Dr Imaan Joshi

Dr Imaan Joshi Procedural specialist GP; Full Face Aesthetics + skin disorders + skin cancer surgery. Sydney Subtle and Sensible Rejuvenation to enhance your natural beauty.

Interesting times when the regulators & make rules but fail to in essence, understand that specialities are regulated ...
09/07/2025

Interesting times when the regulators & make rules but fail to in essence, understand that specialities are regulated by Colleges and Boards that govern our training, conduct and keep us in line and working within scope in order to work within the given speciality.

When there is no recognised speciality, as with there’s no:
- prerequisites to apply for training
- minimum standardised training upon entry into a training program
- training requirements with logbooks as with all procedural specialities
- exit examination to qualify as minimally competent
- an expectation that all graduates of this training uphold a minimum standard within a narrow scope to stay current.

So when regulators say we may not use certain terms nor even educate patients on normal vs atypical outcomes with drugs which are highly sought on eBay etc, we risk outcomes such as these behind closed doors which is arguably more dangerous.

- this isn’t safeguarding the public; it’s gagging actual experts to allow misinformation to continue to flow.
- it’s allowing minimally qualified people with questionable training and skillset to act like salespeople with a licence to harm

How is this safer? It’s a genuine question from someone who genuinely enjoys educating people, 99% of whom will never be my patients, but now find myself unable to say much at all.

Is this what we want for a speciality that’s not going to go quiet but which may go underground?

This article by was shared with me & I am quoting the journalist’s experience only. While AHPRA and the TGA are working...
08/07/2025

This article by was shared with me & I am quoting the journalist’s experience only.

While AHPRA and the TGA are working to regulate this field of medicine the real issue at hand is that in the absence of adequate minimal standards we will continue to see as just an extension of beauty and choose based on price and convenience rather than a thoughtful plan with the longterm in mind.

When did you last see a doctor or even another AHPRA registered clinician eg a psychologist and not pay for their services ie you take your concern to them and they assess and advise and charge you for it.

In medical aesthetics the world over, we have been trained to charge not for our skills, our expertise or results but by the unit, the syringe or the drug.

We have been trained to be consumers, ordering retail, not patients seeking advice on whether a particular treatment is right for us at this stage of life.

Have i gotten this wrong? No doubt more times than I care to recall. But the basis of all medical consultations is still FIRST DO NO HARM, patient initiated, patient centered care that includes saying no if it is in the patient’s best interests.

Learning that, is a nuanced skill in itself that takes years to do well.

So while I’m disappointed by this article, I’m not surprised.

Science and medicine can be humbling. Even when we’ve done something for years. - I may be skilled enough as your doctor...
07/07/2025

Science and medicine can be humbling. Even when we’ve done something for years.

- I may be skilled enough as your doctor and yet the field is so vast none of us is ever knowledgeable about everything at any given time.

This week I learnt to screen for *dry eyes* in new patients before potentially considering some drugs.

Why? Someone with a tendency to dry eyes may find their eyes become drier post treatment.
- not always
- not predictably.
- not permanently, symptoms will wear off in time. Eye drops will help meantime.

I was perplexed so I contacted some trusted colleagues for their experience & input. The symptoms and timeframe aren’t “textbook” but as I keep saying to all of you, we cannot possibly predict how humans will respond to any given drug or issue.
- human anatomy and physiology varies;
- evidence and trials give us a ballpark for safety and efficacy & that still needs to be tailored to you.
- if in doubt, contact your doctor (me) & organise a review appointment.

The same drug that is used to treat excessive tearing of the eyes (epiphora, pic from Eye Wiki) may also, paradoxically I learnt this week, cause dry eye in someone.

Informed consent for all medical procedures anticipates:
- common side effects that are usually minor but may be worrying (bruises, lumps and bumps)
- rarer but serious
- unexpected because they’re so rare/uncommon or unusual.

We rely on our patients giving us the courtesy and grace to contact us and to let us know & to assess so we can help them & warn future patients.

This is why informed consent exists- with complex living systems outcomes are never ever guaranteed.

