Managing patient expectations: “I want to look like a celeb”

You may be forgiven for thinking that learning complex aesthetic procedures, understanding facial anatomy, and honing your injection skills are the most difficult things for an aesthetic clinician to get right – which is true – but one of the hardest skills to master is managing patient expectations.

Dr Tim Pearce has been surveying his audience for the most common questions about managing patient expectations. In this blog, he will delve into how to get into the mind of your patient – before you put a needle into them – so you understand their complex psychology and what they expect to gain from treatment. Learn how to handle a patient who wants to look like a celebrity, or what to do when a patient asks for more dermal filler in their lips than you feel comfortable delivering.

Do you feel anxious about causing complications? Many clinicians feel so overwhelmed with the thought of causing a vascular occlusion that it stops them growing their aesthetics business. Dr Tim is currently hosting a webinar series to help you overcome your fear of complications so that you can uplevel your knowledge, and increase your CPD-certified learning to build a successful aesthetics business. Sign up here >>

Are you worried your patients are going to be underwhelmed with their result?

Your patient has an image in their head; often younger patients are very excited about what is attainable with cosmetic procedures, and they carry that excitement into the consultation room. They are hoping for the image in their head, but you must somehow align them with what is possible with treatment.

The first thing to realise during the consultation is that by showing you photographs, pointing to and animating their face, your patient is trying to communicate a goal.

This is perfectly correct and what they should do. You must take that ‘goal’ on board and reflect it back to them. This is when you can show them, in your treatment plan, the elements that you can and cannot achieve. In medial aesthetics, the truth is we can always get closer to the aesthetic goal – even if they want to look like Angelina Jolie but they have thin lips, you can still get them closer to that goal, but you must be clear that you will not achieve it.

Blunt honesty with your patient is essential

Dr Tim explains one strategy for a very excitable patient profile. He recommends ‘destroying’ all hope for their desired goal before you then rebuild the hope into what you can achieve.

Using the same example, this would mean explaining that they have very different anatomy to Angelina Jolie, thus you will never achieve her look, but you can enhance their lips. Ensure that you seek validation that the patient understands what you are saying.

Sell the journey towards the goal

Most patients do understand; they are just hoping you can do more. Hence, you are levelling their expectations down to almost nothing, and then you start to pick out the details from their expressed concerns/desires and explain what you can achieve that gets them a little closer to their original ideal.

Dr Tim finds that this results in patients who are happy with the aesthetic result, even if it is not the same as the picture that they brought in to show you. This is because you are selling the journey towards the goal, rather than failing at achieving the original goal, and most patients are thrilled with that approach.

Is it even possible to achieve Kylie Jenner lips

Dr Tim has seen that many of his younger patients bring photographs of Kylie Jenner and ask if they can look like her. As aesthetic injectors, you may be wondering if it possible to achieve this result, but is this result even real?

This is what Dr Tim does. He finds a video featuring Kylie Jenner and takes a screen grab to compare with the photograph that the patient is presenting. A dynamic, unedited image of this celebrity’s face reveals that the filler (or lip implant) in place is distorted and not all it seems, nor like the photograph the patient is clutching.

This focuses the patient away from the aspirational look they have seen in the air brushed photography, which is far from the real life individual. It is very important to make patients conscious of this type of image deception and manipulation of reality, which creates an illusionary celebrity look that you will never achieve with cosmetic injectable treatments.

There will almost certainly be something you can do to improve the patient’s lips, so rather than leave them miserable, you can then teach them about the ways that you can help them to achieve some of the ‘real’ desires they have from treatment and what is possible with lip filler injections.

My patient wants more mls of filler, but I am not comfortable adding those quantities, what do I do?

This is a situation where you must be in tune with your patient’s psychology, advises Dr Tim, understanding what they are searching to achieve.

Patients who ask for more filler when it is not clinically indicated or suitable are still seeking some sort of change which they believe will make them better off; we must understand what is driving this need – unpack their motivations and educate them about the different drivers.

