Five minutes with: Dr Sarah Hart

Dr Sarah Hart is an experienced appearance medicine physician and Fellow of the New Zealand College of Appearance Medicine. Dr Hart is one of only two New Zealand doctors on the international Botox Advisory Board and trains other doctors around the country in facial rejuvenation techniques. Dr Hart works at the Palm Clinic – a centre for varicose veins, liposuction, appearance medicine and laser treatments – in Auckland, New Zealand.

What inspired you to become an appearance medicine physician?

I was attracted by the artistic side of it – I love art and now I can combine that with medicine. I see the face as my canvas and needles as my paintbrushes. I can sculpt beautiful cheeks or lips using dermal fillers. And all in a safe, non-invasive way.

I wasn’t sure about doing appearance medicine at first – I thought it might be superficial, but it’s not at all. After working as a hospital doctor I began specialising in psychiatry and appearance medicine, and to my surprise I found with appearance medicine I could make dramatic improvements to my patients’ lives and wellbeing.

Our appearance influences how we feel about ourselves and are perceived by others. It is very satisfying to be able to help people make positive changes in their lives. I believe appearance medicine is the ideal way to look naturally better.

What do you like most about your job?

There is something very rewarding about making a few simple changes to a face that can transform the way the world treats people. I love bringing out a person’s natural beauty, especially when they are unaware how attractive they really are. The mutual good feeling I get from my patients is quite simply addictive.

Do you think that society places an unfair emphasis on beauty and looking 

Yes it is certainly unfair. But I believe humans are hardwired to favour beauty. It’s innate; an evolutionary adaptation to enable you to pick a healthy partner with strong genes. Most things considered beautiful, like sparkling eyes, glowing skin and glossy hair, are outward signs of good health and fertility. Those basic instincts will never change.

What are the most common treatments at Palm Clinic that you 

Botox is our number one treatment in the appearance medicine side of Palm Clinic. It’s a special interest for us. The clinic’s founder John Barrett started using Botox back in 1996 and is perhaps the most experienced specialist in Auckland. He taught me, and I am now a member of the International Botox Advisory Board which sets the guidelines in Australia and New Zealand on how Botox should be injected.

At Palm Clinic we are passionate about making Botox undetectable, so our patients look natural. I think that’s why we are so well known in this field.

Have you seen a shift in appearance medicine over the last few years?

Appearance medicine is one of the fastest developing areas of medicine. The understanding of facial ageing has taken giant steps forward in the last 10 years.

Treatments are more effective, safer and cheaper than ever before. There has also been a shift towards natural-looking results. In the early days there were a lot of “frozen” Botox faces and oversized “trout pouts”. New techniques and aesthetics have superseded this now. People who use appearance medicine should just look better – there needn’t be any other tell tale signs.

Is there any reason for people to be concerned about the safety of
 injecting foreign substances in their bodies, such as Botox or dermal

Botox is an incredibly well researched product with 40 years of safety data behind it. There have been over 10 million treatments worldwide now. Unlike other freely available medications we think of as harmless, like aspirin, there have never been any life-threatening side effect associated with cosmetic Botox use.

Personally I have been using myself Botox for over 10 years and it has done wonders for my skin. So no, I don’t have any concerns about its safety. But I recommend people make sure their practitioner really is using Botox, as there are other, less well researched botulinum toxin products out there.

With dermal fillers, there are a lot on the market but I don’t use them all. I prefer non-permanent fillers which are well-researched and made by reputable companies.

I only use dermal fillers made from collagen (a protein) or hyaluranon (a sugar) as these are gradually broken down by the body’s own natural enzymes. I would not use permanent fillers as there have been reports of reactions many years later.

Do you ever come across people who are strongly opposed to appearance 

Yes! Not in my client base, obviously, but I have very dear friends who openly express their disapproval of my chosen career, in the nicest possible way. Luckily they love me anyway and our friendship has nothing to do with my career.

