Getting services on demand in the comfort of your own home has become the new normal across the United States. Practically anything you could possibly want can be brought directly to you with the tap of a finger — and we’re not talking about skincare via the two-day delivery of Amazon Prime®. Everyone from hot tool-wielding stylists and lactation consultants to housekeepers and private chefs can be discovered, booked, and provided within a 24-hour window.
Interestingly enough, some experts in the medical field are following suit. However, these aren’t the house calls of yesteryear: dermatologists are knocking on doors to administer injectables. Over seven million injectable wrinkle reducers were administered in 2018 alone, and with that much demand, it’s logical that some patients would prefer to have their appointments at home.
That’s why more and more providers are offering house calls to their injectables patients. One such doctor is Marnie Nussbaum, MD, a board-certified dermatologist in NYC. “When administered by an experienced board-certified dermatologist or plastic surgeon who understands complicated facial musculature and follows strict safety protocols, injectable house calls [can be] a solution for patients seeking greater privacy and convenience,” says Dr. Nussbaum.
Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you.
With possible bruising post-injection and lengthy travel times to and from the derm’s office, privacy and convenience are what make injectable house calls so attractive to many. In particular, many of Dr. Nussbaum’s house calls are for existing patients on a retreatment program, who know what injections they want and are looking to save time. “The ease of being able to answer your door at a specified time, have your procedure, and go right back to your day is invaluable to busy parents or working moms,” says Dr. Nussbaum. “Sometimes, after transportation to and from the office, as well as the occasional waiting time, a few hours may pass — that time can be better spent doing something else that’s more important to my patient.”
Frazzled nerves pre-procedure might be another reason to stay home. According to Norman Rowe, MD, a board-certified plastic surgeon with Rowe Plastic Surgery® in NYC who offers injectable house calls, in-home treatments can put patients at ease. “Patients are more comfortable in their own space and don’t feel like they are receiving a medical treatment,” he says. “This is especially helpful for those who get jitters about going to the doctor’s office.” Plus, some people just don’t want to be seen after injections, especially if they prefer to keep their treatments under wraps.
However, other providers aren’t so keen on taking house calls. “Would you ask your dentist to come to your house to perform a dental cleaning?” asks Michelle Yagoda, MD, a board-certified plastic surgeon in NYC. “If the answer is no, then you should not ask your doctor to come to your house to give you injections of filler or [wrinkle reducers].” She reiterates that medical aesthetics treatments are just that — medical, and should not and cannot be confused with beauty treatments like manicures, hair color, or spray tans.
So, why do some providers prefer to administer injectables at their practice? Some, like Dr. Yagoda, consider the office setting as something of an insurance policy — you choose it in the unlikely event that you might need it. And a handful of other dermatologists we spoke to agreed. “I personally perform all of my injectables in the office, where the lighting, positioning of the patient, and cleaning of the room can be controlled for,” says Joshua Zeichner, MD, a board-certified dermatologist in NYC. “Side effects of injectables [can happen] . . . I have had patients [experience them]; so in these cases, I like to be prepared to take care of my patients in a controlled office environment.”
That said, many providers who offer house calls believe that treating their patients in the comfort of their homes is comparable to administering injectables in their office — so long as you’re choosing a provider carefully. “The most important factor with any injectable procedure is who's doing it,” explains Dr. Nussbaum. “It is essential to have a board-certified dermatologist or plastic surgeon who follows proper protocol using universal precautions, [such as] ensuring sterility, setting up a sterile environment, and taking precautions with biohazardous material by wearing proper gloves and disposing of materials properly.” (Learn more about selecting a credible provider here.)
Cleanliness and proper protocol regarding sterility is an essential component of a successful at-home injectables appointment, and you should ask your provider what measures they take to ensure your at-home treatment is comparably clean to one in the office. Dr. Rowe notes that he and his team treat patients in the same manner, regardless of the location. “We have the same procedures during house calls as we do for in-office appointments, such as using aseptic technique, which is an important part of injections — no matter the type of injection or the setting it is given in,” he explains. “Supplies are brought along to ensure that the procedure remains aseptic.” Aseptic technique means providers work to prevent contamination from bacteria with certain procedures, such as using sterile gloves, masks, and instruments.
There are also providers whose thoughts and actions fall somewhere in the middle. One, for example, is David Cangello, MD, a board-certified plastic surgeon in NYC. Although he has performed “hotel calls,” as The Plaza Hotel℠ is near his office, he still believes that injectable treatments are better controlled in an office environment. After all, it isn’t only your provider who is present in the office for your treatment. “You have an entire staff trained and dedicated to performing these procedures,” he says. “You just have an added level of safety.”
Having a staff on-hand can be beneficial, if anything were to go wrong. Like any medical treatment, there are risks involved, which might go up if performed in a non-medical setting. “While these injections may seem trivial to some, there are potential risks that physicians and patients should be aware of, [including] injection of the filler material into an artery that can lead to a breakdown of the skin, scarring, and, in rare cases, blindness,” warns Roy Geronemus, MD, a board-certified dermatologist in NYC.
Dr. Yagoda offers another factor to consider when thinking about out-of-office treatments — a possible lack of insurance coverage. “In some states, malpractice insurance coverage is only in effect when the doctor practices in his or her office or a hospital setting,” she explains. “That means that if a complication occurred after a procedure performed in a spa, storefront, home, or other environment, the patient may not have any recourse.”
Injectable wrinkle reducers are continuing to increase in demand, and considering convenience is king these days, it’s possible we may see requests for injectable house calls increase, too. “[Injectable house calls] are already such a popular trend,” explains Dr. Rowe. “With the demand for injectables at an all-time high, people are wanting easier, more convenient access to legitimate injectable appointments.”
Some doctors, like Dr. Yagoda, are hoping for the opposite, claiming that providers shouldn’t overlook the possible risks of a convenient at-home treatment in favor of bolstering their injectables business. “It’s important to remember the Hippocratic Oath, ‘First, do no harm,’” she says. “Like everything in life, it’s important to do the right thing!”