This article caught my eye… At what point is enough… enough? Some key points made here I’ve been saying for years now: -...
01/07/2025

This article caught my eye…

At what point is enough… enough?

Some key points made here I’ve been saying for years now:
- as we live to well in our 80s, & work longer we want to look ABLE for as long as possible which involves projecting a certain physical appearance.
- as we live longer, we want those years to be active, meaningful years, not reliant on others for the day to day
- equally most of us - men included- want to look as good as we feel.

The reality that is missing?
- it takes starting before the signs are obvious so much that most of us are now shocked when we see someone look age appropriate “she looks OLD!”
- it is possible to delay and even avoid surgery with careful planning & maintenance & the right genetics but that takes planning for 10-20 years from when you start dabbling & clinic shopping.
- some of our genetics mean surgery may be our best option at some stage & then ongoing maintenance

What’s missing from the equation? The unspoken part?

All of the above is a lot of effort, money and pressure.

As with travel in the days gone by, renovations & other forms of wealth, good work takes more than you may realise or want to save for.

As with health for the ageing body, the is an ongoing work to maintain.

Lastly, not acetone wants to look 40 at 60, 65 or 70. Many are grandmothers & have no desire to be seen as “sisters” with their daughters.

So yes transparency is wonderful because it acknowledges the effort it takes to continue to age beautifully.

And it also helps you understand if you are someone to whom this is *enough* of a priority to make the effort.

That’s what true informed consent involves. Not “lunchtime” specials.

So following on from my post yesterday… Quieting the internal judgement and hate, especially if you’re a girl is an ongo...
19/06/2025

So following on from my post yesterday…

Quieting the internal judgement and hate, especially if you’re a girl is an ongoing lifelong process. And that’s ok. But recognise it when it is happening so you don’t contribute to it too.

Sometimes that means taking less selfies especially in unflattering lighting.

Sometimes it means being guided by your chosen expert and not crowdsourcing opinions, or jumping online for “relief” when you feel anxious & going rogue on the treatment plan…

Sometimes it means taking a pause.

Ultimately, & if you choose to do it, is an ongoing longterm commitment. It is meant to bring you mostly joy and not add to your stress, worries and sense of “ugliness”.

So. After looking at and disliking the photos of me I went back to do some therapy on myself.
- I have lovely, mostly even toned skin that’s mostly a lifetime of sun avoidance.
- my face mostly moves in harmony when I’m not especially excited or animated.
- my face is mostly all in the same decade.

Ultimately, if I end up needing surgery I do… (which will be a want not a need) but for now, I’m headed in the right direction.

Lastly- this is why I invested in 5-figure photography in clinic and why I tell you to come in for reviews barring emergency; your selfies, like my selfies, are unreliable.

This is also why photography is an industry in its own right. Even celebrities and formal events go through hundreds of posed photographs to arrive at a mere handful that we like.

So. Go easy on yourself & recognise that the things in ourself that it’s so easy to fixate on, are often invisible to those who love us, or simply not that big a deal.

Do it for you, yes, but within limits don’t tip you into unhealthy focus on what may not even be true.

My almost 18 year old was so sad to read my post yesterday, she said “if I was the photographer at the event mum, I’d have taken photos only of you because you looked so cute.”

May we all have people in our lives who let us pursue our aesthetics goals despite thinking we are already more than cute enough.

Self acceptance is an inside job. Nowhere was this more apparent than when looking at the photo dump by following a tho...
18/06/2025

Self acceptance is an inside job.

Nowhere was this more apparent than when looking at the photo dump by following a thoroughly inspirational 6 days with .

Many have posted about the content & the aha moments.

I want to reflect today on the uncomfortable moments - for me- given the work I do in especially for women of a certain age and the fine fine line between wanting to age well that can all too easily tip into hate.

I think I look IRL like the selfie.

The candid photos through the 6 days say otherwise.

I dislike most of them, of me, when everyone else looks SO CUTE.

I showed them to my kids who think I look cute too… it’s taken me this long to post any of them. Why?