I understand totally where they are coming from. The idea of thinking about what you look like or tampering with what nature gave you is not acceptable to everyone. However I strongly believe in making the most of what you’re given, whether that be with make-up, hair colour, dressing to suit yourself or a bit of Botox and dermal filler. 

You have worked on the TV series Ten Years Younger for the last three
 seasons. Do you think it really is possible to shave a decade off your age?

Most definitely yes. For most people, appearance medicine can take care of the skin and face part without too much trouble. Our procedures work synergistically, meaning they give a better result when used together.

The change you can make with Botox plus dermal fillers, high concentration skin care and skin lasers is really astounding. I also learned on the show that teeth, posture, figure, hairstyle, make-up and clothes all express your age to the world and can be altered if you wish to appear younger.

Youth recaptured

The film The Curious Case of Benjamin Button (2008) is the story of a man (played by Brad Pitt) who is born looking old and 
“ages backwards”. Watching the film, you see the ageing of the 
skin in reverse as Benjamin Button’s complexion eventually becomes more youthful, smooth, even, supple and luminous.

While the chance of this reverse ageing happening in reality is zero to none, scientists 
at LancĂ´me have pinpointed which genes are responsible for the complexion’s youthfulness.


The LancĂ´me Research Laboratories joined forces with eminent scientists in the field to try to detect the messages expressed by skin genes (the study of genomics) and the impact these genes have on protein synthesis (the study of proteomics).

The skin’s beauty and youthfulness are largely determined by genetic inheritance. How the skin reacts and changes over time is coded in the genes from birth. However, our parents are not entirely to blame.

Gene activity in the skin includes the formation of thousands of proteins, the basic substance from which skin is created. These proteins determine the skin’s density, elasticity, strength and appearance. 
As we age, the expression of 
some of these proteins changes and therefore so does the skin tissue. What the researchers at LancĂ´me wanted to know is which of these thousands of proteins determine youthfulness.

Studying the most superficial layer of the skin, the stratum corneum, using samples collected from young and older women, the researchers were able to compare proteins and identify which ones typified young skin. Analysing 1300 proteins, they discovered that running over the surface of young skin like a watermark is a specific protein profile – a bar code of sorts for youthful skin. Better still, they discovered this marker of youthfulness could be reactivated in aged skin.


The second major find was the discovery that specific genes code the proteins that give the skin its youthfulness. By screening 4400 genes (the genes normally expressed in the skin) the researchers at LancĂ´me analysed how gene expression in young skin compared with that in aged skin.

They concluded that young skin appears to be much more active than aged skin, with 
peak gene expression detected 
six hours after stimulation in young skin and after 30 hours in mature skin. What this shows is the skin reacts less efficiently 
with age to the various aggressors to which it may be subjected.


LancĂ´me has applied this knowledge and understanding of age-related changes in the skin to the development of its latest product, GĂ©nifique Youth Activator, a serum formulated with active substances that relaunch the activity of certain genes whose expressions have dwindled with age and thereby boost the synthesis of the proteins that characterise young skin.

“We now know that to look younger we have to boost gene activity and synthesise specific proteins in order to restore the bar code of youth to our skin,” says VĂ©ronique Delvigne, scientific director of LancĂ´me International.

Testing the formulation on 
100 women, it was shown that with regular use of GĂ©nifique Youth Activator (twice a day for 56 days) the proteins that characterise young skin reappear on the surface of the skin. What this means is the qualities associated with young skin start to reappear; the complexion becomes more smooth, even, toned, supple, hydrated and luminous. With ongoing use these improvements become more visible.


The LancĂ´me Research Laboratories put GĂ©nifique Youth Activator through a series of tests to prove its ability to recapture the appearance of youthful skin. Testing the formulation on 100 women, it was shown that with regular use of GĂ©nifique (twice a day for 56 days) the proteins that characterise young skin reappear on the skin’s surface. The complexion becomes more smooth, even, toned, supple, hydrated and luminous. Application is 
two or three drops twice daily. 
RRP $190 (30ml).