Look up. Trust me, things are looking up. By simply lifting our gaze to higher places, greater satisfaction and contentment may be found. Far too long, many of us have been lost in the crease and crevice. Unwilling or unable to look higher, we clung to the monotonous security of the fold or the rhytid. Pumping them full of collagen, hyaluronic acid and calcium hydroxyapatite, we hoped to satisfy these physiologic and emotional voids. Indeed, we were often successful. Sometimes, however, they were made to appear smoother but no younger.
Colloquial expressions illustrate some of the problem. Why the long face? We are losing face or falling apart. All illustrate the perception of downward decline associated with aging and loss. By looking higher and moving our words and syringes higher, I believe that in many of our patients, we can take things to the next step or higher level.
Whenever Possible, Take the High Road
We and our patients — by biological endowment and cultural privilege — are driven to seek out happiness, satisfaction and contentment. In the context of the medical-cosmetic relationship, the directional flow is implicit. They are seeking; we are expected to deliver. Patients seeking cosmetic procedures are by definition dissatisfied with some element of their appearance. Further, this dissatisfaction produces enough emotional discomfort to pursue or acquiesce to a potentially uncomfortable procedure with inherent risks and unknown outcome.
As all clinicians are painfully aware, objective clinical outcomes do not necessarily correlate with the subjective evaluation of a given patient. Choosing to take the high road, filling both the mind and upper face with quality messages and well-chosen product can maximize patient satisfaction.
Beauty Lies in the Eyes of the Beholder
Appraisals of beauty, wellness, kindness, energy and approachability are rapid and largely subconscious. This nearly instantaneous “Gestalt” powerfully drives perception, expectation and subsequent behavior in us and in others. The appraisal is a culmination of cues offered by the glabella, eyebrow complex, orbital size and shape, eye gaze, temporal hollows, upper and mid-cheek volume, angle of the oral commisure, upper lip volume and suspension and pre-jowl sulcus. This incomplete list of facial characteristics illustrates that, singularly or in combination, static and dynamic facial appearance can communicate strong messages to others.
Unfortunately, a good many of the natural biologic changes of the aging face can in some people lead to an unintended conveyance of negative emotion, giving the impression of sadness and malevolence. Addressing these changes in both the cosmetic consultation and subsequent procedure can help patients to effortlessly put on a happy face.
The Evaluation, the Promise, the Delivery
Share your philosophy with patients. You want to make them happy by giving them a natural, non-augmented, happier appearance. Reach higher with appropriate expectations. You want to convey a truth that they possess a beauty of their own that can be gently enhanced and restored. Open their eyes, literally and figuratively.
In layman’s terms, explain to them that the visual cues we choose to focus on can stimulate the limbic system in the brain. This stimulation leads to a cascade of biochemical events eventuating in feelings of pleasure, safety, satisfaction and contentment.
Show them concretely and tangibly how and where to look. Each patient should be gently guided so they can better attend to their own visible cues of health and beauty. Touch their forehead gently. Talk to them about how dynamic contractions in the glabella and forehead can convey a stressed, distressed and angry appearance. Explain how neurotoxins can transform their appearance into a softer, less stressed and kinder one.
Touch the temporal hollows and explain how their presence can be interpreted as wasting and depression. Tell them how easily they can be ameliorated. Kindly elevate the brow a bit and feel for the depression above the supraorbital ridge. Show your patient how placement of a small amount of filler here and laterally around the upper and lateral orbital rim can open the eye to give a brighter and more alert appearance.
Illustrate for them the dull or matt finish appearance of flattened upper cheeks. Gingerly lift the upper cheek a bit showing the brighter and perkier appearance of the cheeks and eyes with modest fill and elevation to a more youthful level. Gently move the oral commissure to a level horizontal position versus a downward angulation. Illustrate how a downward turn conveys a negative, sad, mean and judgmental message. Gently lift the cheeks upward and toward the temporal fossas. Exhibit for the patient how this subtle suspension can result in better “lip show” of the lateral upper lip and even some improvement in the marionette lines. Emphasize how this very subtle intervention from above can give the mouth a more youthful appearance.
With your index fingers, demonstrate how a small amount of filler 2 mm to 3 mm laterally placed above the upper vermilion border to replace lost volume can give suspension and eversion of the lip. Illustrate the benefits of filler at and below the oral commissures. These, and perhaps treatment of the depressor anguli oris with neurotoxin, can augment the natural appearance and function of your higher-level interventions.
