WHO IS THE FACIAL SPECIALIST ? HYALURONIC ACID FILLERS : OPTIMISATION OF AESTHETIC DENTISTRY AND PATIENT LOYALTY
Figure 2 . Facial proportion analysis . Soft tissue examination is performed in the three projections : frontal ( A ), oblique ( B ) and lateral view ( C ). The patient should be evaluated standing up with his head in a natural head position , with the eyes staring at a point to the horizon on the same plane of his or her eyes . Drawn by Aldo Zupi using ZygoteBody™ 3D Anatomy Viewer . Zygote Media Group Inc ., American Forks , UT
Contraindications are rare : skin diseases , infections or viruses ( e . g . herpes labialis ) in progress , autoimmune diseases of the skin and collagenopathies 12 . Although there is no evidence of contraindication , it is safer not to administer HA fillers during pregnancy and breastfeeding 12 .
3 . Who is the facial filler specialist ? The first objection raised from the dentist ( about filler procedure ) is always the same : “ can the injection technique be done in a dental clinic ?” or “ wouldn ’ t it be better if specialists such as dermatologists and plastic surgeons did the facial filler ?” Surely , from an historical point of view , dermatologists and plastic surgeons have been the first to focus and take care of people ’ s faces and use therapies ( more or less invasive ) for the maintenance and the recovery of the health and beauty of the patients . In the last years , minimally invasive procedures ( such as fillers ) started to spread around and different professional categories such as anaesthesiologists , medical aestheticians , ophthalmologists , internists and so on , started to be interested and so they also begun to use facial fillers in their every day practice . In some cases , the filler practice left the medical area to cross into the paramedical area ( in the best case scenario ). It is not rare that non-medical staff performs procedures such as filler , botulinum , sclerotherapy , and mesotherapy 5 , 13 . Usually , the training for these procedures is only focused on the technical aspects . Teaching focuses on just a few concepts . They are surely important , but , perhaps , not enough to create the facial filler specialist . Many facial filler courses are focused
on “ where ”, “ how much ” and “ how ” to inject . They offer a very quick refresh of our facial anatomy knowledge and of its critical and dangerous areas . The whole aging physiology is discussed rapidly in a couple of sentences . This is enough to gain all the necessary techniques for the surgical procedure . However , they give the necessary anatomical and functional knowledge for granted . A dentist , any dentist , has spent his whole professional training ( from the first day at university ) studying and mastering the anatomy and physiology of the oral and perioral area . They have studied and mastered all the aspects and they know the characteristics better than any other medical specialist . In addition , the dentist is the only specialist who spends every day of his profession working on this area , dealing with its singularities and the changes that happen with time . If this were not enough , everything is subject to the aesthetic judgement of the patient every single day . Therefore , dentists have to accept the ugly truth of being the ‘ real ’ specialists of the oral and perioral region ( or rather from the chin to the cheekbones ) and that their very specific scientific background and their daily work is not comparable to that of any other specialist ’ s . No dermatologist , plastic surgeon or other , will be as competent and confident as the dentist . With increasing frequency , patients ask us , or our colleagues , for a generic improvement of their physical conditions ( Fig . 1A ). In these cases , usually , the approach is different depending on the specialist . If the interlocutor is a traditional dentist , the operation will be limited to the teeth and mouth . A traditional dentist sees the patient ex-
170 STOMA . EDUJ ( 2016 ) 3 ( 2 )