Pearls and Pitfalls in Cosmetic Oculoplastic Surgery (PDF)

"90 Evaluating Potential Botox Patients (p. 294-295)

Samuel M. Lam

Understanding the clinical bene? ts and limitations of Botox (BTX) therapy is important; these must be effectively communicated to every patient in order to ensure uniform satisfaction. As almost every practitioner of cosmetic enhancement, surgeon and physician alike, use Botox in his or her clinical practice, it is important to differentiate the quality of one’s Botox therapy from competitors. This chapter will recount how to attain consistently excellent results and to minimize patient discomfort so as to increase patient loyalty and repeat visits. Botox injection is easy to perform but must be undertaken with care and attention for optimal results.

Evaluation of the Potential Botox Patient

Botox therapy provides excellent and safe periocular cosmetic enhancement when applied in a deliberate and conscientious method. During the initial consultation, the physician should ask what experiences the patient may have had with Botox in the past and what expectations he or she should hold. Review of the patient’s prior experiences is informative as to what pitfalls the physician can avoid in the current session. For example, if the patient says that the brow position descended excessively with prior usage, the physician should pay particular attention to how to treat the frontalis.

Excessive ecchymosis from a previous treatment may re? ect careless or inadvertent venopuncture or a patient’s excessive usage of a nonsteroidal antiin? ammatory medication. Counseling a patient during the initial phone encounter to avoid aspirin, herbal therapies, or other blood-thinning medications is important as is avoiding treatment 1–2 weeks before an important professional or social engagement in case ecchymosis arises and cannot be entirely camou? aged.

It is helpful during the discussion to study the patient’s habits of animation and

From the reviews:

"The editors … provide insight that may allow surgeons to perform more efficient, productive, and successful surgeries. … The book is intended for both aspiring surgeons and established surgeons in oculofacial plastic surgery. It is most suitable for those in the more advanced stages of their training … . It would also be of benefit to established surgeons wishing to broaden their knowledge of treating a particular surgical problem. … useful for more experienced surgeons seeking additional insight … to treat a particular surgical problem." (M. Reza Vagefi, Doody’s Review Service, September, 2009)