Cohabitation of Filler and Neurotoxins
Once conceptualized as agents living alone in their own sequestered locations, it is becoming increasingly apparent that fillers and neurotoxins play well together. The synergistic effect of using hyaluronic acid and botulinum toxin together in the glabella is well-recognized. Acknowledging the rare occurrence of vascular compromise and tissue necrosis, the augmentation of immediate cosmetic results and longevity of effect is impressive. Similar additive benefits have been seen in the perioral and periorbital regions. As we continue to aim higher with fillers, more opportunities for this cohabitation will arise and hopefully lead to more satisfying and longer lasting results.
Help Them Believe
Look into their eyes. Earn their trust by seeking help from above. Start very high with proper preparation of their mind, expectations and perceptions. Promise that you will deliver meaningful rejuvenation of their skin and restore visible signs suggestive of a friendlier, perkier, more energetic, accepting and youthful person. Deliver what you promise. Stay high, paying close attention to the upper cheeks and periorbital regions. Continue at a high level providing volume restoration laterally and in the temporal fossas. Concentrate on uplifting emotional affirmations and create physical vectors correcting defects and restoring volume when possible. Allow them to feel safe in your hands, seeking to return faithfully on a regular basis for your gentle care.
Now, how is that for an uplifting experience?
Dr. Fried, who is a psychologist and dermatologist, is clinical director at Yardley Dermatology Associates in Yardley, PA.
Disclosure: The author reports no relevant financial relationships.
Look up. Trust me, things are looking up. By simply lifting our gaze to higher places, greater satisfaction and contentment may be found. Far too long, many of us have been lost in the crease and crevice. Unwilling or unable to look higher, we clung to the monotonous security of the fold or the rhytid. Pumping them full of collagen, hyaluronic acid and calcium hydroxyapatite, we hoped to satisfy these physiologic and emotional voids. Indeed, we were often successful. Sometimes, however, they were made to appear smoother but no younger.
Colloquial expressions illustrate some of the problem. Why the long face? We are losing face or falling apart. All illustrate the perception of downward decline associated with aging and loss. By looking higher and moving our words and syringes higher, I believe that in many of our patients, we can take things to the next step or higher level.
Whenever Possible, Take the High Road
We and our patients — by biological endowment and cultural privilege — are driven to seek out happiness, satisfaction and contentment. In the context of the medical-cosmetic relationship, the directional flow is implicit. They are seeking; we are expected to deliver. Patients seeking cosmetic procedures are by definition dissatisfied with some element of their appearance. Further, this dissatisfaction produces enough emotional discomfort to pursue or acquiesce to a potentially uncomfortable procedure with inherent risks and unknown outcome.
As all clinicians are painfully aware, objective clinical outcomes do not necessarily correlate with the subjective evaluation of a given patient. Choosing to take the high road, filling both the mind and upper face with quality messages and well-chosen product can maximize patient satisfaction.
Beauty Lies in the Eyes of the Beholder
Appraisals of beauty, wellness, kindness, energy and approachability are rapid and largely subconscious. This nearly instantaneous “Gestalt” powerfully drives perception, expectation and subsequent behavior in us and in others. The appraisal is a culmination of cues offered by the glabella, eyebrow complex, orbital size and shape, eye gaze, temporal hollows, upper and mid-cheek volume, angle of the oral commisure, upper lip volume and suspension and pre-jowl sulcus. This incomplete list of facial characteristics illustrates that, singularly or in combination, static and dynamic facial appearance can communicate strong messages to others.
Unfortunately, a good many of the natural biologic changes of the aging face can in some people lead to an unintended conveyance of negative emotion, giving the impression of sadness and malevolence. Addressing these changes in both the cosmetic consultation and subsequent procedure can help patients to effortlessly put on a happy face.
The Evaluation, the Promise, the Delivery
Share your philosophy with patients. You want to make them happy by giving them a natural, non-augmented, happier appearance. Reach higher with appropriate expectations. You want to convey a truth that they possess a beauty of their own that can be gently enhanced and restored. Open their eyes, literally and figuratively.
In layman’s terms, explain to them that the visual cues we choose to focus on can stimulate the limbic system in the brain. This stimulation leads to a cascade of biochemical events eventuating in feelings of pleasure, safety, satisfaction and contentment.
