Dr Frances

It’s shortly before 9am on a weekday when I arrive in front of the entrance to the private London dermatology practice of Dr Frances Prenna Jones. The cleaner is outside, busily scrubbing away at the black tiles on the steps, polishing them to an almost military level of shininess. Other than that, though, the entrance, even the building itself, is nothing remarkable, forming part of a typical Victorian mews in the heart of Mayfair. Inside, it’s all very sleek: a narrow, four-storey house with white walls and dark wood floorboards and a simple reception on the first floor. This is control central for the Doctor – for that’s how her staff refers to her: “The Doctor is running late,” “The Doctor is a few minutes away,” “The Doctor is ready for you.”

In truth, the people who know her well refer to her simply as Frances, so it’s not that she’s a stand-on-ceremony kind of a person. But it does add an air of formality to the place, and it also helps to keep Frances the woman apart from Prenna Jones the cosmetic doctor (though ‘anti-ageing expert’ is the term she’d prefer), maintaining a touch of personal mystery amid the needles and the pulsing light rays.

For Frances is something of an enigma, so much so that before we meet, it’s impossible for me to find much written about her. Yet this is a woman who is at the very epicentre of the new approach to cosmetic dermatology – an easy-does-it attitude to Botox, fillers and everything else between and around them. She represents the preference for a natural look over reshaping a face just because you can and not because you should. In the short space of a single decade, Frances has built up a reputation for excellence and a stellar client list that includes several TV personalities, singers Sharleen Spiteri and Natalie Imbruglia, the world-famous make-up artist Pat McGrath, and, allegedly at least, Kate Moss.

So I call a couple of beauty editors to see if they can shed some light on the enigma that is Frances Prenna Jones. One describes her as “blunt and brilliant”, another as “very shy and nervous”. “But she’s very knowledgeable,” they add – “someone here had rosacea, and in one session she cracked it. She has flawless skin and really is a good endorsement for her own work. Oh, and her clothes are a-mazing!” The same editor also warns that Frances is a stickler for punctuality, recounting a story that Naomi Campbell once showed up late for an appointment and missed it – no second chance, no poaching someone else’s slot. Frances herself later tells me she is “very regimented” in the way she runs her clinic; she puts this way of working down to her training in the NHS. “It’s about the way you work, every day prioritising every decision, and so I’m very, you know...” She snaps her fingers – click, click, click. Nor does she travel to see clients. “I literally don’t have time in my day.” She likens her endless appointments – starting at 10am and finishing at 8pm each day – to speed dating, but you’ll still need to book six to 12 weeks in advance if you want a consultation.

When I arrive for our interview, the woman herself is waiting for me in her office-cum-treatment room on the ground floor. She’s not quite what I expect from the descriptions; she’s warmer and more welcoming. “I’m a nervous wreck,” she says. I assume she’s talking about the impending interview, but the nerves turn out to be the result of a drive through dense traffic from her north London home, which she shares with her two dachshunds.

She’s petite, at 152cm, but seems taller, courtesy of a pair of black high-wedged Fendi boots. She’s also wearing a vintage black velvet Byblos dress with a fitted bodice – she always wears black to work – and a black Hermès Birkin bag sits on a shelf behind her. With her pale skin and her blonde, almost Nordic hair, which is simply scrunched back, she’s strikingly, classically attractive. Her age, appropriately enough, is indeterminate: she could be anywhere from mid-30s to late 40s. For her part, she will never divulge it. Her face isn’t frozen but animated, and there’s none of the waxiness or newborn sheen to her complexion so often seen on professionals who wield Botox and filler syringes.

Cosmetic dermatology was not part of Frances’s original life plan; she’d wanted to go to art college. She had a change of heart at 16; as she’s the daughter of two doctors, it was perhaps inevitable that she’d follow in their footsteps. “The thing about medicine is, I’d recommend it for anybody who’s not quite sure what they want to do,” she says. “It’s quite a long course, and there are so many sub-specialities within it that I think anyone could find their niche as they go.” Initially, she thought she’d plump for psychiatry, but she became disillusioned with the medication side of things and ended up specialising in cardiology. “I loved internal medicine, because it appealed to the geekiness in me – it’s the fix-it part of medicine, and I liked the kind of cut and thrust of it, the adrenalin rush.”

