Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_19_библиотеки_им_акад_М_И_Перельмана

their physical appearance. Emotional terms are critical to notate as it can help understand the emotions behind the patients aging process and give the injector further insight into the possibility of some underlying body dysmor­phia. The psychological well-being of confidence, distress, self-esteem, and self-consciousness are all emotional hurdles to the patient’s interpretation of the esthetic outcome’s success. Injectors can hit a home run, but if the patient is not willing or capable of seeing their beauty, the harmonious, bal­anced, and beautiful outcome will be wasted. Patients long to feel normal in their skin at all ages. At age 30, patients will pick apart their flaws and will not appreciate their beauty until a decade later. When the patient turns 40, they long to go back to the beautiful and youthful image of 10 years ago. It is not easy to appreciate what we have until we do not have it any longer. After the patient has been augmented, the flip side of this coin is that they are now uncomfortable in their new face, and it can take them a few days to get used to it.

the pictures are not consistent, this is not a useful tool. Note-taking is essen­tial during the consultative process. Watch their body language, which areas do they touch most frequently. Listen to their word choices, especially the words that are emotionally charged, such as, “ I look sad,” “I look old,” “I look like my mother.” The word sad, old, and mother are critical emotional elements to the successful development of a treatment plan. These are the three key emotional trigger words related to what needs to be changed in the patient’s mind. With the syringe, injectors are changing things both physically and emotionally. The syringe’s success is directly connected to an injector’s ability to get inside the head of the patient and understand them psychologically while figuring out the emotional motivators and hang-ups. If someone states that they fear they will look like their mother, ask them for a picture of their mother and have them point out their fears. Beauty is in the eyes of the beholder. Figuring out what beauty means to every patient will be the key to success and of course, in combination with award-winning results. Most injectors start with neuromodulation then branch off to filler, chemical peels, lasers, and the addition of esthetics services to provide lashes and facials. Even when in the infancy stages, a wholesome understanding of aging and treatment options should be understood. The patients signed con­sent long before they got into the treatment chair, but now it is time to have a verbal consent. The consult’s consent portion is when the products, pro­cedures, goals, risks, benefits, maintenance, and cost are all verbally mapped out. The written consent and verbal consent go hand in hand. In order to be genuinely informed, one must first be educated. Take the time to educate the patient to be genuinely informed, so their signature has more merit on the consent. As we become experts in the industry, we can lose detailed educational components to the treatment plan. Patients are well educated these days and have already done some homework on Google and other social media platforms. They have an agenda and a plan of their own before they even walk in the door. At times, it can take real rewinding to properly educate and inform the patient about what is best for them, not what is best for their friends or family members. It is common for patients to think because a friend had filler in their chin and that they also need filler in their chin. Figuring out what the patient’s perception of beauty is difficult. The patient’s friend who had the chin filler probably looks great, so now the patient also wants to look great. It is up to the injector to be the expert and figure out which treatment is best for them to look great. Patients will hear what they want and retain about 10% of what was said.

uncontrollable. The patient will often ask for neuromodulation of the “11 lines” in their upper face. The well-informed injector realizes how and why the lines arrived, but most often, the patient does not understand the phys­iological changes. Here is where it is essential to properly consult the patient to set realistic expectations for the treatment. When treating the dreaded 11 lines in-between, the eyes ask the patient if they want the static line or the dynamic lines gone. Keep in mind; the patient most likely will not understand static versus dynamic, so it will be necessary to use words like at rest or in animation. If the patient is treated with neuromodulation in the glabellar region and wanted the static line gone, they will be unhappy with their neuromodulation results. Neuromodulation is working on the muscle, not the skin. There can, however, be a secondary effect of smooth­ing of the skin, but that is not the intended purpose of neuromodulation. Neuromodulation stops the muscle from compressing the skin and breaking it down, further exacerbating the static rhytids. More often, the static lines in the glabellar region are deep and challenging to get rid of, so injectors must counsel the patients on what neuromodulation can genuinely achieve. In the case of a patient with static rhytids, neuromodulation should be done to ini­tiate a preventative plan that will prevent the further breakdown of the skin in that area by the blockade of the muscle. After neuromodulation has been initiated, then it is appropriate to explore resurfacing or collagen inducing therapies.