The Evolution of the Non-Surgical Consultation

bio-greenWhen I first began practice 17 years ago, I found it very strange that folks would show up at our surgical office with no intention of ever having surgery. They came looking for the magical, noninvasive, miracle treatment with no downtime and no risk. Some days, I enjoyed these visits because the appointments were very short. We had very little to offer other than the Obagi system, a Retin-A based skin care line that has been around for over 25 years (and that we still use with great success). Collagen injections did exist at the time, but the results only lasted about three months, and many people were allergic to the product as it came from cows. I personally never thought the injections were worthwhile.

Then came Botox. We added this to the practice about 12 years ago, and all of a sudden the consultation appointments started to get a little longer. Botox works amazingly well as long as it is injected into the right location, and it is minimally invasive with essentially no downtime and minimal risk. Not exactly a miracle treatment, but close.

This is a photo of Dr. Green from 1996.

This is a photo of Dr. Green from 1996.

11 years ago, I decided that I would like to add laser to the practice. The fact that I had had no previous laser experience didn’t slow me down as I have always enjoyed learning new tricks and techniques. With a willing group of “guinea pigs” among my staff and friends on which to learn, the various laser applications (hair removal, spider vein treatment, wrinkle reduction, etc.) quickly became some of our most popular non-surgical treatment options.

Rapid improvements in injectable fillers soon followed, with longer lasting products that did not provoke any allergic response. The typical fillers of today are composed of materials already found in the body, and so the immune system does not recognize them as foreign. We can also inject them more smoothly, minimizing the appearance of lumpiness. One of the nicest things about fillers is that the results are visible almost immediately, and much longer lasting than the collagen of old.

Now when a patient comes into the surgical office with no intention of ever having surgery, we actually have a lot to talk about. The appointments last as long as a surgical consultation, and patients have many options to consider. Almost too many sometimes!

Patients often ask me to tell them what they should do. I rarely choose to do that, opting instead to tell them what they could do rather than what they should. Twenty-three years of marriage has taught me that is the better strategy!