This past weekend I spent all day Saturday in cadaver training with a renowned injector/educator Dr. Arthur Swift and professor of anatomy Sebastian Cotofano. In groups of four, we had an opportunity to ‘inject and dissect,’ appreciating the intricate anatomy of the face with a visual of where filler and other injectables go when we inject. This opportunity to learn from the best and in this type of setting has no doubt improved my skills!

This year I have committed to investing in my education. The power of injectables to make a positive impact is great; there is nothing better than watching someone ‘wow’ at their own appearance. When we perceive ourselves positively, our interactions in the world follow. To deliver this caliper of results, the injector 100% has to be aware of the anatomy. Injectables are increasing in popularity and more practitioners are injecting. The more I learn, the more I learn I don’t know!  Understanding and respecting the anatomy of the face, with particular attention to the vasculature like arteries and veins is foundational to safe outcomes with filler, botox, and other injectables. Adverse events can and do happen with injectables and typically happen when there is insult to the vasculature. While human variation exists from one person to the next, there is a general pattern that exists. Dr. Swift made a point to say that we are like snowflakes; not one of us is exactly the same. 

Our faces consist of skin, fat, muscles, ligaments, and bones. When a client comes in with concerns, we have to take a step back and consider all the anatomy and how it is intricately connected to itself. Jowling is one of the most common concerns as we mature and it seems sensible to use filler in the area to soften, however this is not the case. Jowling presents in the lower face but results from the entirety of the face maturing, and ultimately descending. In fact, when we injected the cadavers with filler in the temple area, there was a residual lifting of the lower face. This learning speaks to treating the entirety of the face rather than sections at a time. 

As for neurotoxin, of which I mostly use Botox injection, the importance of depth and understanding muscle movement is what I learned most. For example, when treating the frown lines between the eyes, three points are deep and two superficial. As for the forehead, points higher up can elevate the brow and lower can make the brow feel heavy. I used to think that Botox was simple and straightforward, however the more I learn I see that this is not the case. 

Lastly, it was emphasized that everyone deserves a proper consultation. I have been spending more time with clients, going over the process of aging and coming up with a treatment plan. When we understand what is happening, it empowers us to treat the underlying cause and ultimately get better outcomes. 

April 6th I have another big training session with Dr. Swift and I know this will be transformative for my skill. I offer complimentary, hour-long consultations where we have an opportunity to look at your face, discuss goals, and come up with a plan. These are available to schedule online. 

Thanks for reading and I’m excited to share these learnings with you.

XO 
Dr. Heather Friedman