age, skin type, pain tolerance, recovery window, budget, risk appetite, whether you want subtle or dramatic results, whether you'll travel and whether you'll commit to maintenance. It's as nuanced as asking me who the best husband would be for you.

1. What can I do about my jowls – Morpheus8, Ultherapy, Sofwave, threads...?

The answer depends on how much laxity you have, your skin thickness, your age, facial fat distribution, how strong your face and neck muscles are, and your budget. Some of these devices will give someone with mild laxity a genuinely lovely result, but on others, it could melt away a much-needed fat pad and make you scrawny, not snatched. This one needs a proper consultation, not a Google search.

2. Who’s the best and cheapest for blepharoplasty in Ireland?

Best and cheapest should never appear in the same sentence when someone is operating near your eyes. A blepharoplasty is one of the most transformative procedures available but the margin for error is real and the results are permanent. Price should be the last thing you optimise for.

3. What can I do about hair loss?

The market is flooded with treatments making wildly-inflated claims. The answer starts with a diagnosis. Hair loss has many causes – hormonal, genetic, nutritional, stress-related – and the treatment that works brilliantly for one cause can be useless for another. Get a medical assessment before spending a penny.

4. Since peri/menopause I just look exhausted – where do I even start?

The hormonal shift affects skin, hair, fat distribution, facial volume and bone density simultaneously. It is a whole-face change, not a single concern, which means a single treatment will never address it. Start with someone who understands the intersection of hormonal health and aesthetics – not just someone who wants to sell you filler.

5. Who does a good facelift and how much will it cost?

The results you see on celebrities are rarely one procedure – they are years of staged work combined with excellent genetics and professional lighting. A well-executed facelift by a skilled consultant plastic surgeon here will cost from €12,000-€60,000 or more. If you’re looking at facial surgery in the US, think €100,000 upwards.

6. Which liposuction is best – Vaser, traditional, BodyTite...?

The most important variable is not the technology, it is the surgeon using it. The same device in different hands produces completely different results. People also wrongly assume lipo is a weight loss treatment, it is definitely more one for delivering body contouring.

7. Should I get CO2 laser resurfacing?

One of the most effective skin treatments available – and one with the most significant downtime, the steepest learning curve for operators and the widest variation in results. Recovery is weeks, not days. Not something to shop around for on price.

8. Who is the best Botox injector in Ireland?

I get this several times a week and won’t answer it publicly – the best injectors have waiting lists that make the point moot anyway. What I will say is that the injector matters infinitely more than the brand of toxin, and the best results come from practitioners who are conservative, understand facial anatomy deeply and will occasionally tell you no.

9. What’s best for under-eye hollows and dark circles?

Arguably the most complicated area of the face to treat and the one where I’ve seen the most disappointing outcomes. Under-eye concerns usually have multiple causes – pigmentation, vascular issues, volume loss, laxity – and rarely does one treatment address all of them. Proceed carefully, and only with someone who specialises in this specific area.

10. I’ve lost a lot of weight on Ozempic/Mounjaro and now I have loose skin – what surgery actually works?

Rapid weight loss with GLP-1 medications is driving a surge in demand for skin removal and tissue-tightening surgeries. The reality is that once skin has significantly stretched, no device or cream is going to recreate surgical results. Procedures like tummy tucks, arm lifts, thigh lifts, breast lifts and lower face and neck surgery can be transformative – but only once weight has stabilised. Again, the surgeon matters far more than the marketing.

For one-to-one guidance on any of the above, visit www.aestheticadvice.com