(music) The patient should choose a physician who's got a very good reputation in their community. They should choose someone who is board certified, and they need to have a confidence level. You're going to do something to their face, that's your app, that's your brand, when you go out into the world, that is your brand, so people are very concerned about what happens to their face. I could say fairly everybody pays as doctors the same thing for Botox, the same thing for fillers, there's no cheap way to do it. Some people, some doctors, add more onto their purchase price than others do, but if you see it too cheap, if it's too good to be true, it's too good to be true. Then you get to the question of who's actually got their hand on the syringe, and I like to think that someone who is concerned about their appearance would be very concerned about who has their hand on the syringe.

Do I think that nurse injectors are bad? No, I don't think their bad, I think that there are some nurse injectors that are quite capable, but they haven't had the background, they haven't had the anatomy, they don't know the things that your physician knows. When I see a patient, I know that underneath that area is an artery to be avoided, a nerve to be avoided, a place that will cause a lump, or a bump, or a nodule that is going to give trouble, and I avoid that. Nurse injectors don't know that, and when I say nurse injectors it's not just nurses, it's physician assistants, and nurses. It's interesting, I have two physician assistants that work for me, they both came in to the office with the idea, "I want to do this, I want to do Botox," and they watch. At first you watch somebody for a while and you say, "Oh, that looks easy, I can do that."

Then they see the patients that are sent to me who have gotten in big trouble somewhere else, and they see what big trouble it is to bail the patient out, and then to get them back to being just good.

Now you ask either of my P.A.'s, do they want to inject, and they say, "Oh no," because they know what bad can happen, and until you know what bad can happen, you feel like it's child's play. Am I mad with nurse injectors? No, I understand that plenty of physicians use them, I think the patient should be cautious and ask who you are, and what you're training is, and how much have you done of this, etc., because it's important.

The other thing I always point out is that when a physician does your injection, he'll also notice if you have a skin cancer sitting an inch away, it won't happen if a cosmetically oriented nurse, or P.A. will do that. Very few of them will know that. I can tell you that the age range that get most of the injections are 35-60 and that's the age range that we see skin cancer. I can tell you for sure, at least once or twice a month, I have a patient who comes to me for Botox, or comes to me for filler, and I'll say to them, "How long have you had that?" And they'll go, "What? Oh don't worry about that." And I'll say, "How long has it been there? It needs to be biopsied," and they'll kind of be annoyed with me because that's not what they want, but not infrequently I'll find something that's significant that needs to come off and is very, very important. So that's the other aspect of having a physician do your injection. (Chimes)

How to Choose a Doctor for Fillers

Doctor Steven Mandy walks patients through what to look for when selecting a doctor for fillers and injectables.