Top 10 List: Qualities of a Really Good Cosmetic Injectables Practice

Dr. Kevin Johnson’s Advanced Aesthetics

Neuromodulators likeDysport® and dermal fillers like Restylane® and Perlane® are wildly popular worldwide.
According to most research of cosmetic trends worldwide, both of these two entirely different treatments are annually the most commonly performed, everywhere.
In my opinion, the reason people, including my dermal filler and Dysport patients in Coeur d’Alene, like these treatments is their immediate, reliable and reproducible results. This is why we like to use these tools so much in our practice, and our patients love the results.
As a cosmetic surgeon it is most gratifying to be able to perform a liquid facelift procedure in under an hour that reveals immediate, look-in-the-mirror, “holy cow”, “WOW!” results for our patients.
The challenge for patients is to find a safe, reliable, cost effective and ethical place to perform this popular treatment. As with any cosmetic procedure, it is important to feel comfortable with not only the practice and office staff caring for you, but also the person performing your injections.
I am a true believer that cosmetic medicine is a multidisciplinary specialty and all types of backgrounds contribute to the field. But performing cosmetic injections on patients is the practice of medicine. And, these products are only available by prescription.
Here comes the controversial statement –
Although it is legal and ethical for all physicians and nurses to perform cosmetic injections, not all physicians and nurses really perform injectables well.
What are best practices when it comes to cosmetic injectables? A provider can say they are really good at injectables, have been injecting people for a long time, and inject a lot of product, but not be really good at it. I realize the term “good” is partially subjective because the result of this treatment is ultimately what our patients are paying for. But, what makes a cosmetic injectable practice and a provider really good at injectables?

Here is my top 10 list:

  1. A good knowledge of functional facial anatomy including blood supply, muscular and nerve function.
  2. Understand the common (and uncommon) changes associated with facial aging and listen to your patient’s concerns.
  3. Have the ability to diagnose conditions that will benefit from injectables as well as have the ability to recognize when to say “no” if a treatment is not indicated.
  4. Have the ability to inject products that make visible, but subtle, changes in facial appearance that restores a more youthful look….and know when to stop.
  5. Perform the treatment in the most economical way for each patient using the best products possible indicated for that patient.
  6. Have good follow-up evaluation in order to make necessary corrections.
  7. Be able to treat any complication that might occur quickly and correctly.
  8. Have a physician involved in medical evaluation, diagnosis and prescribing treatment and performing follow up for EVERY patient before a needle ever touches a patient.
  9. Have good policies about handling the products in the office with safety.
  10. Have a policy about providers’ “self-injecting”.

Being really good at fillers isn’t about “filling-in” creases and cracks anymore. The understanding of what fillers can do and how they are being used currently in 2014 is really important in getting amazing results with these products. This is reinforced by package insert warnings that assert they should only be used by physicians who have appropriate experience and who are knowledgeable about facial anatomy and the product for use in deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation.”
Injectable cosmetics is an art form, therefore, personal taste of the injector plays a huge role in the result being sought after in treatment. One last word of warning about choosing a provider is to take a look at your injector’s face. Since many injectors use the products they inject, their face holds some of the artificial enhancements that they consider “pretty”. Do they look overdone, artificial, frozen or too plumped up for your personal taste? If they do, chances are that you will also be encouraged to achieve that look unless you have the sophistication and courage to explain exactly what you’re looking for with your injectable treatment.

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