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Should You See A Dermatologist Or A Plastic Surgeon For Injectables? Here's What Experts Say
You know you’re ready to dive into the wild and wonderful world of injectables — the only thing you’re *not* sure of is where to start. Should you go to a plastic surgeon for fillers and Botox? A dermatologist? That random med spa you’ve seen advertised at the gym? There are all kinds of practitioners claiming they can work their magic with a single flick of the wrist, but unfortunately, not all of them are legit. So how do you know who to trust? Experts say there are a few things to keep in mind when finding the right type of doctor for you — but first and foremost, make sure they're actually qualified.
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“When selecting a physician for injectable procedures including soft-tissue fillers and neuromodulators (i.e. Botox), the most important consideration is to make sure the physician is board-certified," Kathleen Cook Suozzi, M.D., director of aesthetic dermatology at Yale Medicine, tells TZR. "Both board-certified dermatologists and plastic surgeons are properly trained to perform injectable procedures as well as to manage the complications. A skilled dermatologist or plastic surgeon will be able to advise you on what procedures will help you achieve your desired results."
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It might seem obvious to see a trained and certified physician for a procedure bringing needles into contact with your face, but in practice that doesn't always happen. As injectables become more popular — a according to a new report released by the American Academy of Plastic Surgeons, nearly 16 million non-invasive cosmetic procedures were performed in 2018, with soft-tissue fillers and neuromodulators like Botox overwhelmingly the most common — there's a greater chance of encountering a provider who lacks the proper training and experience. And because both neuromodulators and dermal fillers require regular maintenance and follow-up appointments, finding a doctor you’re comfortable with for the long haul is so important. Most experts agree that both dermatologists and plastic surgeons are equally qualified to administer age-fighting injectables such as Botox or fillers, but you’re still going to need to do your research. Here’s what to look out for.
Make Sure Your Doctor Is Board-Certified
It may seem obvious, but it bears repeating — above all else, double check that your practitioner is board-certified in their field of specialty. "Both dermatologists and plastic surgeons do a great job with injectables," Beverly Hills dermatologist Dr. Lisa Chipps, MD, FAAD, tells TZR. "What's important is that you're going to a reputable board-certified physician who is well trained in facial anatomy and can handle any complications should anything go wrong."
Complications are rare, but they do happen. Both board-certified plastic surgeons and dermatologists have the medical training to manage any issues that might come up during or after injection. "With neuromodulators, complications could be something as simple as asymmetry, where one eyebrow goes up higher than the other," Chipps says. "A physician who understands her anatomy, will know exactly where these muscles need to be injected because it's different on every single person. Every face is different. The shape and size of each of our muscles is different. So we have to target those appropriately."
Ask If Your Doctor Will Be The One Actually Doing The Procedure
Ideally, you want your dermatologist or plastic surgeon to be the one handling your injections — and at the very least, you want them on site should any medical complications arise. Look out for med spas and other offices that don't actually have a qualified physician in-house.
"Beware of nurse practitioners or physician assistants that are not directly affiliated with a plastic surgery or dermatology practice," board-certified plastic surgeon Dr. Brian Pinsky of Long Island Plastic Surgical Group tells TZR. "Many plastic surgery or dermatology practices will employ nurse or PA injectors and will ensure that they are properly trained with proper oversight and supervision. Spas or salons may offer injectable treatments but often have no MD on site and can be supervised by a physician with little to no actual training in aesthetic medicine or surgery."
Discuss Your Long-Term Plans For Treatment — And Make Sure Your Doctor's Skill Set Matches Up
Simple Botox or filler injections can be done by either a dermatologist or a plastic surgeon. However, if you're considering other procedures on top of your injectables, that's when you might want to choose one type of doctor over the other. “I think it can be particularly helpful to see a dermatologist if you are interested in exploring a range of non-surgical options for facial rejuvenation,” NYC dermatologist Dr. Hadley King tells TZR. “Because they don't perform cosmetic surgeries, they often offer a greater range of non-surgical alternatives including Botox and fillers and also lasers, radio frequency and ultrasound devices, Eurothreads, chemical peels, and more. And they may be better versed in discussing skin care.”
Plastic surgeons, on the other hand, are better equipped to help you through more invasive procedures that require surgery (like face lifts, for example). “If you are considering a surgical procedure then I think it is helpful to see a plastic surgeon because they can give you details about exactly how they perform the procedure and what you can expect,” King says. “And they can compare and contrast this to the non-surgical options they offer and also discuss how best to combine both surgical and non-surgical approaches.”
If you are thinking of potentially getting more involved procedures down the road, discuss your plans early with your doctor. You want to make sure they are equipped to meet your needs now, so that you won’t have to switch doctors later on in the process.
Find Someone With An Aesthetic You Love
Both dermatologists and plastic surgeons can produce beautiful results when it comes to facial rejuvenation — but you want to make sure your doctor produces work you actually like before you commit to anything. Ask if you can look at photos of past procedures your doctor has done to see if your vibes match up. "Injectables are products, and they are injected with skill," Chipps says. "So the analogy I often use with patients is, these products are like paints. You can buy a set of paints and give it to five different painters, and you will get five different paintings. It's a matter of choosing who you're most comfortable with and whose outcome you appreciate. It's a very personal decision."
Know What Red Flags To Watch Out For
Dr. Gary Linkov, a plastic surgeon in New York City, suggests the following criteria to guide you while you're looking for a practitioner: "Make sure to check board certification, sufficient experience in your procedure of interest, the surgeon's aesthetic sense, how the surgeon and staff make you feel, [and] the operating facility," he tells TZR. If your doctor checks off all the boxes, you should feel comfortable moving forward.
Equally as important is knowing what red flags to look out for. Don't be afraid to trust your gut, Linkov says. "Red flags can be universal or based on the individual patient," he says. "For instance, lacking board certification should be an automatic red flag for anyone, but a surgeon's style can resonate with one person but not with another. In short, missing any of the aforementioned criteria factors should be alarming."
At the end of the day, either a board-certified dermatologist or a plastic surgeon can help you achieve the results you want. The key is finding someone who is best suited to your individual needs. "The important point is to look for a doctor who is well trained and experienced in the procedure you are considering, and who has an artful eye and an aesthetic that you like," King says. It's not hard to find someone who is right for you — it just takes a little research.
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