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Aesthetics Practice Today

Respect for Social Downtime with Facial Injectables

Published December 2, 2014 3:46 PM by Mina Grasso
As we get into the holiday spirit, we find this time of year to be a bit busy in the clinic and challenging with the patient that we see. Media and advertising many times underplay social downtime. Although some patients don't mind letting others know what they had done, others prefer not to have to answer questions or make excuses for redness, bruising or swelling.

During the holidays some patients take advantage of the extra time off and use that time for healing post procedure. Others prefer less downtime due to holiday events and parties.

We do not like to underplay and respect each patient's time during the holiday season. Social downtime with facial injectables can be described as mild redness, swelling and bruising. This can affect feeling self-conscious at work or during social gatherings. I usually inquire about events in the upcoming few days.

Patients fear having to explain or cover up bruising, redness or swelling. I prefer to wait one to two weeks prior to an event to perform a procedure. In addition, patients are given a list of medication and herbal supplements to avoid in order to reduce the risk. When using facial injectables bruising is always a risk when using traditional needles due to the vascularity of the face. It's almost a wonder how one doesn't bruise after injectables due to the extent of vascularity. I will usually have the patient or an assistant hold pressure over the treatment site to minimize bruising post injection.

IPL or V-Beam has been an effective way to reduce bruising. Protocols for these procedures must be followed, because they are not without risk. Treating a "bruise" with a large target of blood can create more energy absorbed than desired, potentially leading to blistering and necrosis.

Post-procedure arnica, vitamin K and other herbal preparations may help prevent or shorten the duration of bruising or swelling. When using injectable fillers, the trend for safety and reduction of bruising using blunt cannulas is on the rise. If someone is attempting to avoid bruising as much as possible, I prefer to use the cannula. Precision to some degree especially in the lips, is somewhat sacrificed, but with much practice in using cannulas for lip injections beautiful full or hydrated lips can result. Again, I sometimes find that the tradeoff is potentially more swelling, especially if the skin is very thin. When injecting under the eyes using a blunt cannula, I like to make the patient aware of the probable swelling the following 2 mornings, especially after awakening.

Although patients may seem okay while they are in your clinic, bruising can certainly be a reason why a patient doesn't return to you. Although the patient may already have had photos and topical anesthetic ready to go, it's almost better to reschedule their procedure if their downtime seems unrealistic. Management of expectations and potential post-procedure social downtime can be addressed by communicating with the patient. Better communication and respect goes a long ways in customer service and patient satisfaction.

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    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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