Plastic Surgery 101

Choose practioner carefully when considering injectable fillers in face

Q. I have been reading lately about all the crazy stuff that can happen with injectable fillers. How should I go about choosing a doctor, and what should I ask when I go to have my fillers done?

A. Fillers are great but are dangerous in the wrong hands! Experience and safety are the two most important aspects of choosing a provider who does your facial injectables. In addition, knowing what is being injected into your face is very important. This would seem an obvious statement, but in many places it isn't quite so! Never be embarrassed to ask the experience of the provider. Always ask to see the product that is being injected into your face. Make sure that it is coming out of a box that is sealed. Ask if the clinic or office has a form of hyaluronidase. Hyaluronidase is an enzyme that dissolves hyaluronic acid (the product in Perlane, Restylane Juvederm and Voluma).

Ask if they have a protocol for reversing and or improving the situation if you were to have a vascular event caused by an injection into a vessel. While these situations are rare, they do happen. Making sure that the clinic or office that you were dealing with has a standardize treatment protocol is a safer bet.

As far as choosing a provider, it is generally safer to choose a physician assistant nurse practitioner who is under the supervision of a facial plastic surgeon, plastic surgeon or dermatologist. These physicians have the most experience in injectable treatments and know what steps to take should there be a problem. Physician assistants, nurse practitioners and other providers who are working under the auspices of a non-aesthetic physician are generally shouldering the responsibility of evaluation and treatment of patients. Because of a lack of experience in aesthetics they may not be able to provide care and emergency treatment should a problem arise with a filler. Beware, be safe and be happy with your choice of the filler and the provider.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at