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You know, it is confusing to take that first step, but when I look at a patient, I just don't look and say, what neuromodulator like Botox or Dysport or Xeomin is going to work best. I look at the patient as a person, as a whole person and I try to figure out what I can do to achieve the best result in that patient. Sometimes, it may only be softening the muscles with a neuromodulator. Sometimes, it might be just filling up the cheeks a little bit, but oftentimes, it takes multiple approaches. It takes using products that make the lashes longer. It takes using products that makes the skin nicer and less pigmented. It takes using lasers that gets away the redness from the skin. It takes putting fillers to reestablish that normal youthful contour and it takes neuromoduclators to soften the lines of muscular movements. It often takes many different steps and so what I do with my patients, it’s just like a decorator coming into your house. I try to give my patients a plan. I try to say, you know, these are the different things we can do to achieve one nice result, just to make you look prettier, to make you look better.

And I don't concentrate on just one product so we give a full range of products that can be used. My staff almost gives a menu of ideas that we can do. Everyone has a budget, and it’s really our responsibility. Not only to give a plan, but to work within the patient’s budget. You don't have to do everything at once. Just like if a decorator comes in to your house, you don't decorate the entire house at once. Sometimes, you start with the kitchen and then you move to the living room and you start with different rooms. As dermatologic surgeons, we can do that as well.

What is the First Step When Considering Cosmetic Treatments?

Dr. Mitchel Goldman discusses the first step when considering cosmetic treatments.

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