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Over the past several years, I have consulted thousands of patients on how to maintain and enhance their natural beauty.  While we always try to come up with the optimal aesthetic and budget conscious options for every single patient, I also try to make sure that my patients are not simply patients, but educated consumers.  Today, I would like to share with you a couple of pointers I usually discuss with my patients during these consultations.  Hopefully, this will make you, my reader, more aware of the potential pitfalls and will provide ideas on how to make your path to beauty rewarding and safe.

1. Obtain a thorough consultation prior to any work being done.  Before you even talk to the physician, evaluate the atmosphere you are in.  Is the staff polite?  Do they seem receptive to your questions and concerns, or are they abrupt and try to move on to the next task.  These little things usually reflect the general attitude in the practice and most importantly reflect the mentality of the captain of the ship, the physician, who will be working on you.  Try to have your questions answered during the consultation, and more importantly, evaluate the information given to you.  Ask yourself – Do you have a sense of professional environment where the attention is around you, the patient? Are they really listening to what YOU need and want or just trying to sell you everything they have in their armamentarium?

Always ask for a “before and after” portfolio.  What I usually recommend is to study the “before and afters” of the physician.  Do you like results?  If the answer is yes, chances are you will be happy with your own.  If you do not really feel like they are your cup of tea, move on.

2. Always know what is being injected in your face.  I see A LOT of patients that have had unknown substances put into every single part of their face and/or their body.   They do not know the names, the longevity, or the side effects of these substances.  While a complication could potentially happen with every single procedure, the probability of a problem is much higher with substances that are not Food and Drug Administration (FDA) approved.  No doubt, it could be very enticing to get injected with a French-sounding filler or to be told that it is only available in Europe or South America.  Yet, as an American trained physician, I can assure you that it is much better to let Europeans be leaders in the world of fashion or automobile manufacturing, but to avoid getting injected with substances imported from outside of the United States.

First, there is a reason why outside medications are not allowed here, in the US.  FDA has a very vigorous system of controls when allowing certain substances to be injected into the human body.  These medications have to be tested for YEARS in different environments, and their manufacturing is closely monitored.  The system is very different in Europe, and certainly in South America, Turkey, China, etc.  There are hundreds of different substances available, none of which have undergone even comparable safety evaluation.  Their production is just not controlled as strictly as it is here.

Secondly, a lot of injectables that are brought into the USA are not what they seem.  Let me explain: Most of us have heard or seen a nice row of stores in China Town selling counterfeit Louis Vuitton and Chanel bags.  Some of us even own one.  Those bags look good from far away, but upon close inspection, one can see the difference between a fake and the real deal.  Now imagine that instead of carrying this fake Louis Vuitton on your hand, somebody actually injects it under your skin.  I think most people would think twice before doing it.  Now those small differences that did not matter from a far begin to play an important role.  This is exactly what you are doing by allowing somebody to inject “imported” fillers.  So, unless a cosmetic product has been purchased via the official distributor, there is no guarantee that the Botox, Dysport, Juvederm or any other product you are getting is not manufactured in China or Turkey’s counterfeit shops. I encourage you to talk to your physician and make sure that the product being used came from the manufacturer and was not purchased from a much cheaper, outside source.

3. All aesthetic procedures have to be performed in a proper environment.  While it could be very enticing to save money and get injected at your local salon, resist the urge.  While it could be easier to get eyelid or facial surgery right in the doctor’s chair, avoid doing it. There are strict rules and regulations when it comes to performing the procedures properly. This especially applies to more invasive procedures like facial surgery or liposuction.  We have all heard stories of these procedures done in unsterile conditions in somebody’s basements. Even physicians often neglect the need to perform these procedures in sterile environment.

Here are some basic rules: Only get injected or operated on by a licensed COSMETIC physician. Do not let anybody with anything other than MD after their name perform any invasive procedures.  If a Registered Nurse or a Physician Assistant is doing an injection, he or she has to do it under physician’s supervision.  If you decide to undergo a surgical procedure, keep in mind that preoperative medical clearance is a must.   Moreover, I urge you to thoroughly investigate the location of your procedure.  As of 2009, all of the surgical procedures in a state of New York requiring ANY kind of anesthesia have to be performed in an accredited surgical facility.  A doctor’s “procedure room” or chair does not qualify.

As an inspector for AAAASF, an organization responsible for accreditation and overlooking surgical facilities in the USA, I visit other providers’ surgical suites all the time.  What I can tell you is that there are some excellent surgical suites in our city, but then, there are some in which I would not want to step a foot, let alone be operated on.   That is why I urge you to do your homework before any invasive procedures.

4. All skill is not equal in the world of cosmetic medicine.  I cannot tell you how many patients we see that come in with lumps and bumps due to improperly placed or chosen filler material; burns to their faces as a result of improperly used laser or chemical peel; or poorly created incision scars.  In today’s world, pediatricians, family docs, gynecologists, podiatrists, neurosurgeons, dentists and your hair dresser perform cosmetic procedures and speak with conviction and authority. That is why it is so important to UNDERSTAND what you are getting and why.  For example, certain fillers are only good for certain areas of the face, and while they will produce excellent results when properly used, the results can range from unsatisfying to dangerous when used improperly.  Neurotoxins like Botox or Dysport will do wonders for the facial wrinkles when used properly, but could mean months of anguish and discomfort if these substances are administered in a wrong muscle.

While it looks very simple to the uninformed outsider, plenty of knowledge and skill goes into any cosmetic procedure.  Thorough knowledge of anatomy, techniques, and indications are just the tip of the iceberg.

5. Finally, don’t forget about “aesthetics” in any aesthetic procedure. With our hectic lives, busy schedules, and limited budgets, we often forget the reason WHY we began thinking about cosmetic medicine or surgery.  It is to beautify ourselves, thus improving our quality of life. I truly believe that a cosmetic provider has to have a vision of the outcome on top of impeccable technique and skills.   Having a truly artistic eye is a skill that is very difficult to teach; that is why I encourage you to choose a provider who understands and appreciates the standards, parameters and nuances of human beauty.

In the meantime ask questions, read, and get multiple opinions. Most of all, live healthy and happily.  Please join us on Facebook at www.facebook.com/enhanceaestheticarts for updates, more information and monthly specials.  If you are interested in getting our monthly specials via email, please sign up at www.THE ENHANCERSNY.com