“I always start by asking them what got them to the point where we’re having this conversation, what they started to notice, what they would like to change,” Hartman says. “It gives me a better idea of their mental state – there’s a big psychological component that goes into the decision to pursue cosmetic procedures.”
Understanding the sensitivity surrounding a patient’s insecurity allows for a more strategic and nuanced approach. And more importantly, allows the practitioner to avoid a potentially awkward conversation by building on a patient’s unrealistic goals in a thoughtful and empathetic way.
In these cases, Hartman chooses to “gently educate them about how their bone structure won’t support what they want, or how it will put their other features out of proportion, or how it’s just not a good idea. to do so much at a time because you’re going to stretch your skin and create problems for yourself later, but overall it’s definitely an opportunity to educate.”
What kind of putty will you be using and what is your technique?
For a first-time patient, it might seem overkill to ask for the exact type of filler, but for Rabach, it’s crucial because “the expectation of what the product can do really, really depends on the type of filler being used.” and in which region.
It divides the two classes of fillers into two categories: soluble and insoluble. Soluble fillers are formulations of hyaluronic acid, “which are like a big sugar molecule”, most commonly used in beginning patients, while non-soluble fillers are biostimulating and made up of a range of other materials, each with a different set of side effects, periods of impact and endurance.
Unlike skin from the collarbone down, the texture of facial skin is diverse and tender, with each area requiring a specific technique to administer.
Take, for example, the hypersensitive area under the eyes, says Rabach. “Those dark circles that we all have under our eyes most of the time, it’s not just that the skin is thin, but there are a lot of vessels under the eyes that show through the thin skin,” he explains. -she. “It’s an area that could be very bruised if you don’t use a cannula.”
Rabach describes a cannula as “a kind of blunt, flexible straw”, which should be used in sensitive areas that require less filling, but increased precision, while the traditional filling needle can be used for the cheeks, the chin or other larger areas.
What are the potential complications and what is your emergency plan?
“I consider a filler procedure to be one of the most high-risk procedures one can do,” says Goodarzi. “When you inject fillers – for the best of us and the worst of us injectors – there’s always a chance you could inject that occlusive gel into a blood vessel,” which could lead to necrosis skin in the area supported by the perforated blood vessel. , or blindness, if this blood vessel supplies the eye area.
