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Physician Botox Training Tips for the New Aesthetic Medicine Physician

March 4, 2009 |

Since first introduced to the medical community in 1989 as a treatment for eye muscle disorders, Botulinum Toxin Type A (Botox®) injections have now become the most popular non-invasive aesthetic medical procedure performed in the United States.  According to the American Society for Plastic Surgeons (ASPS), “Botox® procedures rose to 4.6 million performed in 2007, up 13 percent from 2006.”  However, such pervasive market growth has lead to the undesired reality that physicians and non-medical professionals alike mistakenly think that all they need to do to capitalize on the profitability of Botox® for their practice is to simply hang out a sign and start injecting.  Therefore, to both successfully capture a share of this burgeoning market, as well as ensure that practitioners are expertly trained, physicians are challenged to find Botox® training that is professionally delivered, up to date, and procedurally comprehensive.

“Botox® is a tool in the physician’s anti-aging arsenal, and patients’ concepts of anti-aging have grown significantly.  It’s also critical that physicians entering this field have comprehensive hands-on Botox® training,” says IAPAM executive-director, Jeff Russell.  In the May Supplement to the Consensus Recommendations on the Use of Botulinum Toxin Type A in Facial Aesthetics, published in the Journal of Plastic and Reconstructive Surgery (PRS), Drs. Carruthers, Glogau and Blitzer astutely comment that, “rejuvenation has changed from a somewhat two-dimensional focus to an appreciation of the three dimensional aspects of aging, including the contribution of volume loss appearance, and furthermore, a “thorough knowledge of the process of facial aging and the anatomy and physiology of the facial musculature is paramount to treat patients successfully.”  With this understanding has come a paradigm shift from treating wrinkles and lines to relaxing the musculature, restoring volume, and re-contouring to provide a balanced, harmonious aesthetic result.”

It follows, therefore, that new entrants into this field of aesthetic medicine must receive industry-leading training in facial skin and musculature to ensure the most successful patient outcomes.  Comprehensive, multi-day programs, akin to those offered through professional organizations like the International Association of Physicians for Aesthetic Medicine (IAPAM), must be delivered by board certified dermatologists acutely familiar with the skin, and the cosmetic use of Botox®.  Dermatologist Dr. Jennifer Linder states, “when looking for a Botox® training program, one should look for a comprehensive curriculum that covers the entire procedure: from initial consultation through to satisfied patient.  First and foremost, ensure that the person who trains the physician is very experienced so that they can answer all of the doctor’s questions.  I personally believe that a tiered approach is important to becoming as proficient as possible with the injection of Botox®.  The first tier should be an introduction to the basics of the treatment.  One should be comfortable performing within this tier prior to advancing to some of the more advanced techniques, such as treatment to the lower half of the face.  All training should include didactic as well as hands-on teaching methods.”

Plastic surgeon, Dr. Marc Scheiner, applauds courses like the IAPAM’s Botox®/Filler Bootcamp, primarily because they “allow the physician to inject over 10 live patients” which truly gives the “confidence necessary to begin immediately offering the procedure” upon successful completion of the course. Dr Linder also adds, “in order to perform Botox® treatments well, one must understand the medication and how it  specifically works.  Practitioners must know how to appropriately dilute the product and how to safely  and effectively  administer it.   Training should provide an in-depth discussion of facial anatomy and how one evaluates muscle movements to decide on product placement.  One must  understand the details of how  Botox® interacts with the muscles, the natural variations of the musculature of the face, as well as how to achieve beautiful aesthetic results by decreasing muscle contraction in a designed and organized fashion. Effective training programs should also offer preparation to effectively handle any adverse events both from a medical standpoint as well as helping the patient to understand the situation.  Marketing assistance is also very valuable and good training should discuss how to market your services.”

Another key element to an industry-leading Botox® training program is the training and experience of the instructors. Dermatologist Dr. Toni C. Stockton similarly cautions that the instructor must have experience with possible complications that might arise from the use of a specific product or from a discrete procedure. “Someone who is comfortable with dealing with a possible adverse event due to the procedure should be immediately available” at the training, reminds Dr. Stockton.  She also recommends that attendees ensure that all instructors, program directors or speakers have qualifications and experience that can be confirmed.  Dr. Stockton will often “google” presenters to validate their experience.  She also comments that registrants “ensure that products or devices being demonstrated are FDA approved, are in good working order and are sourced from reliable manufacturers.” The IAPAM’s Aesthetic Medicine Symposium is supported by Botox® product with an unconditional educational grant from Allergan.

Dr Linder also says, “any effective training program should provide tips on how to give an effective consultation with each patient. This should include a thorough evaluation of the individual characteristics of the face, a comprehensive discussion with the patient regarding risks and benefits, and most importantly, how to appropriately set and manage realistic patient expectations.”

Finally, as the Dr. Carruthers et al. mention in the May PRS Journal Supplement, “patient education and counseling are essential when developing a comprehensive treatment plan, so that patients can make informed decisions about their treatment choices.  Clinicians must also be knowledgeable about the strengths, but also about the limitations of various products and how they may be used optimally to individualize treatment for each patient’s needs and goals.” The faculty instructing at the IAPAM’s Aesthetic Medicine Symposiums, as well as at the IAPAM’s Botox/Filler Bootcamp strictly follow these Consensus Recommendations and the May Supplement Recommendations on the Use of Botulinum Toxin Type A in Facial Aesthetics.  This pre-eminent faculty is experienced in the “industry’s best practices” particularly regarding the teaching of Botox® injection techniques and protocols.

About the International Association for Physicians in Aesthetic Medicine (IAPAM)

The International Association for Physicians in Aesthetic Medicine is a voluntary association of physicians and supporters, which sets standards for the aesthetic medical profession. The goal of the association is to offer education, ethical standards, credentialing, and member benefits.  IAPAM membership is open to all licensed medical doctors (MDs) and doctors of osteopathic medicine (DOs). Information about the association can be accessed through IAPAM’s website at  Additional information about the Symposium and other educational programs can be accessed through or by contacting:

Jeff Russell, Executive-Director
International Association for Physicians in Aesthetic Medicine (IAPAM)
1-800-219-5108 x705

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 * Botox is a trademark of Allergan, Inc.

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