Enhancing Appearance Procedures

In this interview, Dr Ablon explored cutting-edge techniques, personalized approaches, and practical insights in appearance procedures by addressing complications, patient satisfaction, and guidance for dermatologists.

Glynis Ablon, MD, is a board-certified dermatologist at the Ablon Skin Institute Research Center in Manhattan Beach, CA. She is also an associate clinical professor at the University of California, Los Angeles in Los Angeles, CA.

The Dermatologist: Can you share some innovative techniques or technologies that you believe are crucial in achieving successful outcomes in appearance procedures? How do these techniques contribute to clinical and therapeutic excellence?

Dr Ablon: Technology really changes rapidly and it's imperative to know what's new and what's developing in the aesthetic realm from laser devices, procedures, and injectables to topicals. When you find a new technology that excites you, take your time and really understand how it works. Read about it, and check if the research is there. Safety is always number 1. Then get a sample, or get a demo, try it out on your staff. You know, exosomes are one of the most innovative products that’s out there and coming to market more and more. Again, you need to understand how aesthetic treatments are done, and what's best for your office. I think combination works. I like to combine procedures with topical therapy, both in the office and then also have patients do things at home. Don't say you're going to make everything perfect the first time. Aesthetic patients need to be realistic and understand what you can offer them. So, almost every treatment that I do really kind of elevates the practice.

The Dermatologist: When considering appearance procedures, how do you tailor your approach to meet the individual needs and expectations of your patients?

Dr Ablon: It is imperative when you're performing these appearance procedures to sit down and have a serious discussion with your patient about their expectations. You want to spend time discussing all procedures, the downtime that's associated with them, the cost, and the number of sessions that you'll need. And keep in mind that it really needs to be a trust that you're establishing with the patient, which typically takes time. So, after each consult, I give lots of handouts that patients can take home, photographs are taken, and then the patients are called the next day to really discuss if there are any questions they have, because it can be overwhelming, especially if you give them a lot of handouts. You want them to be able to take their time, read about what you've talked about, and then ask the questions, which we do again in the office, but also again the next day. The key to success is to make sure you have a mentally and physically stable patient. You really want to be honest with your patients and know that the patients will then trust you and then they'll keep coming back. I think being on the cutting edge of technology and understanding new developments also keeps the aesthetic surgeon on top of his or her game.

The Dermatologist: How do you approach the prevention and management of complications associated with appearance procedures?

Dr Ablon: I actually published an article in Plastic and Reconstructive Surgery in 2016 specifically about the prevention and then the treatment or management of these complications. It's imperative that you know your anatomy and if you choose to perform injectables in your practice, you must be an expert at this. It’s not the 1 case that goes wrong even if 99 go right. It's the 1 case that goes wrong and can you take care of it. That's what sets you apart from others. You must know what to do, how to handle a complication if something goes wrong, and how to make sure that the outcome is the best it can possibly be. If you're in this business long enough, something's going to happen. It happens to everyone, but you stay calm and have all your emergency measures in place, like a crash cart.
 

I am cardiovascular life support certified, and my head nurse is as well. I think having that certification is important. Also, phone numbers to reach people. I have my specialists on speed dial if there's any questions or issues that come up. In other words, you really want to be prepared for the worst, which sounds awful, but you want to be prepared so that you can handle any complications that arise and it's better to also reduce the risk of complications or prevent these complications. I give handouts before all my procedures. As you can tell, I'm a handout girl, and I make sure that the patients come in the office as prepared as possible. So, I reduce their risks of complications from day 1, even just the consultation. Also, avoid aspirin, acetaminophen, and ibuprofen, but taking arnica can help, and it's all in my handout.
 

Patients really know what to do before they come in. I also avoid dental procedures. I actually do 1 month before or after, because I think you're just increasing your risk of something going wrong. I really want my patients to be happy and feel like everything is great and that the success is really fantastic. I call my patients after every surgery or every procedure that night or the next morning. If it's something more invasive, they'll get a call that night. If it's less invasive, it will be the next day, but just to make sure that there aren't any questions and that everything is great. I have my cell phone also listed on the voicemail at the office so my patients can find me, and they can get a hold of me. The worst thing you can have is something goes wrong and a patient can't reach you, and that's what you don't want.

The Dermatologist: How do you measure and ensure patient satisfaction after appearance procedures? What is your approach to post-procedure follow up and long-term patient care?

Dr Ablon: Patient satisfaction is critical, and that's why being honest and realistic with your patients is extremely important. That's how you get success and that's how you perceive your office is successful. If you have a patient who’s complaining about another physician, you may want to think about it because you'll be the next physician that they complain about. So choose your patients wisely just as they choose you. If I don't feel that I have a connection with them, I'll send patients away. I'll just say, "There’s no charge for a consultation and good luck to you. I don't have the same thought process or I’m not understanding what you’re looking for.” So, I think you really want to get a good feeling about the relationship. I'm very realistic with my patients. I set out a plan. We describe how often they'll have to come see me, how often I have to come to the office, and once I have them where I want them, then how often I'll need to see them will determine the follow up.
 

Maybe it's once or twice a year, and then things will change. You have the maintenance, but we mature decades of our life. Things are new and things have other issues. It's really kind of figuring out what a patient needs and changing those procedure guidelines as they get wiser and more mature. Again, addressing any kind of issues or concerns that they have. That’s why we'll pull out a mirror, ask the patient what they're looking at, and reevaluate every few years. We have a plan in place, but change that plan based on what the patient is looking for. Patients want to look their best. They may want to look younger, and it's really nice when I have pictures and we'll pull them out. A patient who I've seen for 15 or 20 years looks younger now than they did 15 or 20 years ago.

The Dermatologist: For dermatologists looking to incorporate appearance procedures into their practice, what are the key takeaways or practical insights?

Dr Ablon: If you're going to incorporate aesthetic procedures in your office, the best thing you can do is start with a questionnaire. Have a paper that you hand out to your patients so when they come in, they can fill out the questionnaire thinking of what they are looking for. Sagging skin, sun damage, hair removal, it really depends on your patient population. So, a questionnaire is a great idea to start. The American Society for Dermatologic Surgery did a study back in 2019 and they published the data showing 14 million aesthetic and medical procedures being done. That was just back in 2019, so the numbers continue to go up. You really want to know what your patient's interests are and then what you like. So try some new things. Talk to mentors. Get companies to bring devices in. If I don't get to try a device, I will not purchase it for my office.
 

I'm really adamant about getting to try devices. Try them out and see what you like, what works well in your hands, and understand that you want the best for your patients. You want something that complements your practice, and you want to have a good reputation. You also want to work with a company that has a good reputation. The last thing you want to do is buy a device and have it be off the shelves and you can't find anyone to fix it. You really want to work with reputable companies, especially when you're starting out as you can start small. Start with neuromodulators, microneedling, things like that that don't cost a lot of money. See what your patients like and what you enjoy because the more you like it and your staff likes it, the more they're going to talk about it.