Show them concretely and tangibly how and where to look. Each patient should be gently guided so they can better attend to their own visible cues of health and beauty. Touch their forehead gently. Talk to them about how dynamic contractions in the glabella and forehead can convey a stressed, distressed and angry appearance. Explain how neurotoxins can transform their appearance into a softer, less stressed and kinder one.
Touch the temporal hollows and explain how their presence can be interpreted as wasting and depression. Tell them how easily they can be ameliorated. Kindly elevate the brow a bit and feel for the depression above the supraorbital ridge. Show your patient how placement of a small amount of filler here and laterally around the upper and lateral orbital rim can open the eye to give a brighter and more alert appearance.
Illustrate for them the dull or matt finish appearance of flattened upper cheeks. Gingerly lift the upper cheek a bit showing the brighter and perkier appearance of the cheeks and eyes with modest fill and elevation to a more youthful level. Gently move the oral commissure to a level horizontal position versus a downward angulation. Illustrate how a downward turn conveys a negative, sad, mean and judgmental message. Gently lift the cheeks upward and toward the temporal fossas. Exhibit for the patient how this subtle suspension can result in better “lip show” of the lateral upper lip and even some improvement in the marionette lines. Emphasize how this very subtle intervention from above can give the mouth a more youthful appearance.
With your index fingers, demonstrate how a small amount of filler 2 mm to 3 mm laterally placed above the upper vermilion border to replace lost volume can give suspension and eversion of the lip. Illustrate the benefits of filler at and below the oral commissures. These, and perhaps treatment of the depressor anguli oris with neurotoxin, can augment the natural appearance and function of your higher-level interventions.
Cohabitation of Filler and Neurotoxins
Once conceptualized as agents living alone in their own sequestered locations, it is becoming increasingly apparent that fillers and neurotoxins play well together. The synergistic effect of using hyaluronic acid and botulinum toxin together in the glabella is well-recognized. Acknowledging the rare occurrence of vascular compromise and tissue necrosis, the augmentation of immediate cosmetic results and longevity of effect is impressive. Similar additive benefits have been seen in the perioral and periorbital regions. As we continue to aim higher with fillers, more opportunities for this cohabitation will arise and hopefully lead to more satisfying and longer lasting results.
Help Them Believe
Look into their eyes. Earn their trust by seeking help from above. Start very high with proper preparation of their mind, expectations and perceptions. Promise that you will deliver meaningful rejuvenation of their skin and restore visible signs suggestive of a friendlier, perkier, more energetic, accepting and youthful person. Deliver what you promise. Stay high, paying close attention to the upper cheeks and periorbital regions. Continue at a high level providing volume restoration laterally and in the temporal fossas. Concentrate on uplifting emotional affirmations and create physical vectors correcting defects and restoring volume when possible. Allow them to feel safe in your hands, seeking to return faithfully on a regular basis for your gentle care.
Now, how is that for an uplifting experience?
Dr. Fried, who is a psychologist and dermatologist, is clinical director at Yardley Dermatology Associates in Yardley, PA.
Disclosure: The author reports no relevant financial relationships.
Look up. Trust me, things are looking up. By simply lifting our gaze to higher places, greater satisfaction and contentment may be found. Far too long, many of us have been lost in the crease and crevice. Unwilling or unable to look higher, we clung to the monotonous security of the fold or the rhytid. Pumping them full of collagen, hyaluronic acid and calcium hydroxyapatite, we hoped to satisfy these physiologic and emotional voids. Indeed, we were often successful. Sometimes, however, they were made to appear smoother but no younger.
Colloquial expressions illustrate some of the problem. Why the long face? We are losing face or falling apart. All illustrate the perception of downward decline associated with aging and loss. By looking higher and moving our words and syringes higher, I believe that in many of our patients, we can take things to the next step or higher level.
Whenever Possible, Take the High Road
We and our patients — by biological endowment and cultural privilege — are driven to seek out happiness, satisfaction and contentment. In the context of the medical-cosmetic relationship, the directional flow is implicit. They are seeking; we are expected to deliver. Patients seeking cosmetic procedures are by definition dissatisfied with some element of their appearance. Further, this dissatisfaction produces enough emotional discomfort to pursue or acquiesce to a potentially uncomfortable procedure with inherent risks and unknown outcome.
As all clinicians are painfully aware, objective clinical outcomes do not necessarily correlate with the subjective evaluation of a given patient. Choosing to take the high road, filling both the mind and upper face with quality messages and well-chosen product can maximize patient satisfaction.
