The Total Facial Esthetic Journey

Twenty-eight years into practicing general dentistry my office manager and wife, Beatriz , came across an email from the American Academy of Facial Esthetics (www.facialesthetics.org). I have to admit I was intrigued at the prospect of being properly trained to offer Botox® and dermal fillers as services at my two dental offices in Chicago and suburban Hinsdale. What concerned me was what I thought I knew about the action of Botox®. My wife told me that if I did not take the course she would go to a dermatologist or plastic surgeon to have this done. With hearing that I decided I could at least give up two days to take the course and better understand what all the buzz was about.

Beatriz signed me up and went as my assistant so she could better understand how to implement this into our Michigan Ave practice. I have taken so many courses over twenty-eight years since I graduated from the University Of Illinois College Of Dentistry.  The two day course we had signed up for turned out to be the most organized and focused course I had ever taken. Dr Louis Malchmacher presented and trained us in a most effective and easy to understand manner. As the first morning unfolded, I had all my own myths and misconceptions dispelled about what Botox® really was all about. The course covered not only the history of Botox® but the mechanism of action of how it works.  I was very surprised to learn that Botox® did not paralyze the muscles, rather it decreased motor activity.  I became very excited because I had seen everyone from my hairdresser Judy to my own wife tell me if I offered this at my offices they would be my first patients and send their own friends and family in. When we first checked out the American Academy of Facial Esthetics website for a Level One course on Botox® and dermal fillers, one of the things that intrigued me the most was being able to bring our own patients to practice on.   This was a tremendous advantage as we could monitor the success of the treatment and see for ourselves how these procedures worked.   In all the CE I have taken over the years, I had never had the opportunity to do something like this.

One of the best parts of the morning was the facial anatomy lesson. The American Academy of Facial Esthetics approach is anatomically based which then makes it much easier to understand how to treat patients with Botox® and dermal fillers. Dr. Malcmacher also reminded us that we were the best injectors of any health care provider and had been trained on proper injection techniques from the very beginning of our careers.

Based on the anatomy, Dr. Malcmacher taught us where and how to inject each facial area for both cosmetic and therapeutic uses including TMJ, bruxism cases, and facial pain. There was a lot to learn including Botox® reconstitution, dosing, indications, adverse reactions and how to avoid them.

The hands-on live patient session was simply outstanding!  We observed and performed a wide variety of Botox® procedures in the afternoon of day one.  The American Academy of Facial Esthetics faculty closely supervised our initial technique making sure we knew how much Botox® we were administering, where it was going and what it would do. I have to admit I was nervous at first but as I was performing these techniques it became obvious almost immediately that this was well within my skill set. I left that first day with many thoughts and ideas. I had not felt this well trained so quickly and efficiently in any course I had previously taken in my twenty-eight years of dental practice.  I could not wait to come back for the second day of this course and develop yet another new skill to further my thirst for knowledge and technique for my budding practice of “Total Facial Esthetics”!

As I sat there on the next morning where we were going to be trained in the use of Dermal Fillers, I started to see the scope of how this course was going to change the way I practiced dentistry forever.  We learned the chemistry, proper indications and use of dermal filler therapy and how it fills out the folds in the oral and peri-oral areas, subtle lip augmentation for both cosmetic and therapeutic uses like gummy smile and angular cheilitis.   In a well presented way I learned about hyaluronic acid substances which are quite safe and effective when used properly to volumize a person’s face and temporarily reverse the effects of aging in a natural manner. I honestly did not know much about what dermal fillers were  but the material was presented in a very logical manner which allowed me to just move forward and confidently inject my very first patient right after the lecture portion that morning.  Placing dermal fillers in a pain free manner involves what we do best. Anesthetizing our patients  as dentist puts us into an entirely different realm of pain control for what our own patients have been enduring at the dermatologist or plastic surgeon offices. I have become a hero with my own patients and staff who badly want this done but were terrified or turned off by a very painful past experience with dermal fillers.

While Botox® takes a few days to begin showing the effects on a person , dermal fillers produce immediate results and it was exhilarating to see that happened as I injected the dermal filler Juvederm® into my patient. What can be done with this product when used by a properly trained operator opens  up another rewarding and lucrative dental procedure that can easily be implemented into our daily operation. Who better to enhance someone’s smile than the person who studies and observes this on a daily basis which happens to be us, their dentist.

By the end of the second day, I was well prepared to implement these new procedures into my practice immediately.  As part of the course, we received very well organized and easy to understand training manuals that I often refer to.  We were given all the forms to give to the patient for pre and post operative instructions as well as consent forms.  There was also a clear list of the materials needed to get started so all we had to do was call up our supply company and we were ready to go.  There was no expensive starter kit to purchase or complicated process to put into action.

There are so many areas of dentistry that require a huge capital investment to get into which have prevented you and I from diving in. Not with Botox® and dermal fillers, all you need is the education and the live patient experiences so that you will be well trained.  The cost of the adjunctive materials you need to buy is literally pennies per patient. The cost of the Botox® and dermal fillers directly relate to the patient fee.

Now that I had completed my Botox® and dermal filler training with The American Academy of Facial Esthetics, my public relations and marketing juices were flowing. I already had a well established patient base and could not wait to get back to the office and start training the staff and patients on our new service! I walked out of that course all fired up to start offering this service as soon as possible. The buzz that was created at my Hinsdale office when I told them I was taking a two day training course on Botox® and dermal fillers totally caught me by surprise. With a staff of 13, they told me across the board how much they wanted to be my first patients. I had never seen them so excited by a job “perk” I could provide them with.  Who doesn’t want to look younger? What was even more revealing to me was the fact that they would only have it done if it was from someone they knew and trusted. I then realized I would look at my patient base differently and was seeing an entirely new and exciting opportunity for my dental practice.

One year later we have established ourselves as a leader in our area providing Botox® and Dermal Fillers within my general dental practice and have expanded our patient base and production in a very healthy and positive way. Our own patients keep sending their friends and family because the word is out that we are the office to have this done at in the most comfortable and thorough manner. When we call our patients that night to see how they are doing, they are in shock and tell us the medical offices they had gone to never did that. The forms we print out off of the course CD allow us to show our patients how much we care about them.

Like anything else, once you begin in a new area of expertise, you want to continue to grow.  I have since been to the American Academy of Facial Esthetics Level II course which has allowed me to add even more services to my office. I also use their training DVD’s as a reference and for staff training. I watch these on a regular basis to provide the best possible care and results for my patients. It is a wonderful review system that I use all the time.

My practice has always believed in minimally invasive dentistry, whether it be caries risk, veneers, periodontal and restorative procedures.  By taking The American Academy of Facial Esthetics courses, I have become a real hero with my patient’s, staff and family. I am producing more per hour with these procedures than almost every other procedure I offer. I am expanding not only my production but my patient base. I am having a lot of fun and at 54 feel rejuvenated again after 28 years of practicing general dentistry. These courses have altered my path forever!

 Dr. Peter Harnois runs two very successful esthetic practices at One Magnificent Mile in Chicago, and in suburban Hinsdale, IL. He is a nationally recognized leader in minimally invasive total facial esthetic techniques. He was an assistant professor of Oral Diagnosis at the University of Illinois College of Dentistry and is an active member of the American Academy of Cosmetic Dentistry. Dr. Harnois is a faculty member and Fellow of the American Academy of Facial Esthetics . For more information go to www.facialesthetics.org.