”If you’re here for cosmetic injections, I just want to fill you in on a couple of new things and update you on a couple of our strategies so that you’re familiar with. Most of you had Botox, Dysport or Xeomin before or a cosmetic filler but there are few things that we’d like to make sure that you’re aware of, that I’d personally we’d like to make sure you’re aware of.

First of all we schedule the appointment with photographs so that we’re always working off a baseline and if you have a concern or a problem, I’m able to study your before pictures and you can even send me a selfie afterward if there’s some irregularity or the muscles are not quite perfect and I can study them and compare them to those baseline photos and make sure I know exactly what’s going on so that’s a part of our standardized photography. I’d really love it if everyone would come back at about 2 weeks and just do a quick drop by picture and get us with your fully images, raising your brows, squinting down, smiling and squinting. Those are really helpful for me to measure our outcomes and to really make sure that you’re getting the best possible result that I can achieve, but if you can’t I understand we always take pictures on your arrival and so we always plan that for your appointment and thanks for being patient with us in getting those things. To me a photograph is what an EKG is to a cardiologist, it’s a baseline measure of where we are and to measure success or failure, hopefully there’s not many of those, I need to have those photographs in mind.

Secondly is a part of our standard operating procedure and this is really always for people’s comfort we plan numbing I use this specially compounded topical numbing cream that when apply to the area and our studies have shown this as well as many others, reduce the sting of the injection needle. I know it’s very tiny but it reduces it by 70% or more and some patients that are really sensitive to, and probably this is a lot of fear factor too, but are really sensitive to needles so this makes an enormous difference and it’s very hard for me to tell who’s going to be a sensitive patient and who’s not, so we’ve added this as standard part of the protocol, and the numbing cream when applied really meets or gets to its peak effectiveness after about 30 minutes.

Usually we can treat people at 20 minutes and that we’re close to that 60-70% reduction and sting but we plan then photographs and you come in and we’ll get the numbing cream on as quickly as we can, you can certainly put make-up on right after it, we’ll clean the area, put a numbing cream and then you can re-apply make-up.

Now in some patients, they don’t want to have numbing cream and that’s totally fine because it is a small needle but unless you specify in advance so that the staff knows we’re going to plan for you to get the standard operating procedure numbing cream and sometime for that to work, and again 20 minutes is usually the standard waiting time for Botox. It can be a little longer for fillers especially around the lips and we’ll use seclusion because that’s a little more sensitive of an area. So I appreciate your planning appropriately and understanding that we can really make a big difference if we do those things.

The last is, and I just again want to thank you for remembering avoiding aspirin non-steroidal anti-inflammatories like Advil, Aleve, Motrin, ibuprofen all those we’ll take the chance of your having what would be a tiny little dot bruise into a bigger bruise that’s very noticeable and make it very, very small specially with Botox, Dysport or Xeomin, and I think that’s important because I want you to have zero bruises.

With fillers of course it’s a little different, again all those things are really important to fillers because the chance of bruising is obviously higher when we’re doing fillers and when we do Botox. When we do the fine lines treatment, if you’re here for fine lines treatment the little etch lines around the lips, the cheek area or other zones. Everybody has tiny little dot bruises, is what I call them, and there certainly just dots as long as you’re not taking the non-steroidal anti-inflammatory medicines. So please make sure, just as a reminder, even though you’re here today and getting a treatment today that you’re avoiding it for the next treatment if you didn’t do it for todays.

So I wanted to outline those standard operating formats, we might even take a picture of you today after this treatment if you’re getting a filler because the results are immediate and areas in particular like the tear tracks, the lips, the cheeks if we’re doing volume it’s really important that we can grab that picture and not you know have to set schedule a follow up appointment for you because you can get the immediate result and even post those on this system, the touch system that we use for our patient education portal right away so you can see your own results and even put some comments in there for me to see them.

The last thing I wanted to do is update you and just talk a little bit about the Botox line of products. Botox, Dysport and Xeomin are the three products that we can choose. I’ve kind of dropped Xeomin off at the current time because Xeomin’s dosing per price is not quite as good as I think Dysport and Botox are. Really at the dose that I use with Dysport, Botox and Dysport are exact same price. You may read online that Dysport is less expensive, well it’s only less expensive if you use a smaller number of units than what I use. At the number of units that I use, I use a 3:1 ratio or 60 units of Dysport the same as 20 of Botox. They’re roughly the same cost and so it’s really your choice and really I’d like to have everybody try both to see which works better for them.

And lastly just as an update on fillers, we do now have a new product called Juvederm Voluma which has been designed and studied for use in facial volume enhancement. Historically many of you may know or maybe haven’t talked to me before about fillers, but I would use Radiesse which was a small micro particulate product made of calcium hydroxyapatite, a big fancy term but it’s really a bone mineral and tiny microscopic spheres or even in some cases Sculptra, and now Voluma has really taken over.

The reasons for Voluma occupying what I think is center stage as it relates to volume replacement for the cheeks and mid face and temple areas where we get age related volume loss is that in the studies Voluma showed a 2 year duration of effect and almost or over 2/3 of patients which means it might even last 3 or 4 or 5 years in many patients and that’s a significant step up from even the stimulatory fillers like Radiesse or Scupltra.

So again this is a special message thanking my cosmetic injection patients for being here explaining a little bit about how we look at your appointment today, thanking you for being patient with us on photographs, on our strategies for numbing and making it more comfortable and in some cases we’ll do icing in addition to the topical numbing and inviting your feedback. I want you to have a good experience, I want you to have a perfect outcome and if it’s not perfect, I want you to call and let me know, call my staff we’ll get you back, we’ll make sure it’s a better experience and a perfect outcome the next time.

As always it’s a great pleasure to take care of you, I consider the great honor that you trust me with your care and your appearance and I will do my best to make sure you stay that like. This is Corey S. Maas MDTM on Looking Your Best.”

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