NUMBER 1: KNOW INJECTION ANATOMY. It is not enough to memorize the muscle names. Be able to visualize the structure, shape, and function of each muscle and exactly what movement it is affecting. . . and what movement you do not want it to effect. Know the depth and potential variants (and there are a lot) of the veins and arteries in order to avoid vascular entry and prevent bleeding and bruising. Injection anatomy has been identified as a unique perspective, compared to a surgical anatomy perspective, but detailed 3D study and cadaver training is common to both. The central key is an absolute understanding of the correct depth at different injection sites and the precise dosing at these sites based on the individual case.
NUMBER 2: REVIEW PATIENT GOALS AND THE DESIRED OUTCOME. This seems like a no-brainer but it is imperative that a detailed and personal discussion and review of expectations be reviewed not only in the beginning of a treatment relationship but also periodically, as time and experience may evolve individual needs.
NUMBER 3: SNAP STANDARD PHOTOS FACE ON AND AT 45 DEGREES. No one can remember (with any exactness) the pretreatment appearance. This is helpful to the patient, who should be interested in their personal outcome, as well as the injector, who should always be learning from their outcomes and making adjustments over time to continue to develop their skills.
NUMBER 4: PATIENT PREP, CLEANING AND SETUP. Clean and sterile injections prevent infection. Patient prep can also include a local numbing cream, a pharmaceutical compounded mixture of benzocaine, lidocaine, and tetracaine or similar. Some patients may opt to forgo this step depending on past experience, procedure related anxiety, or smaller injection visits.
NUMBER 5: CHECK YOUR PRODUCT LABEL, SOURCE, & EXPIRATION DATE. Double and triple check your product label for identification, authenticity, and confirmation of expiration date. Even if you just received that shipment, manufacturing or shipment errors are still possible. Once your name is on that product, verify you want your name on that product.
NUMBER 6: USE ACCURATE TECHNIQUE WHEN MIXING THE TOXIN WITH SALINE AND TRIPLE CHECK STANDARD BEST PRACTICE MEASUREMENTS. Sterile saline is used to mix toxins from powder form just prior to use. Botox and Dysport must be in refrigeration until ready to use. Verify the number of units in the bottle, do the product specific calculations and double check as you prep the solution.
NUMBER 5: MARK AREAS FOR INJECTION.
NUMBER 4: DRAW UP THE SPECIFIC NUMBER OF UNITS FOR THE PRODUCT YOU ARE USING AND CHANGE TO A FINE 1/2 INCH 31 OR 32 GAUGE NEEDLE. Use an 18 gauge needle to draw up your product through the rubber stopper then change the needle to a fine gauge for skin penetration. This ensures your needle is sharper and minimizes discomfort. For a larger number of injections, changing the needle halfway through avoids a dull point.
NUMBER 3: APPLY A COLD MASK AND/OR ARNICA TO HELP WITH TRANSIENT SWELLING, REDNESS, AND TO AVOID BRUISING AND SORENESS. Finish your procedure with class. Don't leave pinpoints bleeding and swollen. A cool mask or arnica kept in the fridge is greatly appreciated by clients. It just takes a quick minute while you are cleaning up.
NUMBER 2: REVIEW POST TREATMENT INSTRUCTIONS INCLUDING NO LAYING DOWN FOR 4 HOURS, NO EXERCISE OR EXERTION, NO RUBBING THE FACE. Even vets need to hear this quick reminder. No one wants the toxin moving after the toxin has been specifically placed.
NUMBER 1: SCHEDULE A 2 WEEK FOLLOW UP TO EVALUATE RESPONSE AND ADDITIONAL RECOMMENDATIONS AS WELL AS COMPARE BEFORE & AFTER PHOTOS FOR A PERFECT RESULT. This is highly recommended for anyone you have never injected before. Individual responses to product or your pattern of injecting may need to be adjusted for perfect delight in the result. It's ok. I do mine for free. I can adjust the treatment to just the right amount next time, and my client leaves in perfect condition!