Communication skills in aesthetics

Question 1

Patient comes into clinic with concerns of fine lines around her forehead and crow lines around her eyes. How would you start your consultation?

History of presenting complaint

Answer 1

Its important to ICE when taking history

-what are her primary concerns
-how long has she had this concern for
-does she ever find herself looking in the mirror
-what does she expect from this consultation

Question 2

What would you ask in aesthetic history?

Answer 2

-have they ever had aesthetic treatments done
-when and where was treatment done
-products used
-any adverse side effects

Question 3

What would you ask in past medical history?
-absolute contraindications
-relative contraindications
What are the specific contraindications to botulinum toxin?
What are the specific contraindications to juvederm filler?

Answer 3

-ask generally about medical problems
absolute contraindications:
-body dysmorphic disorder
-allergy to local anaesthetic/hyaluronic acid fillers
-pregnancy/breast feeding
-local infection at the site

relative contraindications
-ask about bleeding problems
-ask about herpes simplex virus-cold sores
-ask about skin conditions; are they prone to hypertrophic scarring like keloids
-ask about autoimmune conditions; suppress immune system-HIV

specific contraindications to botulinum toxin
-NMJ problems: lambert eaton syndrome; myasthenia gravis
-bell’s palsy

specific contraindications to juvederm filler
-porphyria
-epilepsy

Question 4

What are the important things to ask in drug history?

Answer 4

-blood thinners (anticoagulants, antiplatelets like warfarin, aspirin)
-immunosuppressants (steroids)
-allergies
-v important to ask for allergies to local anaesthetics like lidocaine or hyaluronic acid

Question 5

what are the important things to ask in lifestyle history?

Answer 5

-what do they do for a living
-do they spend a lot of time on the camera
-ICE!!
-smoking, ETOH, exercise hx

-screening for Body Dysmorphia disorder

Question 6

Examination
What do you look for in examination?

Answer 6

Age, gender
Ethnicity
Face shape
Examine face-in frontal, side views in 1/3 (static)
Examination of face in animated expression-raising eyebrows; smile; pursed lips; specific treatment area

Question 7

Examination of face in 3rds

Answer 7