is it normal to have to go for a
touch-up hi I'm dr. Johnny today we're
talking about the touch-ups so touch-ups
and fillers and neuromodulators like
botox it's a very normal thing one thing
I wanted to address was that people now
have the perception and it's partly
through social media through Instagram
they believe that it's a very easy thing
you go in you get the treatment it's
always perfect and nothing ever needs to
be touched up and one of the conceptions
is when things do need a touch-up
it's the providers problem or fault one
of the things that's changed 20 years
ago I used to see everyone back at 2
weeks it was a normal thing it's how we
learned we didn't have all the
information we have today from pooling
the resources you go to a conference
there may have been 50 people and if you
were lucky to pool our knowledge now
hundreds of people go to and tend many
conferences every year you just don't go
to one so we learned a lot we got to see
back our treatments to know where we
should put things why is it now that
it's thought to be an error well like I
said social media but the other thing is
that there's so many clinics to go to
people say oh well doctor so-and-so or
the nurse over here didn't do a good job
I need a touch-up I'll just go to
another clinic and they bounced around
and it's so detrimental because the
provider never gets to know the anatomy
and the expectations and the nuances of
the specific patient so I thought I'd go
through five reasons of why touch-ups
are necessary and it shouldn't be
something to be frustrated about but I
you look at the 80% rule I say 80% will
be perfect and don't need a touch-up of
anything until their next treatment or
they need to come back about 20% would
be an industry average the people say
getting lip filler or getting
neuromodulator will need a touch-up or
want some added or even taken away so
let's go through the five reasons number
one and something that pee
don't think often about is that people
now have had treatments over time so a
filler if you're getting coming getting
your second third or fourth pillar or
neuromodulator like Botox and your say
you're getting a forehead which is a
lower dose and you see a provider for
your third or fourth time and they look
and see your movement and they know
what's there and they treat you
according to that some of that movement
may come back weeks one two three four
or five weeks or a month or two after
you left and it looks like you need a
touch-up when in reality you were
treated perfect at that time or with the
cheek filler
it was added up high and now the filler
below in two months is starting to go
away and so you really need that touched
up so as things wear off it's a moving
target and so that leads to
irregularities and changes in contour
that one might not like so there's one
reason number two especially with
neuromodulators variability of the
product so when you get a vial of Botox
or one of the other ones say there's a
hundred units in there it doesn't mean
there's exactly a hundred units there's
some variability we don't know what that
is we don't have that information but
there could be 90 it could be more
towards at 110 I think many of us
believe there's variability in the vials
themselves number three is variability
of storage neuromodulators most of them
are temperature specific so if you think
about the FedEx truck driving around
delivering them in the summer versus in
the winter in temperate climates the
storage can play a role when we get a
shipment here I'm nervous all the time
that we don't miss it or that it goes
directly in the fridge or freezer
storage and transport is the key factor
and a reason why you go to a reputable
place number four is variability of
response and many people don't think
about that but if you have any type of
treatment in your body vitamins or a
blood-pressure drug or anything else
there's always fine tuning in
variability of the body and it changes
over time so the response on several
months ago to it
treatment is going to inherently be
different a few months down the road
there's just variability of the body
integration of the fillers and
medications patients might be on or the
state of their body at the time is it
fatigue is it is the immune system amped
up is it low we're always changing into
the body by nature his variable response
to external stimuli and that includes
medication and implant such as fillers
so that's another variability number
five of course is expectations so when
people need touch-ups there's two things
with expectations number one is it's
never achieved so the patient is
something in their mind and they go home
endeavour was quite as large enough or
it was too large or it didn't quite last
as long okay or the fact is they get
used to it that's the second one so they
go home I want one vial or one and a
half miles in the lip area they see it
they love it and then it Forks I think
it all went away I don't see much the
reality is they got used to it it brings
a lot of attention in and then
everyone's used to including the patient
and they want a little bit more so
expectations play a big role so there's
five reasons the touch-ups are normal
but I wanted to make that point that
it's not a knee-jerk reaction that the
provider did something wrong or didn't
give enough understand all those five
reasons are things that might change and
might need a touchup or tune-up it's
very normal to have to go back to 80 20
year old think of that so let us know
what you think do you often have to go
for touch-ups do you like to a lot of
patients like to fine tune who make
things perfect let us know in the
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