Self love is an inside job. I say it all the time to my patients, every week especially if I think they’re wanting what is physically not possible because we are humans, even if money was no object.

And yes, I’m not immune to those insidious thoughts when faced with the reality of what you all see when you look at me.

So I’m posting some of the least flattering, non curated photos of me as a reminder- to myself and to you. By all means, strive for better for yourself as you age, AND never lose sight of the fact that :
- you have worth irrespective of that
- you are your own worst critic and enemy.

It’s ok to want to look our best AND it’s ok to also learn to love the parts of ourselves that make us cringe… especially when we can’t do much about it.

“First do no harm” doesn’t always go with what often passes for care when it comes to . It’s a topic close to my heart...
14/06/2025

“First do no harm” doesn’t always go with what often passes for care when it comes to .

It’s a topic close to my heart because even colleagues, who I’d have thought would know better, fall prey to treating this speciality of medicine as “just beauty on demand” with no formal assessment, no diagnosis , no plan & often, no exclusivity between them and their doctor/clinician.

🤯

Equally predatory is preying on young women leading up to weddings especially when there’s little to fix, correct or improve, beyond *possibly* .

You will likely never be this beautiful ever again…

So my job, on a weekly basis is the tightrope between assessing concerns & whether I can help you or if it’s better you wait.

Equally assessing your psychological health when it comes to dealing with the common (& rare) side effects of - time to results, bruising, lumps and bumps and yes, perception drift.

Equally, if you ever want surgery, is there a reliable record including photos, of what was done to share with your surgeon?

Like ALL medical care, there should be a clear process - including for referrals- that’s mostly bypassed at present & a lot of pressure for young people, who fall prey to social media trends, to rush in.

I work differently. I’m your Asian Aunty; your surrogate mummy who tells you to stop; wait; do you really need it? Can you finance it? Are you mentally ready?

If you don’t ✔️ all boxes, I often say no… I’m watching out for you even if that means angering you.

Seriously gurl, I get it AND unless there’s stuff to improve objectively, let’s focus on .

The long awaited guidelines by are apparently out & while it seems like a lot is worse… it’s not really. Mandating mini...
02/06/2025

The long awaited guidelines by are apparently out & while it seems like a lot is worse… it’s not really.

Mandating minimum 12 months of general experience as a nurse or dentist before entering is a no brainer & not especially outrageous…

The requirements for additional training hints at this extra training but doesn’t actually go any further…

If anyone can find the guidelines pls share with me… on the face of it it’s mostly still business as usual. Am I wrong?

Healthcare on every level is in trouble… but also pple in other countries are regularly shocked to hear how many rules and regs we have ostensibly for patient safety… it’s a strange time to work in medicine…

I posted some fun photos by AI of famous people if they didn’t have $$$ to spend on their faces and bodies. Someone comm...
26/05/2025

I posted some fun photos by AI of famous people if they didn’t have $$$ to spend on their faces and bodies.

Someone commented that Jen Aniston, only 7 years her senior, doesn’t look 56 but at least 70.

I love using comments to educate. In this case:
- how we age is dependent on so many factors. No two faces will age the same or the same way.
- are as mostly about but they can also be about & overactive muscles especially with age
- I’ve seen people as young as 23 with deepest wrinkles & two of my patients shown here with deep wrinkles at 41 and 49 respectively ie well < 70
- how we will age has less to do with a number and a lot more to do with :
- genetics especially bone structure
- stable weight
- skin colour & ethnicity
- lifestyle : & more.

Jen Aniston I think, looks like many 56 year olds who’ve not had access to & haven’t looked after their skin or done so minimally.

Her wrinkles aren’t especially deep for 56.

The reason we may think she looks much older :
- we are comparing her to our own age & how it looks for us
- we may be getting help even if it’s ad hoc or for single issue eg for lines and wrinkles.

Regardless this is not an unusually aged projection of a 56 yo face.

It’s ok to normalise typical ageing in the absence of a fair bit of consistent effort & commitment.