Eventually, though, the pressure took its toll on Frances. “After a while, I just wasn’t actually sure I could do this for the rest of my life. You get that call at 2 o’clock in the morning, you know, ‘Can you come in and do an angioplasty?’ and you feel, ‘Ugh!’ And when you start to feel like that, then it’s time to get out. I wasn’t sure what to do with myself after that. I literally just stopped.”

I wonder if she’s prone to workaholism. She sighs. “I’m a perfectionist. I think most doctors have got a bit of OCD. I think that’s normal. When you’re at medical school you don’t recognise it, because everybody’s the same as you. It’s only when you come out of that scenario and have to work with other people that you realise they don’t work the same way you do – and it’s kind of irritating.”

It was luck that led her to her current field, she says. She’d decided to do another degree, for which she studied part time. “I didn’t really have a job, and a friend of mine who was an anaesthetist for a whole pile of plastic surgeons said to me, ‘You know, Frances, you’d be really good at all that aesthetic stuff that’s coming through. It would appeal to you, and you’ve also got that medical background.’ So I thought I’d give it a go. This is going back ten years or so; at the time there weren’t courses that you could go on. So I went off to the States, to South America and to Europe to watch what other people were doing and sort of taught myself really.”

Around the same time, the UK pharmacy chain Boots headhunted Frances to help it set up its laser clinics, and she got interested in skincare. So she set up her own small private dermatology practice on Harley Street in London. It was about six years ago, when she was asked to give a lecture to some plastic surgery trainees, that she realised just how much she’d learnt. “I was a bit nervous. I thought, ‘What am I going to be able to teach them?’ I remember walking into the lecture centre at the Royal Society of Medicine, filled with professors, and I thought to myself, ‘Oh, whoopsie!’ But halfway through it, I realised that they didn’t know anything that I was talking about.”

It was only then that it dawned on her that she was at the forefront of her specialism. It was also the point at which her business grew. Frances relocated from Harley Street to the heart of Mayfair, where she has come to be regarded as the go-to expert in external and internal anti-ageing.

Part of this success lies in the fact that Frances isn’t known for doing just one thing or creating a certain look but for being practical and well informed. She championed red light therapy to treat skin complaints when it was first available and played a key role in making the treatment mainstream. But that isn’t all that defines her. She’s also known for combining of treatments to clear up skin – one week a light peel, perhaps, and the next some intense pulsed light to tighten pores or improve skin texture – spreading her mantra of ‘age maintenance’ as she goes, working her magic on everything from acne to cellulite, scars to spider veins. Her menu also includes the things that attract column inches, such as fillers and Botox, but she has forged her own approach. Frances thinks long-term with treatments – and her patients’ faces.

She’s launched her own product line, too: a highly focused range of just three products, Clean & Prepare (a cleanser), Formula 2006 (a hero product for skin) and Formula 2006+ (a booster for photo-aged skin). She describes the venture as completely indulgent. “If I’d sat in a business meeting at Estée Lauder, it would never have happened, as it’s all about what I want to put in a skin care line – completely narcissistic.”

So now here she is, drinking her rooibos tea (no milk) from a white cup and saucer in her pristine treatment room. Although she looks composed, she does, when carried away by her topic, talk almost without punctuation. She twice mentions that old colleagues refer to her as “the quack” but notes that now “they all want something done – they’re queuing up. Now they see that what I do does make a difference. I know I’m not performing life-saving brain surgery, but I think you do make a difference to people’s lives.”

Frances doesn’t consider herself to be blunt, more a straight talker. “I know that some of my colleagues can be very confrontational – the break-’em-down-to-build-’em-up routine. I don’t do that; I don’t tap into that psychology. I think it’s about making people feel good about themselves, so I’d never criticise. But I think I’m very direct, insofar as ‘This is the problem, and this is what we’re going to do.’ I don’t namby-pamby around. I’m not interested in doing a treatment if I don’t think it’s going to work or if I don’t think it’s the best thing for somebody. From that point of view, I do say no to people. I treat people the way I’d like to be treated myself, and I’d rather somebody said to me, ‘Honestly, you don’t need it.’”

That’s the thing, I say to her: people go too far. They lose sight of reality. “I’ve thought about this a lot,” she says, “and I think you can get into a group of friends and if everybody looks one particular way, you gradually suddenly start to think that’s the norm.” And yet, I say, all too often doctors seem happy to cater to it, to keep injecting. “You could argue I should do whatever people want, and, well, maybe I should, but I can’t. Personally, I would want somebody to say to me, ‘Look, Frances, that’s enough now. Not pretty anymore. You’re just starting to look odd.’”

