Thank you for the question. You are asking a very reasonable question asking how do you
know in advance how good a doctor is with injectables. And in the substance in your
question, you are asking about Botox™ and injectable fillers and the question is how
do you know the doctor knows how and where to inject the injectable and that they are
not just shooting in.
Well, you’ve asked a question that certainly has some degree of controversy to it but I’ll
give you some guidelines as to how people come to me and how I have advised people about
choosing a doctor for any procedure whether it is injectables or anything else. A little
bit of background, I’m a board certified cosmetic surgeon and fellowship trained oculofacial
plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years.
I’ve been doing injectables for all this time and I was of the earliest doctors to
use Botox™ back in 1993. So certainly the question has relevance. In a lot of ways,
there is no doubt that you have been exposed to a lot of people, lot of physicians and
a lot of non-physicians offering this treatment all claiming the best, the cheapest and etc.
I can give you some idea as to how I would recommend this to you in determining what
works for you.
First of all, understand that everyone who does these treatments comes at this from a
different perspective. When it comes to the ideal outcome, what you want is someone who
has a good sense of artistry. They are creative and they understand proportion and you want
someone who has excellent technical skills, very good hands and someone who is committed
to precision and quality in the delivery process. That means maximizing sterility and comfort
for the patient using topical anesthetic or local anesthetic. And there are certain, I
think red flags that or I should say situations where you can be a little bit more options.
For one thing, I think that you are responding to ads where people are offering very cheap
injectables. I think that is a red flag. If you are getting some kind of incentive where
again it’s becoming the treatments becoming commoditized, I think that’s a red flag.
My feeling is that injectable treatments are in no way different in surgery. When you are
doing injections, you are going through skin barrier and therefore you are entering inside
the body. Now that means that you want to ensure that the doctor is not going to be
rushing, is communicating with you about what your desired outcome is and spending time
with you.
One of the challenges that people face today is they may find something compelling about
a physician and go there go to this doctor but if they find themselves sitting and the
doctor rushing through, invariably is not as good result as you can get. So again understanding
those parameters is very important. I would tell you that one of the best ways to make
the best decision is by seeing people who actually had treatment by this doctor and
what do I mean? Well, within a social group, there is a certain aesthetic that is consistent
of that social group so the people come to me very often are naturally attracted to my
style because I believe in a very natural appearance. I feel like preserving character
and maintaining a very natural youthful appearance and not an exaggerated appearance is what
resonates for me, resonates with my patients. Very often those patients have friends and
family members who are like minded and therefore they refer or their friends ask them do you
know somebody. And so word of mouth is certainly very important and very good.
I think that if you don’t have that benefit of getting someone through referral you may
want simply just do consultations and meet with the perspective doctor, get to know them,
get to know their style and listen to how they evaluate your appearance. When I see
my patients, one of the first things I do is I take photos and I review them with the
patients. I put them up and I ask the patients what bothers them the most. What do they see?
What are their concerns? Like any other procedures, I want to know what it is important to them,
what are their expectations, what are their desired results and beyond that, my job is
not only to listen and then provide the solution for what they want but also to educate them
about other options. Very often people are confused. It is so often that people ask me
what is the difference between Botox™ and Restylane. It is clear that part of the brand
names and they understand they both improve wrinkles but they don’t understand how they
improve wrinkles. So my role as their doctor is to educate and to give them a perspective.
Many times, we also have distinction in methods. For example, we perform a procedure where
which is basically adding volume to the structural level of the face. So this is very different
of what 99% of doctors do because what we are doing is placing the material with a very
specific, at the level of the bone structure and that is a unique approach to facial rejuvenation
and this also further expands the idea of collateral procedures. If someone wants to
have improvement in volume, they may also want improvement in skin quality. So it really
is education process. And what I feel is very important is that you choose someone who you
are comfortable with who will be with you along the duration.
How I see myself in for many of my patients is I’m their beauty doctor and I don’t
just do their eyelid surgery or their facelift surgery or their liposuction. I am also their
primary care doctor for their aesthetic needs in the big picture, in the long run. Very
often, they’re being inundated by a lot of information that is being promoted by talk
shows and radio commercials and things like that. My job is to educate them and put things
in perspective as to where the factors begin and where the hype ends. And so this is a
very important decision. So I think that certain things that I describe including both the
objective of the style and then your comfort level is the way to choose the doctor. This
probably means for you is to meet with different doctors and see what you are comfortable with.
You may just want to let the doctor you’ve met maybe do something and see how your experience
goes. I really don’t think that any doctor who offers injectable treatments is just “shooting
it in”. I think everyone comes into the table with the best impression to do a good
job but as the case for surgery, everyone has different styles, technical skills, and
ultimately it has met with your aesthetics.
So I hope that was helpful, I wish you the best of luck and thank you for your question!