Saving Face
For anyone considering cosmetic injectables to preserve their youthfulness, clinicians with expertise in this area suggest choosing wisely
by Bill Donahue

The signs are difficult to ignore. Step into almost any medical clinician’s office these days, and one has a good chance of seeing advertisements for cosmetic injectables such dermal fillers and neuromodulators, designed to restore or maintain an individual’s youthfulness. Even so, the men and women who consider this an area of specialty offer a word of caution along the lines of “buyer beware.” 
Like any other tool, each of these injectables is designed for a specific purpose. Likewise, these procedures are not without the risk of complication, so whoever has the syringe in hand should have the knowledge and expertise needed to select the right tool for the job and use it safely and correctly. 
We spoke with Steven Davis, D.O., FACS, of Davis Cosmetic Plastic Surgery, which has offices in Philadelphia and in Cherry Hill and Northfield, New Jersey. Dr. Davis offered his perspective regarding how patients can educate themselves before deciding on a certain treatment or provider.

When patients come to you with requests for cosmetic injectables, such as neuromodulators and dermal fillers, is there a lot of education involved? 
People are more informed than they have ever been. There’s a lot of information that they come in with from seeing things on social media or understanding from friends. Because of that, it is truly incumbent on all of us as physicians to help patients understand their options and whether they will be good candidates for certain treatments. The palette of facial injectables is very vast. A lot of times patients are really excited about the possibility that we might be able to help them. The question is: Will the result that a certain injectable offers be the result the patient really wants to achieve?  

People have a lot of options in terms of professionals who offer these services. What should they keep in mind before choosing a provider? 
In a way, these products are almost becoming a commodity. If you list on your website that you have these facial injectables, it doesn’t equate to you being an expert and having been trained properly. For the population of patients who want to go out and get this, they need to know at least three important things: One, are they a good candidate for what they’re asking for; two, is the product they are asking for the right product for them, because there are so many different places to inject, with reasons to choose one injectable over another; and three, is the person who is doing the injecting skilled and safe? There are some disastrous things that can happen—injecting into a blood vessel is one of them—so this is not something that should be treated lightly.

Are there certain qualifications people should seek in a provider? 
It doesn’t have to be a certain kind of doctor or nurse, but someone who is seeking this out should ask if the provider has been injecting for a while—years rather than months—and if it represents a big part of the practice. A surgeon may decide to do this, but they may not have taken the courses needed to make it an area of expertise, because there is a skill set that is needed. Check to make sure that whoever you are going to has a reputation for doing this kind of work. 
Another part of the discussion is, do they offer other things besides just a certain injectable? Over the years, I have had to fix a lot of people’s issues because another provider gave a patient only a certain product in a certain way. You want to make sure you’re a good candidate for the injectable you’re getting. Maybe you would be better served by laser resurfacing or even a surgical option, like a face-lift. If you’re not a good candidate for a certain treatment, you’re going to get an unsatisfactory result. 
If you need to get a tooth pulled, you’re probably going to go to someone who specializes in pulling teeth. You’re not going to someone around the corner who says, “Sure, I think I can do that.” It really is more of a specialty thing, which people will understand once they talk to someone who has spent the time to learn about doing this the right way. 

How has the landscape changed in terms of the patient outcomes cosmetic injectables deliver?
There are a few products on the market now that do things we were never able to do with an injectable. Some of these products can lift and suspend facial tissues in a way that you used to need to have a mini-face-lift or surgical procedure to achieve. Also, the longevity of some of these products is incredible—as long as two years, in some cases. A line of products that never disappoints is the neuromodulators. You can do more with these neuromodulators than most people even think about. Aside from making wrinkles better, you can even use them to make skin quality better. It’s remarkable.

Is there anything new or on the horizon that excites you?
One area that is becoming more and more highlighted is the jawline. Now we’re seeing FDA-approved products that can address the chin and jawline. More people are getting that done so they can have the sharp angle to the chin and jawline restored, and look more youthful. This may be a way to camouflage jowling. 
Also, we’re seeing the increased use of a cannula to inject facial fillers. These plastic disposable cannulas allow us to sculpt the face without having to make a lot of needle sticks. It’s like a tiny straw, smaller than a coffee stirrer, and through that opening you can inject all over the face. It can be a much safer technique, and it prevents bruising. It’s an exciting nuance that has been approved for some of these fillers. 

Injecting Life
The Philadelphia area has an abundance of medical practices and med spas that include cosmetic injectables among their areas of expertise.

Bella Body Medical Spa

Bryn Mawr Facial Aesthetics Center 
Bryn Mawr

Cirillo Institute | Cirillo Cosmetic Dermatology Spa 
Bryn Mawr and Newtown Square

Davis Cosmetic Plastic Surgery 
Philadelphia and Cherry Hill, New Jersey

Gambhir Cosmetic Medicine 
Exton and King of Prussia

The Institute for Laser and Aesthetic Medicine 

Kole Plastic Surgery Center

Main Line Center for Laser Surgery

Modern Aesthetic Plastic Surgery
Newtown and King of Prussia

Novique Medical Aesthetics

Princeton Rejuvenation Institute LLC
East Windsor, New Jersey

Subbio Plastic Surgery & Medical Spa 
Newtown Square

W Cosmetic Surgery
Plymouth Meeting

Published (and copyrighted) in Suburban Life magazine, March 2021.