Q. There are a lot of fillers and neuromodulator products on the market. What are the differences?

A. If you are new to aesthetic medicine, the internet should be your first stop. Research both dermal fillers and neuromodulators. Go over the indications and read all you can about their abilities, strengths, and weaknesses. Reviews help, but beware of conflicting opinions from people with varying skill levels. Your research will prepare you to talk to reps about their products. Just a quick note that you can’t go wrong with products from major companies like Allergan, Galderma, and Revance.

For neuromodulators, BOTOX ®Cosmetic (onabotulinumtoxinA injection) is a great product. Made by Allergan, its name has become synonymous with facial aesthetics. Dysport® is another tried-and-true muscle relaxant made by Galderma. I use both and get excellent results. Keep in mind that neuromodulators are coming on the market all the time, so keep up with new releases!

For fillers, Galderma’s product, Sculptra®, is unbeatable for replenishing facial volume lost to aging, and stimulating collagen growth. It’s also great for what we term Brazilian Butt Lifts, (BBL’s),  which are growing in popularity.

Also, when purchasing any injectable, buy only from the company, and not a secondary source. Using black or grey-market products from countries other than your own is illegal, and you’ll receive no help from the manufacturer if you have an issue. Also, you could lose your license to practice. 

Q. I’m giving consults and advice but not getting appointments. Is it common to waste so much time on consultations?

A. Short answer: You’ll spend more time on consults in Aesthetic Medicine than “normal” medicine. This time is NOT wasted. A good percentage of them should become happy patients. But first, they need some education.

It’s taken me years to perfect a consultation system that works. It also allows me to develop genuine friendships with the vast majority of my patients. One of the biggest challenges “normal” practitioners have is adapting to this new paradigm of consulting. We are all too conditioned to the “normal” practice model of diagnosing, prescribing, and then on to the next patient. All Day Long……… This is a new world to you. Relax and enjoy making new friends!

Q. What makes a face beautiful? Are there any specific proportions that are used?

A. In a word, yes! From buildings to art (and faces), all beautiful objects are designed around Phi, which is named after the sculptor Phidias. He ascertained the human head, and more specifically, its face, is perfectly proportioned (and called the (Golden Ratio”). In raw numbers, this Golden Ratio is deemed “perfect” when the width times 1.618 is the height measurement. The midpoint position of the eyes, mouth, and nose locations are also figured in the 1.618 ratio. You can use this technique to get an idea of what is necessary to give your patient’s face a sense of balance, equilibrium, and what we call beauty. There are many articles on the internet with examples of the face and its features evaluated using Phi. It’s a fascinating topic!

Q. Are there any specific patient behaviors that would stop you from treating a patient?

A. Oh yes. And choosing your patients wisely can save you many sleepless nights. I’ve developed some personal guidelines that keep me from getting involved with patients I’d rather not touch.
First, what are their expectations? If they are unrealistic, simply tell them you can’t really achieve what they want.
Second, if they tell me a bunch of horror stories they’ve had with other Practitioners, I let them go somewhere else rather than include me in their next “tell-all.”

Third and last, if they exhibit Body Dysmorphic Disorder symptoms, I steer clear. It’s sad, but they need help that Aesthetic Medicine cannot give.

Bottom line? If your patient is a happy and pleasant person, you are almost guaranteed to have great results. And patients with great results bring their nice friends. Life tends to work that way!

Q. Do you take pictures of patients before treatment?

A. Absolutely. No exceptions. The photos are downloaded from my camera to a secure location. Each time they come in, I take another photo before I touch a patient. This protects me and my practice. Also, sometimes a patient will come in and say “I just can’t see any real change”. So I just take another quick shot of them. Then I load today’s photo on the computer and create a “before and after” side-by-side with their original. They are almost always stunned!  The strange reality is that you can see the difference, and so can their friends. But…. They have trouble seeing some changes since they look at their face daily. And the look on their faces when they see their before and after is priceless!

Q. How important is facial anatomy in Medical Aesthetics?
A. Knowledge of anatomy is essential. Patients can be harmed by improperly placed injections. All my training has facial anatomy as a primary foundation. Without a good understanding of anatomy, tissue necrosis or even blindness can occur. Remember, no technique is 100% safe. Even cannulas can cause bruising, occlusions, and even blindness.

Q. How much do your trainings cost?
A. Let’s start with an answer you never thought you’d hear! You don’t really need to hire me until you get the no-cost “on label” training offered by the pharmaceutical company. However, if you want to get started on the right foot, we can develop a planned training schedule together to hone your safety and practice skills. Just let me know how I can help. 

Now to answer your question about training cost, I’m sorry to use the old excuse of “it depends”. Various factors, such as your needs, past experience, and location, play into costs. I do train out of state; however, if your office is in Southeast Florida, there is less time and travel involved. Please contact me personally, and we’ll discuss your needs. I can then provide you with a written agreement detailing what we’ve discussed, including the exact investment.