Botox, Filler, or Both? Choosing the Course of Action for Your Clients

“I want you to fix this,” laughs Lucy, a cheerful 52-year-old investigative journalist, pointing to the area around her eyes. “And this too,” she says, gesturing to her cheeks and then using her index fingers to trace imaginary lines downward from the corners of her mouth. “Basically,” she jokes, “I want you to make me look like a fabulous mother-of-the-bride for my daughter’s wedding! It’s only six weeks away!”    

Whether you’re new to aesthetic medicine or have considerable experience, you already know that treatment considerations for clients like Lucy can be complex. For this reason, it can sometimes be challenging to determine the ideal course of action. But by following these three steps, you’ll map a clear path forward and discover the best aesthetic (Botox or Dermal Fillers) solutions for your clients.     

1. Look at Things From Your Client’s Perspective

Like Lucy, many clients often don’t quite know how to articulate precisely what it is about the appearance they want to be addressed. For example, when Lucy points to the areas around her eyes with the request to “fix this,” she may be talking about any number of things—only some of which may bother her. 

That’s why all successful treatment begins with standing in your client’s shoes and asking clarifying questions to better understand their concerns. In Lucy’s case, she’s not bothered by her crow’s feet (in fact, she’s fond of them and feels they add character). It’s only her prominent tear troughs she’s hoping to treat. As for when Lucy gestured to her cheeks, she was trying to express her concern with volume loss, not with some of the vascular issues her medical aesthetician also noticed.  

2. Assess Peak Effect, Performance, and Recovery Durations

Even after coming to a clear understanding of your client’s concern, you’ll need to assess time variables to ensure an ideal solution. Lucy has mentioned that she wants to enhance her appearance for her daughter’s wedding. She’s also mentioned it’s only six weeks away. This is a critical piece of information since different products can reach peak effects at different times and perform for different durations. 

For example, while neurotoxins like Botox can act relatively quickly and typically perform well for 3-4 months, bio-stimulator dermal fillers like Radiesse and Sculptra can take months to achieve peak effect but can deliver results that extend over years. You’ll also need to take into account the expected recovery times associated with the type and amount of product that’s used, as well as your client’s age. (Older clients typically take longer than younger patients to heal.) Under different circumstances, Lucy might want to opt for Sculptra to add volume to her cheeks, but under these circumstances, she’ll need to opt for a dermal filler with faster acting results. 

3. Understand the Complex Interplay Between Aesthetic Solutions

Even after you’re sure that you and your client are on the same page and you’ve taken time variables into account, it’s not always immediately apparent which solution will deliver the best possible result for your client. The reason for this is that clients often need a combination of solutions to achieve the results they’re looking for. In other words, it’s a matter of understanding how these aesthetic solutions work together that poses the real challenge.

For example, when Lucy used her index fingers to trace imaginary lines at the corners of her mouth, she was trying to point out her marionette lines. (She just didn’t know the terms for this.) Where things get tricky is that this concern (and many aesthetic concerns) is often best treated using both Botox and dermal filler injections. That’s because, strictly speaking, marionette lines are not just a matter of volume loss. They’re also a matter of muscular patterning that exacerbates and even contributes to it. That’s why you’ll need to take a multi-pronged approach to give Lucy a result that will leave her feeling like the “fabulous mother-of-the-bride” she aspires to be. 

But, of course, this is easier said than done. Especially when using Botox on the lower face, caution is needed to ensure facial function is not compromised in the quest for aesthetic improvement. And it’s not just Botox that warrants caution. All aesthetic solutions bring with them potential risks and benefits. To deliver the ideal solution for your client, it’s your job to understand and assess these risks and benefits, minimizing the first and maximizing the second.  

The Need for High-Quality Training

The complex interplay of factors that go into determining the ideal course of action for your client highlights the need for aesthetics professionals to receive only the highest quality training, practical experience, and accredited oversight. 

At AAAMS, we are proud to be the leading, fully accredited, virtual botox training platform for thousands of aspiring and practicing aesthetics professionals. With face- and body-focused courses designed for all experience levels, we put professional development, career advancement, and continuing education within easy reach! 

Visit us today to become a part of AAAMS Aesthetic Network where you can learn more about how we can help you begin your exciting adventure into medical aesthetics, increase your confidence, or expand your current skill set! We look forward to training and networking with you!