Beauty Lies in the Eyes of the Beholder
Appraisals of beauty, wellness, kindness, energy and approachability are rapid and largely subconscious. This nearly instantaneous “Gestalt” powerfully drives perception, expectation and subsequent behavior in us and in others. The appraisal is a culmination of cues offered by the glabella, eyebrow complex, orbital size and shape, eye gaze, temporal hollows, upper and mid-cheek volume, angle of the oral commisure, upper lip volume and suspension and pre-jowl sulcus. This incomplete list of facial characteristics illustrates that, singularly or in combination, static and dynamic facial appearance can communicate strong messages to others.
Unfortunately, a good many of the natural biologic changes of the aging face can in some people lead to an unintended conveyance of negative emotion, giving the impression of sadness and malevolence. Addressing these changes in both the cosmetic consultation and subsequent procedure can help patients to effortlessly put on a happy face.
The Evaluation, the Promise, the Delivery
Share your philosophy with patients. You want to make them happy by giving them a natural, non-augmented, happier appearance. Reach higher with appropriate expectations. You want to convey a truth that they possess a beauty of their own that can be gently enhanced and restored. Open their eyes, literally and figuratively.
In layman’s terms, explain to them that the visual cues we choose to focus on can stimulate the limbic system in the brain. This stimulation leads to a cascade of biochemical events eventuating in feelings of pleasure, safety, satisfaction and contentment.
Show them concretely and tangibly how and where to look. Each patient should be gently guided so they can better attend to their own visible cues of health and beauty. Touch their forehead gently. Talk to them about how dynamic contractions in the glabella and forehead can convey a stressed, distressed and angry appearance. Explain how neurotoxins can transform their appearance into a softer, less stressed and kinder one.
Touch the temporal hollows and explain how their presence can be interpreted as wasting and depression. Tell them how easily they can be ameliorated. Kindly elevate the brow a bit and feel for the depression above the supraorbital ridge. Show your patient how placement of a small amount of filler here and laterally around the upper and lateral orbital rim can open the eye to give a brighter and more alert appearance.
Illustrate for them the dull or matt finish appearance of flattened upper cheeks. Gingerly lift the upper cheek a bit showing the brighter and perkier appearance of the cheeks and eyes with modest fill and elevation to a more youthful level. Gently move the oral commissure to a level horizontal position versus a downward angulation. Illustrate how a downward turn conveys a negative, sad, mean and judgmental message. Gently lift the cheeks upward and toward the temporal fossas. Exhibit for the patient how this subtle suspension can result in better “lip show” of the lateral upper lip and even some improvement in the marionette lines. Emphasize how this very subtle intervention from above can give the mouth a more youthful appearance.
With your index fingers, demonstrate how a small amount of filler 2 mm to 3 mm laterally placed above the upper vermilion border to replace lost volume can give suspension and eversion of the lip. Illustrate the benefits of filler at and below the oral commissures. These, and perhaps treatment of the depressor anguli oris with neurotoxin, can augment the natural appearance and function of your higher-level interventions.
Cohabitation of Filler and Neurotoxins
Once conceptualized as agents living alone in their own sequestered locations, it is becoming increasingly apparent that fillers and neurotoxins play well together. The synergistic effect of using hyaluronic acid and botulinum toxin together in the glabella is well-recognized. Acknowledging the rare occurrence of vascular compromise and tissue necrosis, the augmentation of immediate cosmetic results and longevity of effect is impressive. Similar additive benefits have been seen in the perioral and periorbital regions. As we continue to aim higher with fillers, more opportunities for this cohabitation will arise and hopefully lead to more satisfying and longer lasting results.
Help Them Believe
Look into their eyes. Earn their trust by seeking help from above. Start very high with proper preparation of their mind, expectations and perceptions. Promise that you will deliver meaningful rejuvenation of their skin and restore visible signs suggestive of a friendlier, perkier, more energetic, accepting and youthful person. Deliver what you promise. Stay high, paying close attention to the upper cheeks and periorbital regions. Continue at a high level providing volume restoration laterally and in the temporal fossas. Concentrate on uplifting emotional affirmations and create physical vectors correcting defects and restoring volume when possible. Allow them to feel safe in your hands, seeking to return faithfully on a regular basis for your gentle care.
Now, how is that for an uplifting experience?
Dr. Fried, who is a psychologist and dermatologist, is clinical director at Yardley Dermatology Associates in Yardley, PA.
Disclosure: The author reports no relevant financial relationships.
