Summer 2016 News: Facial Injectables and The Ideal Esthetic Consultation By GiGi Meinecke, DDS

Creating a top-notch consultation that fully informs both parties is essential to treatment success.

If you’re like most practitioners, you probably consider patient consultation visits but financially unrewarding. Yet this aspect of the treatment process is highly valued by the patient, and is a perfect opportunity to deliver a quality experience that demonstrates your expertise, inspires patient confidence, and creates a loyal and happy patient who will refer others to your practice (and increase your bottom line!)cosmetic dentistry

This article breaks down the esthetic consultation step by step, explains what to emphasize, and how best to use this time to your advantage.

Consultation Format
Like other standardized treatments, each consultation visit should be careful, thoughtful and uniform. Even if the consult is with a dental patient of record, you and your staff still need to prove yourselves in the world of facial injectables. Here are some points to consider:

  • Both practitioner and patient should leave the consultation feeling fully informed—this sets the stage for a positive patient outcome.
  • Following a blueprint for the esthetic consultation allows you and your staff to work in concert, where all the players:  your front desk, your assistant and you, know what’s expected of them. Not having a structured, quality, repeatable experience for all your potential facial injectable patients is both a missed opportunity and may expose you to unnecessary risk.

Let’s turn, now, to the anatomy of the esthetic consult.  We’ll dissect each element and explore the step-by-step approach.

The Esthetic Consult

Step 1: Paperwork

Have the appropriate medical history and esthetic consultation forms available to download on your website, or have the appointment coordinator email them to the patient before the appointment—procedural readiness is always reassuring.   Review the completed forms before seeing the patient.  Demonstrating knowledge about a patient’s medical history during the consultation inspires patient confidence.

Step 2: Diagnostic Photographs

Invest in training your staff how to take quality clinical photos, including: frontal, lateral, and oblique poses in animation and repose.

Step 3: Chief Complaint

Here are the main points to consider.

  • What are the patient’s perceived defects?
  • What do you think are the perceived defects?
  • Are the defects amenable to injectable treatments?
  • Can you agree on a treatment plan?
  • Is this a patient you want to treat?

The patient is focusing on related, but different, areas: What is the cost? Will it be painful? How much recovery time will I need? Are there potential complications? Will I look overdone?

Here are some questions that I find to be helpful when beginning a consultation:

  • What brings you in today?
  • What are the top 3 things that bother you about your face?
  • If money was no object and anything was possible, what would you correct?

You might observe areas that would lend themselves to treatment but they don’t fall within the patient’s immediate esthetic concerns (i.e. the chief complaint).  Unless these areas are related, meaning, they are the etiology of the patients concerns, they’re best left alone at the initial consultation. Upselling in the facial injectable market is ill-advised—both from a patient satisfaction point of view as well as being a legal liability.
Step 4: Photographic Evaluation and Patient Education

Now it is time to look together at the patient’s photos. Why use photos instead of a mirror? Not only does a mirror display a view that is backwards and one-dimensional (lateral and oblique views are invisible) but it can be quite distracting for the patient.

When looking at patient photographs, I find it helpful to discuss the face in thirds:  superior, middle, and lower. Remember to be tactful and sensitive when discussing any potential treatment needs — balancing any negative facial aspects with positive ones. The patient always knows what they want but usually have no idea what they need.  They’re aware of popular products from the media but do not know how these products work.  Much of the consultation is spent educating the patient about facial injectables and what they can achieve.

During this phase it’s valuable to educate your patient as to cause and effect of facial defects.  For example, a patient may be focused on their nasolabial folds that are actually the downstream effect of volume loss in their malar area. Now is the time to hand the patient a mirror.  Have them watch what happens to their NLF when you gently elevate their malar tissue.  This will help the patient understand how malar volume loss contributes to the NLF.

Beauty is defined by balance and symmetry and as we age we tend to become more asymmetric.  Everyone’s face has a fuller, and therefore, a more deflated half.  It’s critical to point this out to the patient before any treatment is agreed upon.

Step 5: Treat or Refer Decision

Be an active listener and observe a patient’s body language as they speak. This is critical when deciding whether or not to treat a patient.  Red flags include unrealistic or extreme expectations, proclamations of dissatisfaction with prior practitioners and results, and over-preoccupation with a certain facial feature. I repeat the following words at every course I teach:  “You’ll never regret the patient you didn’t treat.”

Step 6: What, Why and How

If you’ve decided this is a patient you can and want to treat and the patient is in agreement with your diagnosis of their chief complaint its time to deliver the what (neurotoxins, dermal fillers) why (static versus dynamic wrinkles, volume loss, etc.) and how (the product, treatment plan, and regimen).

Step 7: Q and A

This is your opportunity to address any lingering issues. The concept of esthetics is quite personal and subjective, so connecting with your patients is vital to avoiding problems down the road.

Many patients do some web education ahead of time.  They often know small bits and pieces of the anti-aging treatments available as well as industry buzz words.  Even if you don’t offer any of these ancillary treatments or cosmeceuticals in your office you’ll need to have at least a working knowledge of them. A deep anatomical understanding of the face, its aging process, and esthetics is also an indisputable advantage.

Be an active listener and observe a patient’s body language as they speak. This is critical when deciding whether or not to treat a patient.  Red flags include unrealistic or extreme expectations, proclamations of dissatisfaction with prior practitioners and results, and over-preoccupation with a certain facial feature. I repeat the following words at every course I teach:  “You’ll never regret the patient you didn’t treat.”

Step 6: What, Why and How

If you’ve decided this is a patient you can and want to treat and the patient is in agreement with your diagnosis of their chief complaint its time to deliver the what (neurotoxins, dermal fillers) why (static versus dynamic wrinkles, volume loss, etc.) and how (the product, treatment plan, and regimen).

Step 7: Q and A

This is your opportunity to address any lingering issues. The concept of esthetics is quite personal and subjective, so connecting with your patients is vital to avoiding problems down the road.

Many patients do some web education ahead of time.  They often know small bits and pieces of the anti-aging treatments available as well as industry buzz words.  Even if you don’t offer any of these ancillary treatments or cosmeceuticals in your office you’ll need to have at least a working knowledge of them. A deep anatomical understanding of the face, its aging process, and esthetics is also an indisputable advantage.

In Summary

The facial injectable market is crowded with estheticians, nurses, dermatologists, plastic surgeons, and even gynecologists all vying for the same patient population.  The initial consult is often where the patient’s decision whether or not to choose you as their facial injector is made.

Provide the experience that the patient deserves and collect the information you need.The consultation is an opportunity and you should use it.

Dr. Meinecke is immediate past president of the Maryland Academy of General Dentistry and currently serves on the Maryland State Dental Associations Legislative and Government Affairs Council.  Nationally, she is a spokesperson for the AGD and serves on their Legislative and Governmental Affairs Council.  Dr. Meinecke maintains a full time practice in Potomac, Maryland.

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