Sometimes, she says, the best thing she can do for a client is nothing at all. “Sometimes you just have to stop. I have one client whom I just adore, who was once a great beauty and now looks decidedly odd. Every time she comes, I do nothing interventive, because we’re waiting for a previous procedure to wear off. But each time, I tell her how fabulous she looks. It’s the easiest treatment in the world for me! There are things you can undo, there are things you can dissolve, and some just need time to wear off. Occasionally, there is nothing you can do. I think that’s very sad

It isn’t just patients who can go too far, either. “Even within my profession – that’s scary. When I go to the American Academy of Dermatology or wherever and it’s a venue I don’t know, I’ll say to the taxi driver as I’m getting there, ‘Just follow the freaks!’ And you can see them, particularly in the States, where they just have a different perception of beauty.”

It’s a powerful position these cosmetic dermatologists hold, shaping our faces and our perceptions of beauty and age, I suggest. “Totally, it totally is,” says Frances. “I guess there’s an individual aesthetic of what you perceive to be attractive, and you just have to hope that other people see it your way.”

That said, she’s not in the business of creating a cookie-cutter ‘Frances face’. “You could end up producing a whole pile of Stepford Wives if you wanted. But I think people have got to own a little bit of what they see in the mirror,” she says. “I divide the face, or the body for that matter, into what I call the canvas – the skin – and the gross anatomy – that’s gross as in structure – and say to people, ‘You can have the best structure in the world, but if the canvas looks rubbish the structure doesn’t matter.’ Of course, everybody’s canvas is different, and it’s all about making it look fantastic with treatments. What I try to do is to look at each person separately and think what would look nice on them. That’s probably what I find the most tiring, because you have to really concentrate on each person. Most of our patients don’t want to look ten years younger; they just want to look good for their age.”

A beauty journalist myself, I admit to scepticism about doing anything at all. Yet I’m also concerned that a two-tiered beauty society is emerging between the dos and don’ts – and that I may start to look terrible next to those who subscribe. “It’s absolutely everybody’s choice,” Frances says. “I don’t think you should feel stigmatised in any way for doing something or not. I’m not in the business of talking people into things.” But yes, she says, she has partaken herself. And yes, she administers her own treatments. “There aren’t really many people I would let inject my face.”

She agrees, though, that what people are after can change according to their geographical location. For starters, when foreigners come to live in England, their perceptions change and they want the local look, not their home look; she has American and Italian clients who have toned things down since moving here.

To generalise, she says, the Brits are the worst at maintenance. The Russians “think you’re a bit kooky if you’re not doing something to maintain yourself.” And the mainland Europeans and North Americans also tend to have more work done. In terms of her own preferences, she says she thinks the Brazilians have got a good eye and like a sexy look, while New York is quite harsh – “I’d rather go LA than New York; actually I’d rather go neither” – and she agrees with me that LA can often be too puffy in the cheeks.

Frances’s aesthetic arena extends beyond fillers and frown lines. In the hiatus between quitting medicine and setting up her practice, she fulfilled her childhood ambition to go to art school. She took a degree in womenswear print at London’s Central Saint Martins College of Art & Design, where she developed her cutting skills from the medical to the sartorial and really honed her sensibilities.

And yes, her wardrobe does sound a-mazing, with a whole floor in her London house dedicated to its storage and a humidified closet being built at her weekend country house, which lies on the “Dorset-Wiltshire-Somerset border”. Her clothing collection, which includes Alexander McQueen, Marni, a lot of vintage Chanel and much more (though no jeans – “They don’t suit me; cheap ones, expensive ones, they don’t look good”), is ruthlessly organised, with everything labelled “to within an inch of its life” and colour-coordinated to boot, in a house that’s all white walls, bleached oak floors and Scandi style.

And it’s there, in that country house, where she says she loves to cook up a storm without following a recipe, that I suspect you’ll find the inner Frances, the one who’s clearly rollicking good fun. There, she’s planning mismatched crockery and 18th-century English oak furniture, alongside her custom-coloured Aga. “It’s channelling a very different part of my personality,” she says. “A less controlled part.” Ah, to have a consultation with the Doctor out in the country. Now, that would be a whole other story.