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The whole world is in chaos, everything is different, and nothing will ever be the same again. Lockdown and its devastating financial consequences have affected all walks of life. As aesthetic medical practitioners, we were all similarly affected by the evaporation of patients and income. The lifting of restrictions has, however, allowed us to tiptoe our way back to the “new normal” gingerly. This reset, though, will not be easy, and we will need to adjust our processes to the evolving situation. The words of Warren Buffet: “You never know who’s swimming naked until the tide goes out” is now more real than ever. All businesses closed over the lockdown; many may never reopen. The mask and social distancing regulations have changed the way that we interact, affecting our relationships as well as how we live and work. Businesses, once profitable, are now restricted by social distancing and are no longer viable. Aesthetic practices in these trying times are not spared. Unless we embrace the new reality and adapt our mindset as well as skillset, we will be found wanting. It is now more apparent than ever that Injectables are the new future of Aesthetics. This was driven home to me after being exposed to countless webinars over the last two months. This time exiled from my Plastic Surgery practice has allowed me the time to consolidate various advances and novel approaches in the field of Aesthetic Medicine. The new concepts delivered by Dr Mauricio de Maio regarding the utilization of Aging Trigger Points (ATP) to delay ageing and prolong youth were ground-breaking. The lunchtime Toxin/Filler fast-food approach is over as patients need to be educated to a deeper understanding of their requirements and maintenance rather than a quick fix of two or three areas that so many of them experienced before. A measured focussed approach is essential. This is evident in all the webinars seen to date. Lockdown has forced most of our patients to stay home. This has allowed many to watch countless YouTube videos and experiment with makeup enhancing certain features and downplaying their less desirable ones. The perception of beauty has changed over time, and the concept of light and shade has altered our awareness of attractiveness. I have realized that the concept of beauty in women changes with ageing, from innocence in youth to confidence in the twenties, to possibly the femme fatale in the thirties. Before one injects, one needs to assess each patient individually. Who they are, what’s their age, what do they do for a job, what’s their relationship status, where they are in their lives, and where are they going? Patients buy makeup and use light and shade to improve their looks. As Aesthetic specialists, we can use the application of makeup to drive our injection strategies. Makeup defines features such as the jawline, highlights the forehead and cheeks, can make a face look thinner, and hides imperfections. The future of injectables is to follow the beautification trends in makeup, fashion, the use of photoshop and filters and our patients’ social media projections. Makeup is an illusion and injectables a long term reality that doesn’t wash off or take an hour to apply. Facial skeletal ageing with bone loss results in a relative excess of soft tissue. To restore balance, harmony, symmetry and smooth transition zones, one needs to safely inject deficient areas with fillers then maintain these results regularly over time. The aim in my practice is to make a better version of you rather than to sell you a syringe of filler every few months to “correct “an isolated feature. Recent advances in Injectables has allowed us the opportunity to not only alter the static face but also to change and modify muscle movement and consequently, our expressions. This concept of myomodulation can be performed chemically with Botulinum toxin or physically with Fillers which is more subtle and have a longer duration of action. We are no longer treating for beauty but instead for honesty, integrity and making our patients look how they feel inside. We can change angry, tired, sad, saggy and moody expressions, by treating the perioral and periocular areas. To make our patients look happy, healthy, approachable, trustworthy and able to communicate better. We really have to see injectables through a different lens or rather see the familiar with new eyes so we can deliver what our patients need. Rather than following a commoditized list, we should tailor our treatment by teaching and showing our patients what we envisage; using shadow and light. Light is used to amplify the convexities of youth and shadow to create a dramatic slimming effect, thus creating balance and beauty at rest and in motion. Individually planned treatments can be performed over 2-3 months to attain the final result. Each treatment uses a minimal amount of product ( 2-3 syringes) to achieve specific endpoints. These being to build a suitable foundation to the jawline and chin, contour the cheek and temple then refine the periocular and perioral areas. The last step is to use a skin booster to rehydrate and invigorate the skin. Because of the restrictions placed on us by our current circumstances, it is my opinion that many more patients will avoid facial surgery if possible. They will select the less invasive Filler option, that in the right hands can rejuvenate, restore and revive their appearance as well as uplift their spirits. The future is injectibles and Injectibles are the future!
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