Comprehensive aesthetic consult boosts opportunity for positive outcomes

Maui, Hawaii - Several factors play intertwining roles in achieving a successful aesthetic consult. Actively engaging and connecting with the patient and finding out the patient’s real reasons for wanting to look more youthful are essential for improved aesthetic outcomes, according to an expert.

“The main focus in all of my aesthetic consults is to carefully seek out the real reason why the patient wants to look more youthful, not the stated reason,” says Kent B. Remington, M.D., Remington Laser Dermatology Centre, Calgary, Alberta. He spoke at MauiDerm 2014. “In my experience, the stated reason usually has nothing to do with the real reason for aesthetic improvement and many patients will do almost anything to achieve that aesthetic goal.”

Discovering a patient’s real reasons for aesthetic improvement are almost always associated with an emotional moment in the clinical consult, Dr. Remington says. This could include personal reasons, such as the desire to remain an object of interest for a younger-looking partner, or to keep a youthful and vibrant appearance in a competitive job market.

“There are an increasing number of women who hold higher positions in the job market, such as CEOs and lawyers, and they know intuitively that the job market is a youthful arena,” Dr. Remington says. “During their careers, some may have been bypassed for promotions or possibly have been as an older person. As a consequence of this, they want to look much younger because they know that they are in a very competitive youthful work environment, and seek to have that ‘edge’ over their competitors.”

Point out positive features

Once the real reason for the patient’s rejuvenation desires is established, Dr. Remington says he will refocus and identify the patient’s most positive physical characteristics and attributes, and then try to support, build upon and enhance them.

With the help of a mirror, he will carefully ask the patient to point out what they think are their most positive features about their face and then with the permission of the patient, Dr. Remington will then point out to them where he sees possible aesthetic enhancements and improvements could be achieved, naturally all within the limits of realistic expectations.

“Very often, both the patient’s and my own views and perspectives on what can be improved upon can be married together,” he says. “There is always some middle ground that we can agree upon and this is the first step towards achieving good aesthetic outcomes.”

Many patients will focus on a singular wrinkle or spot, Dr. Remington says, and falsely believe that addressing that particular cosmetic feature and/or performing a monotherapy on the aging face will result in a successful rejuvenation therapy to the face as a whole. According to Dr. Remington, it is absolutely paramount that the whole face of the patient be addressed when performing rejuvenation procedures in order to achieve a successful full-face rejuvenation outcome.

“All aesthetic physicians worldwide are plagued by patients who have a selective focus. One of my central goals during the aesthetic consult is to change the patient’s selective focus on monotherapy and from one area of the face to a full-face restoration project with the correct recipe for that individual patient,” he says.

Symmetry and balance

Beauty is often judged and evaluated on the basis of symmetry, balance and harmony. According to Dr. Remington, many patients will evaluate a certain face as “beautiful” because they view the face as a whole and do not concentrate on a specific characteristic of that face.

Along these lines, Dr. Remington performs rejuvenation procedures in his patients, which are typically multiple and include a mosaic of different fillers, neurotoxins and laser therapies. This allows him to comprehensively address the different aspects of the aging face, such as asymmetries, sagging skin, brow ptosis, dyschromias and general deflation of the facial skin and tissues.

Before any rejuvenation procedure is performed, all of Dr. Remington’s patients will also have at least 10 photographs taken in his dedicated camera room. During the aesthetic consult, the photos are taken as the patient looks relaxed, animated, smiling, and smiling spontaneously. The photographs will not only take the focus off a particular line or wrinkle a patient sees, Dr. Remington says, but it also will help to point out the positive characteristics of the patient’s face, and stress what can be done to support and enhance those good features. These concepts and issues are easy to show in the camera room’s high-resolution monitor rather than just a mirror.

The aging face should not be treated all at once, Dr. Remington says, but instead it should be restored similar to an antique painting - in a piecemeal, progressive and caring fashion. Different approaches should be employed in multiple sessions over time that ultimately will result in a natural-looking, youthful patient.

“The big key is to give time to your aesthetic patients. You need to connect and engage with your patient, which will instill trust,” Dr. Remington says. “Once you connect with them and understand what their genetics are, where they came from, what their job is and what they do, and what their real reasons are for desiring rejuvenation treatment, you can better address their concerns and achieve excellent aesthetic outcomes.”

Disclosures: Dr. Remington reports no relevant financial interests.