Comprehensive Patient Treatment

By Crystal Wilson, CNP

This patient presented to me and wanted a full-face refresh. During our initial visit, we talked about all her concerns and came up with a treatment plan. I typically like to come up with a long-term treatment plan and tackle it over multiple appointments to give the face time to heal from swelling and bruising. The first treatment I did for this patient was PDO lifting threads. I used VSoft Arte 1 19G by 100mm length threads. I placed three per side, for a total of six. On both sides, I placed one to the marionette line, one to the jowl and one straight back along the jawline. This helped in lifting the tissue that was causing lower face ptosis and created a more snatched, defined jawline. Also, during the first appointment, we started with the first of three rounds of PDO smooth threads in the submental area (double chin). This patient was the perfect candidate for smooth threads in this area because she had excess skin that just needed some tightening. I used a total of ten 29G by 40mm length VSoft twist smooth threads. The collagen and elastin that are stimulated from the use of PDO smooth threads was just what she needed. We ended this appointment by doing a full-face neurotoxin treatment. We used Xeomin on her and she got a total of 80 units. We treated her frontalis (forehead), glabellar complex (11’s), bilateral orbicularis oculi (crow’s feet), bilateral brow lift, mentalis (chin), bilateral DAO’s (depressor anguli oris) and platysma bands. The patient returned two weeks later for a follow-up, and everything was looking great. We scheduled her out another two weeks, as I typically like to wait four weeks after lifting threads to do any dermal filler. At the four-week follow-up appointment, we did her second round of PDO smooth threads in the submental region. We recommend at least three treatments, 4-6 weeks apart. I also treated her with dermal filler during this appointment. I used a total of two syringes (2cc’s) of Juvederm Voluma between her cheeks, chin, and pre-jowl sulcus region. The after photos shown were taken immediately after this appointment. We then scheduled her out another four weeks to do the third and final round of PDO smooth threads in the submental area and to evaluate how her dermal filler is looking.  I hope the biggest takeaway from this post is to remember the importance of full-face assessments for all your patients and to come up with a personalized comprehensive treatment plan that will give the most refreshed, natural results.

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