Experienced Botox Injector - Even if Not a Dermatologist or Plastic Surgeon?

The answer to my question is obvious- $$

Go and meet the family practice doc- strike up a conversation. Ask the doctor why he or she did not bother to do a residency and become board certified in dermatology or plastic surgery since he/she is obviously interested in facial anatomy, neurotoxin treatment, facial aesthetics and skin care. 

Botox injections involve injecting a substance that relaxes muscular activity.

There was just a question on this forum about a patient who had a paralyzed hemi-cheek due to administration of Botox into the upper cheek area.

For routine injection into the crow's feet and glabella, most injectors can do this without harming patients.  More complex cases require greater expertise.  When larger and more aggressive doses of Botox are required, say in a patient who is not quite ready for surgery yet but wants to do the most possible with their injections.  Or the patient with underlying differences from one brow to another.  Or a patient with differences in the set of the eyes.  Of differences in their cheeks.

To think you can just inject more Botox into the crow's feet and fix all the wrinkles in the eye cheek junction without a consequence is naive.  A surgeon accustomed to operating on the cheek area knows the anatomy and the limitations, and what the consequences of deactivating certain muscles can be.  They can warn the patient and avoid untoward results.  A plastic surgeon can tell the patient when it is time to contemplate surgery, when Botox and fillers have done their maximum.

An injector should be familiar with the anatomy underlying the wrinkles, not just the effect of placing Botox in a certain area.  They should have the patience to study the patient's face and note its unique features such as muscular weakness or asymmetries.  And they should also have an artistic eye, to know what to do with those asymmetries.

So the injector should have a knowledge of the anatomy, patience to observe the patient and study their features, and artistic ability to factor all these together.

In most instances I would recommend insisting on a board-certified specialist for non-surgical facial enhancement. When it comes to Botox, however, if a physician is doing a lot of it and getting nice results, then it's probably acceptable to use him as a provider. I'd recommend seeing many Botox photos before proceeding.

There are many instances of family practice and emergency room physicians who have decided to shift their practice into aesthetics without the requisite training to do so.  It does not take very long to actually learn to reconstitute the product appropriately and inject Botox.  On the other hand, to intimately understand the facial anatomy and the precise functions of the mimetic musculature and learn how to treat them appropriately to obtain a safe and natural result takes significant time and training.  Is it really worth the risk of having a suboptimal result with a non core provider?

Best Regards,

Jacque P. LeBeau, MD

Why would you not want a cosmetic procedure done by an experienced dermatologist or plastic surgeon who has spent years of training to deliver the best possible aesthetic results?