Proper consultation distinguishes a doctor from an artisan

Interview for estet-portal.com by Professor Daniel Cassuto, Plastic Surgeon, Professor of Plastic, Reconstructive and Aesthetic Surgery, Department of Plastic Surgery, University of Modena Hospital (Italy) .

 - What is the most important thing in the work of a cosmetologist? What should you pay more attention to?

- The most important part of the work of a cosmetologist is a consultation. It is by consultation that you can determine whether a good or bad doctor is in front of you. If a patient comes with a request to remove this or that wrinkle, and the doctor agrees, this is a "craftsman". Such a specialist can perform high-quality injection correction, but he will always see the skin defect, and not the patient as a whole.

The ability to see the image as a whole, take a deep history, understand the causes of aging and draw up the right rejuvenation program can only be a highly qualified doctor. It's like in construction. There are many workers who can lay bricks with high quality. They work well and professionally. And there are only a few talented architects in the world. A good doctor, like an architect of the face, must see correctly how to build beauty.

- How to conduct a consultation correctly?

- Each of you is faced with the fact that the patient stands in front of the mirror and, stretching his skin from the angle of the lower jaw to the tragus and from the angle of the eyebrow to scalp, says: “Doctor, give me this facelift.” Many patients, without a single wrinkle on their face, look old.

- Why?

• We need to understand what happens to facial volumes during life. Eyebrows always rise up with age. Brow lift is a desirable result for our patients, but it does not make them look younger. Patients do not understand – what they want looks unnatural. Such changes do not exist in nature, and even if we raise the patient's eyebrows as high as possible, this will not give the face a rejuvenating effect.

Raised eyebrows are always associated with an older face. The face must be viewed in several projections (full face, profile, semi-profile, lowered down with a pressed chin, raised up). Only after that we will understand exactly in which areas it is necessary to carry out correction.

- How will a cosmetologist's consultation differ from a dermatologist's consultation?

- One of the important rules for a correct assessment of appearance - is to put the patient in the "wrong" light. It is this assessment that will be one of the important differences. When dermatologists are consulting, the light should always be daylight and fall directly on the patient's skin. In cosmetology, the rules are completely different. If you put the patient in the same way, you will not see volumetric changes in his face. Chiaroscuro will not fall on the face as it happens in real life. Most of the time we spend indoors with lighting, when the light falls from top to bottom. The cosmetologist must see the face not only in different projections, but also in different lighting conditions. If you do not see the patient's problems, you will not be able to help him look beautiful, and then the patient will go to look for another doctor.

- How do you approach the choice of patients? Which patients are easy for you to work with, and who do you refuse?

- Before starting work, I always ask patients what they want and what they expect from the result of my work. I always know exactly what I will do, but it is important to hear the patient's expectations. If, in response to my question, I hear that the patient wants to look like she was in her 20s, then in this case I can work with her after consulting a psychotherapist. Such a playful request always indicates that the patient does not perceive himself correctly and this needs to be sorted out. If a patient says that he wants to look better, fresher, more natural and that no one has to guess how it was done - for me this is the ideal patient. It is important to talk with the patient and see his natural facial expressions. Proper consultation is always 98% of all work. Seeing a face in many projections and understanding how to properly restore balance between all parts of the face is a talent. Everyone focuses on injection techniques, but this is only 2% of the work.

that the patient does not perceive himself correctly and this needs to be sorted out. If a patient says that he wants to look better, fresher, more natural and that no one has to guess how it was done - for me this is the ideal patient. It is important to talk with the patient and see his natural facial expressions. Proper consultation is always 98% of all work. Seeing a face in many projections and understanding how to properly restore balance between all parts of the face is a talent. Everyone focuses on injection techniques, but this is only 2% of the work.

that the patient does not perceive himself correctly and this needs to be sorted out. If a patient says that he wants to look better, fresher, more natural and that no one has to guess how it was done - for me this is the ideal patient. It is important to talk with the patient and see his natural facial expressions. Proper consultation is always 98% of all work. Seeing a face in many projections and understanding how to properly restore balance between all parts of the face is a talent. Everyone focuses on injection techniques, but this is only 2% of the work. Proper consultation is always 98% of all work. Seeing a face in many projections and understanding how to properly restore balance between all parts of the face is a talent. Everyone focuses on injection techniques, but this is only 2% of the work.
Proper consultation is always 98% of all work. Seeing a face in many projections and understanding how to properly restore balance between all parts of the face is a talent. Everyone focuses on injection techniques, but this is only 2% of the work.

- Can I have injections before the flight?

- If you are using hyaluronic acid preparations to correct your appearance, remember not to inject before the flight. During the flight, our body receives a fairly strong load due to pressure drops. This leads to a powerful dehydration of the body as a whole. In response to dehydration, the production of antidiuretic hormone begins. The action of this hormone leads to the fact that all the water remains in the body. If you use drugs with high hygroscopicity, then the next day after the flight, the condition at the injection sites will look like overcorrection. Swelling at the injection sites may be more than usual, and the drug will compete. With such complaints, the patient goes to another doctor, If your patient still needs to take an air flight after the injections, you should advise him to drink as much water as possible. And if edema appears, you can not take antidiuretics. You should always be in touch with your patients!

- What drugs do you prefer to work with?

- I love working with Aliaxin hyaluronic acid preparations from IBSA. These fillers combine the maximum clinical efficacy of a combination of hyaluronic acid of different molecular weights. Depending on the area of ​​correction, I choose different preparations. I want to draw your attention to the new product of this company Profhilo. This preparation combines stabilized and non-stabilized hyaluronic acid, which gives a very good clinical result.