How to perfect the cosmetic injectable consultation

Perfecting the cosmetic injectables consultation can be challenging. When offering in-office cosmetic procedures, the devil is in the details, according to one expert.

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“It is paramount that the clinician establish trust with the patient to help overcome their concerns,” says Vince Bertucci, M.D., F.R.C.P.C., co-director, Dermatologic Laser Surgery and Aesthetic Dermatology Fellowship at the University of Toronto, Canada.

Building trust is a multifaceted process that starts with understanding that providing excellent service does not equate to creating an exceptional experience. According to Dr. Bertucci, the experience begins long before patients set foot in the practice. First impressions are very important. Every touch point must be carefully analyzed.

“Great staff answering the phones who can credential the office and succinctly answer queries, and a website that reflects clinic culture and the experience and services provided therein are but a few of the crucial first steps in establishing patient trust,” he says.

At the start of the consultation, Dr. Bertucci says it is important that physicians walk into the room calmly and politely introduce themselves using the patient’s name. Finding a common connection often helps to break the ice and build rapport. It is then the task of the physician to thoughtfully explain the consultation process so that the patient feels comfortable and at ease.

Physicians must carefully listen to the patient to understand their cosmetic concerns to glean information about the patient's motivation and timing. Additionally, it is important to inquire about previous treatments and the patient's level of satisfaction with these. A patient that has been to multiple physicians and is not satisfied with any of the results should be approached with caution as they may have unrealistic expectations.

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After attentively listening to the patient and processing all this information, physicians then need to carefully observe the patient and see if their concerns and expectations are realistic.

“When contemplating a treatment plan for cosmetic patients, physicians should observe not just individual lines, wrinkles and folds, but should also assess the face as a whole to understand how all the parts fit together; thus, allowing for a more comprehensive approach and, ultimately, more natural results. Systematically considering the upper, middle and lower thirds of the face, the vertical fifths of the face, as well as harmony, balance, and proportion are critical when contemplating treatment options,” Dr. Bertucci says.

He suggests that physicians consider all therapeutic injectable options to address the patient’s cosmetic concerns starting from the forehead down to the neck, carefully weighing the options for each individual anatomical area and the impact it will have on other parts of the face.

According to Dr. Bertucci, a systematic approach with combination therapies is often the best route to help patients achieve their goals.

“After carefully assessing the face and considering the various options, treatments should be prioritized according to clinical impact allowing one to deliver the most meaningful results for any given budget. One of the benefits of performing a high impact treatment early on is that it helps enhance the patient’s confidence in the physician and permits the patient to better plan and prioritize future cosmetic treatments that align with their cosmetic goals,” Dr. Bertucci says.

Importantly, physicians also need to be able to distinguish between what the patient wants and what they actually need to achieve their cosmetic goals.

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According to Dr. Bertucci, it is very important to be able communicate this important distinction. This can often be achieved utilizing before and after photos of patients with similar concerns.

“For example, patients often come in saying they want their nasolabial folds treated. Although treating the nasolabial folds may provide improvement, in many cases, nasolabial folds originate from cheek volume loss or from sleeping face down. So, treating the cheeks oftentimes addresses the nasolabial folds while avoiding a simian appearance,” Dr. Bertucci says.

Educating the patient and explaining the interplay between the different areas of the face and how a suggested treatment plan would lead to cosmetic improvement that aligns with their cosmetic needs is paramount.

According to Dr. Bertucci, keeping the patient in the loop during every step of the process is requisite to building trust and avoids unwanted surprises from the first introduction to the last follow-up visit.

“The perfect cosmetic consultation is a continual work in progress and physicians have to adapt to the evolving challenges that patients bring. Feedback from patients is vital so that appropriate adjustments and fine tuning can be made and so that we can offer an ev en more exceptional experience,” Dr. Bertucci says.