We are in a cost of living crisis right now post Covid globally. And yet we also are living longer and most of us want t...
25/05/2025

We are in a cost of living crisis right now post Covid globally.

And yet we also are living longer and most of us want to age on our terms- physically independent but also liking how we look as we age.

One of my patients last week put it this way “I want to look hot in the nursing home.”

Maybe because is such an unregulated industry globally, people routinely fall into the trap of crowdsourcing treatments from peers who know no better than them; or choosing based first on price in a way we’d never do for comparable optional services eg plastic surgery or orthodontics.

It takes time, effort, discipline and yes money to continue to age well especially physically.

So if it’s important to you there’s no other way around it & my advice is to start and then follow the plan.

It gets to a point where surgery may be your best option & that age varies for each of us.

In the meantime, I stumbled across this - as several of my patients have said now, done well is looking to be the next marker of wealth & privilege; over time they notice that peers who’ve had nothing begin to look (age appropriately) older while committing to a regular plan of maintenance slows the ageing process down over time.

You do you, as long as you understand and accept what you’re choosing based on your priorities and temperament.

I love it when people, especially celebrities are open about the work they’ve had done. Make no mistake, looking good as...
25/05/2025

I love it when people, especially celebrities are open about the work they’ve had done.

Make no mistake, looking good as we age takes a serious degree of planning, effort, commitment & yes, money.

In Kris’ case it seems she had at least one prior facelift ~ 2011 at age 55 and a more recent one at age 69. It seems beautiful comprehensive work that involves all the typical features of beyond “just” a sagging lower face.

It’s exquisite work by her surgeon & demonstrates that for true lift, only surgery works.

But the rest - texture, if needed, is all involved to varying degrees to achieve results like these.

It’s beautiful work & it’s surgery. Non surgical work cannot achieve this & it’s so important to recognise that if you decide to do something, the longer you delay starting, the more likely you’ll end up being “surgery-only” in addition to the rest of the non surgical work.

So start as you mean to go on & begin with someone who can guide you for today & for years to come.

Equally, understand what your own tolerance is- some of us are not wired for not just due to cost but also downtime, uncertainty, healing, risk etc.

It’s not “just” beauty.

Sometimes I forget that it’s ok to be different & to remind people if they forget, that I’m wired differently so they do...
23/05/2025

Sometimes I forget that it’s ok to be different & to remind people if they forget, that I’m wired differently so they don’t feel offended.

- eg if you catch me mid consult, I can be abrupt.
- eg if you catch me on an unexpected phone call I wasn’t expecting I might be curt (I don’t do well on forms of communication where I can’t see body language & hear tone; I didn’t realise this was a thing till a psychologist colleague said it nearly ended his relationship in the early days)
- in consultation I’m 💯 focused on you; the flip side of that? Barring emergency/time sensitive stuff I want to see you to review a concern.
- I underwent weekly psychotherapy for ~ 3 years 2018- 2020 to help me with my trauma related PTSD, anxiety and depression (I was suicidal for some years). It’s why I trained in mental health ~ 2011 because I know firsthand the impact it can have on life & our important relationships.
- I don’t post nor share about my kids or impt relationships because they’re private.
- when anxious i’ve had to learn to wait till I’m calm to take action. Words and actions done in a moment of anger/upset still land painfully.
- my kids are my biggest mirror of what still needs work
- I learnt raising 4 kids solo that self care was non negotiable & important for me & for them to watch.
- any relationship worth having will have conflict; rupture and repair are the foundations of all good relationships but most of us avoid this & risk repeating the cycle over and over.

I take my work very seriously so it tires me out emotionally.

And like all drs I take it very personally if someone says I didn’t care for them.

Address

2 Martin Place
Sydney, NSW
2000

Opening Hours

Wednesday 10am - 5pm
Thursday 10am - 5pm
Friday 9am - 3pm
Saturday 9am - 1pm

Website

Alerts

Be the first to know and let us send you an email when Dr Imaan Joshi posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Dr Imaan Joshi:

Shortcuts

Share