• The novelty of having lip filler – if the patient has never had treatment before and gets a good result, it can be a euphoric experience, so they want more of that high, the feeling of new lips, and the comments that come from friends and family. The feeling of newness is not as enduring as the lip filler; thus, patients may still have a good result six months later but want that excitement of having another procedure. With retreatment of the lips contraindicated, Dr Tim will remind them that they have a great result, explore other treatment options to address other perceived flaws they may highlight elsewhere on their face, or advise them to look for the sense of novelty and excitement in more sustainable ways, such as buying a different colour lipstick that will make them feel special.
• The artists eye – there is a small cohort of very artistic patients who are often very aware of the finer details and are chasing a missing component towards a slightly better result, which is attainable, but is not something you have noted. By understanding this driver, you can validate whether they are correct, if is it going to make them more beautiful, but more importantly if it is attainable with additional filler injections. If those two criteria are met then you could perform an additional procedure, but often one is not, and you need to explain why it is not worth adding more filler.
• Dysmorphia – no matter what you do, patients are never happy if they suffer from body dysmorphia. Anyone who gets a good result but then comes back unsatisfied, wanting more, should trigger a conversation where you make it clear that the real purpose of these procedures is for them to live a happier life, not just to have x amount of mls of filler in their lips. You want to see evidence that they are getting happier with procedures because aesthetic clinicians do not want to treat patients who do not get happier, that is not good for either party, so you must say no to these patients.

Top tip: how to say no to a patient

Patients know that aesthetic clinics are a business, and some believe that this is all we care about, however, it can be refreshing for patients to hear you say, point blank, that you do not want to take their money for a procedure because you do not think it is in their best interests.

This makes them realise that you are on their side, and the reasons why you are saying no are for their benefit and not self-interest. This is the art of how to say no to an aesthetic patient without making them angry.

Do not say – “it’s my reputation at the end of the day and I don’t want people to think I’ve done this lip procedure on you” – this will make you an adversary to your patients.

By saying no because you believe you are acting in their best interest, which is the medical model, you provide a softer way of rejecting a patient that does not result in a one-star review!

A new approach to treating lips: become a designer of lip treatments

When managing patient expectations, you can simply realign their expectations to what you think you can achieve but consider if you are technically good enough to get the best out of the set of lips in front of you. This relies on understanding the technical core of lip injections – every move you can make with a needle, or every product that you can use to inject has certain qualities that enable you to get closer, depending on how you use them, to the aesthetic goal.

Before you realign your patients’ expectations around your technical capabilities, challenge yourself – can you design a lip treatment that will get someone closer to their ideal look? (Excluding Photoshopped images).

Break the lips down into their fundamental components – fundamentals of the aesthetic, fundamentals of the anatomy, and fundamentals of your injection technique and products – once you understand that core, you can design much better lip treatments – this is the difference between lip technique and lip design.

Want to know lip injection secrets?

Learn the 3 lip injection secrets experts use to create perfect, Instagram-worthy results.

Plus, how to increase your prices by 61% without losing any patients! Sign up for Dr Tim’s Free lip training webinar on 29^th September 2022.

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Aesthetics Mastery Show

Managing patient expectations | What to do when patients want their lips like celebrities

In this episode, Dr Tim talks about managing your patients expectations when a patient asks for more filler or brings a photo of a celebrity and asks for lips like theirs. Watch the full Aesthetics Mastery Show here.

A practitioner replied to say:

“Yes, as an esthetician, I’m always explaining reality; guiding expectations. Just yesterday, I had to explain to a new client, that her dermatologist prescribed hydroquinone was going to take months to work. And, even then, would very likely not work 100% on her hyperpigmentation. This woman works outside, and wasn’t told: how important it is to have good sun protection, every day! Or that using the hydroquinone, or any other skin lighting methods, would make her MORE susceptible to MORE damage. She was (her words) “very appreciative of my honesty.” ️ “

Read more and join in the debate on our YouTube channel.

Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

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