Laurence Anderson - cosmetic physician, GP, author, artist and filmmaker - could have been a neurosurgeon, might have been a fish farmer, but was never going to be a soldier.

A career strewn with declined opportunities has brought Anderson to a branch of medicine that indulges the vanity of the wealthy, mostly women aged 30 to 60, who feel in need of a little "maintenance".

If there is one consistency in Anderson's career it is his interest in aesthetics and, as long as he does not develop a taste for caricature, his patients can only benefit from his penchant for beauty and art.

As a teenager in South Africa, Anderson studied cell and environmental biology with a view to becoming a fish farmer, but he fled the country when he was called up to the army. He emigrated to New Zealand, where a dearth of courses in fish genetics forced him to study grasshopper genetics instead.

He graduated with honours in zoology, a masters in cytogenetics and an offer to sit for a PhD at Cambridge University. He never took it up."I handed in my thesis on my 21st birthday and I realised I hated every minute of what I was doing, and decided to become an artist," he says.

The experiment lasted only two years until, living in a three-walled garage and struggling to make a living, he gave it up to study medicine. He completed his degree, turned down offers to specialise in neurosurgery, geriatrics and orthopaedics and became a GP. He kept painting. Years later, when he was looking for extra stimulation outside general practice, he was drawn to cosmetics.

"Because I've been an artist before, I was always interested in the more cosmetic side of medicine," he says. "Throughout my years as a GP I was always taking off skin cancers, always striving to make neat, small scars and I got a reputation for that. I think it's good to help people's self-esteem by maximising their appearance - not by altering their appearance, but by maintaining what they have."

That is not to say that he advocates it for everybody. Girls as young as 17 have approached him for Botox or fillers for wrinkles. He has turned them down, a decision he struggles to reconcile against his generally non-judgemental philosophy.

"You have to strike a fine balance," Anderson says. "I don't think it's incumbent on doctors to play God or play in loco parentis and try to tell people how to run their lives. On the other hand, you have to be able to assist when someone has a fixation that's unhealthy."

Anderson realises that some sections of society view cosmetic surgery with suspicion, but he believes the present concern is similar to that once surrounding the Pill and television.

He has just written a second book, Looking Good, a guide to cosmetic medicine and surgery. His first, which was published in 1995 was on the subjects of pregnancy and childhood, he wrote and illustrated.

These days he is winding back his medical work to focus more on his creative side - painting and writing. He has recently had two short-film scripts optioned.

"I've never abandoned creativity and I'm trying to move back into it," he says, in a nod to the 21-year-old who turned down a Cambridge doctorate to paint. He adds: "I'm not giving up the day job."

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