By Elizabeth Stewart, RN
As a new injector it can be intimidating to get started. Often times attendees will express worry about going back their offices and incorporating their new skills after taking a course. I always say practice, practice, practice as soon as possible. I am also new to injecting and it can be intimidating to do a new skill for the first time on a patient. I wanted to share a few tips that can be helpful when you are building your skills and confidence with injectables.
To begin, safety should always be your number one consideration. Before injecting know your anatomy! Consider the technique you are going to use. Where are you injecting? What are the surrounding muscles and vessels? Are the vessels deep or superficial? What adverse effects are possible in the area you are injecting? These are things you should be thinking about before you even touch the patient with a needle. This being said adverse events can happen to the best injectors. We like to say “not if, but when?” What makes you a good injector is knowing how to treat the compilation. Vascular occlusions and compressions are rare, but they do happen. You should ALWAYS have a dissolving agent on your office incase a occlusion does occur. It is equally important to educate your patients on what signs they should be looking for if the occlusion is delayed. This is not meant to scare injectors, but it makes you a better provided if you are prepared and you prepare the patient in the case complication arises.
Secondly, I want to talk about patient selection. Making sure a patient is right for a treatment is important no matter how much experience you have, but very much so when you first begin. Friends, family, and co-workers are going to be the best to start! Not only will they be understanding that this is practice for you, you will also be able to follow their results more closely. For example, when getting comfortable with botulinum toxin dosing it can be helpful to treat a few employees that you see everyday to see the product kick in over 2-10 days. Start low, you can always add more at the 2 week mark, but you can not take product away. Patient expectation is also an important consideration. This is true for any cosmetic treatment. Take the time to discuss what their goals are and what they expect to get out of the treatment. Treating a patient with unrealistic expectations is never good no matter how much experience you have. If they do not understand the results they should expect, they will not like their results even if you did a fantastic job. This will only lead you to have a dis-satisifed patient, and a hit to your confidence if they do not like their result. For example, if you have a patient with dense heavy tissue, and they are expecting it to look as though they had a face lift after threads, they would not be an ideal candidate. However, if they are okay with even just a little improvement and are okay with you practicing go for it! Try to get experience with all different types of patients when you first begin. Young, older, male, female, different skin types, face shapes, and sizing. Every patient is going to be unique, so gaining all the experience you can is going to help you grow confident treating what ever might come in your door.
When first scheduling patients, it is helpful to schedule longer appointment times than you typically would. This will give you time to treatment plan, draw up, and treat and not worry about getting behind schedule for the day. Reconstituting and drawing up product can take time as you are getting started. First time patients appointments will always be a bit longer in order to treatment plan but once they are established you will be on a roll. A lot of providers love to train an assistant to be drawing up for the next patient as the treat the current. This is extremely helpful once you have established patients and can quickly be in and out of appointments.
We often get a lot of questions at our courses about product selection, and what our preferences are. I always say that it is provider and patient preference! It is recommended to have options, so your patients have a choice! For example, in our office we have both Botox and Xeomin for neurotoxin. Some patients will come in who already have a preference, otherwise I explain the differences. When it comes to filler there are so many options from multiple brands. Every provider is going to have a preference, so try different products! Get a feel for what is out there and what would best suit the patient population that you see in your office. In saying this make sure you are getting education from the representatives on the brands to make sure you are using the products in the areas and depths they are intended for, in order to be safe and get the best results.
Everyone has to start somewhere. Try to start seeing patients as soon as possible after hands on training when the information is still fresh in your mind. There more you treat the more comfortable you will be. Take your time and make sure you master treatments before moving on to learn something new. When it’s all said and done just remembered to be confident in your skills. There is so much that goes into injecting. The techniques you are using to inject are important, but patients are coming to see you over other providers for more than just your technical skills. They have trust in you from your experience and fundamental knowledge no matter what field of healthcare you are in. Patients will continue to come see you when you build a therapeutic and trusting relationship. Be honest and provided them education before, during, and after treatment. Make sure they have a way to get in contact with you if their is a complication. You are most likely already doing equal or greater risk treatments in your practice, this is just something new. Be safe and happy injecting!!
Register for the Botulinum Toxins & Dermal Fillers Level I Course to start your esthetic journey! Register here today: https://www.facialesthetics.org/courses/botulinum-toxins-dermal-fillers-level-1/