Aesthetic Treatments

In the Time of COVID-19, Online Provider Visits Include Injectables Consultations

injectables telemedicine virtual doctor consultations | Spotlyte

Amid the Coronavirus pandemic, many people are scheduling online doctor visits in lieu of in-person appointments. While some are seeking help with medical concerns, others are more focused on something else: After a lot of time spent indoors (and on constant video conferences), plenty of people want to know how to address the aesthetic woes that they can’t unsee. Maybe that’s ever-deepening moderate to severe crow’s feet, or sagging cheeks. So, from living rooms, bedrooms, and kitchens around the country, patients are connecting with their doctors to inquire about whether they’re a good candidate to try injectable wrinkle reducer and/or filler.

Editor's Note

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. 

To meet with doctors about injectables over Zoom(TM), FaceTime®, or another communication platform, individuals start the process by simply scheduling appointments with their doctors’ offices. Before you log on for advice and direction, see what we learned when we talked to three doctors about the virtual appointment process, including how to prepare, best practices, and what questions to ask.

What are the perks to booking online appointments?

Compared to in-office consultations, both patients and providers save time with virtual appointments. Beyond getting ready to leave the house and the commute, there’s zero time spent sitting in the waiting room or getting checked in. Also, rather than completing the necessary medical history paperwork while you wait to see your provider, you can complete it at your leisure before your virtual appointment, notes Jennifer Levine, MD, a board-certified plastic surgeon in New York City.

Where do virtual consultations take place?

Online doctor’s appointments can take place on Zoom, Skype®, FaceTime, or other platforms equipped for video calls. Because there are so many options available, it’s best to ask in advance what phone and/or computer applications are needed for your session. That way, you can download specific apps prior to consultation day and also familiarize yourself with the program(s) if you haven’t used them before.

Typically, providers have a preference, and that includes the ones we interviewed for this article. Dr. Levine connects with patients on Zoom. Dr. Robyn Gmyrek, MD, a board-certified dermatologist in New York City, prefers FaceTime. Dr. T.Y. Steven Ip, MD, a board-certified plastic surgeon in Beverly Hills, Calif., primarily uses FaceTime, but occasionally opts for Skype and WhatsApp® to speak with individuals who are interested in injectables. 

How long do virtual consultations last? 

Just like in-office consultations, they’re pretty speedy. Online doctors appointments for injectables can range from 15 to 30 minutes, depending on the patient and the specific questions they have for their provider. If you prefer an in-and-out appointment, you can help streamline your consultation by having a list of prepared questions ready to go.

What questions should I ask during a virtual injectables consultation?

Your questions should be entirely unique to your needs, so it’s best to come prepared to voice your concerns about any particular issues you may be experiencing. With that said, common patient inquiries include the cost of treatment, medications people should avoid when they’re preparing to get injectables (and after), and what filler is made of, says Dr. Gmyrek.

Other frequently asked questions include what specific products are being used and unit amounts, says Dr. Levine. “I go over the risks, benefits, and the alternatives to the treatment, even if they don't ask the question,” she adds. Then, in addition to answering your questions (of course!), your provider will make recommendations for treatment. “I'm going to ask the patient what their concerns are, or what they would like to fix,” explains Dr. Levine. “Then, I'm going to let the patient know what I see, and then I'm going to tell them what I suggest.” 

How else can I prepare for a virtual injectables consultation?

Beyond downloading phone and computer apps, there’s no need to purchase or obtain any fancy technology. Ring lights, for example, help ensure perfection in social media photos and videos, but they aren’t necessary for an one-on-one injectables consultation. (That said, if you’re having your provider examine questionable spots, rashes, or other conditions that would be better examined in real life with quality lighting, you might want to make the investment.) 

Dr. Gmyrek says lighting should not be overly bright, primarily coming from an overhead source or beaming from one direction entirely. But don’t overthink it: “In this case, mild shadows can sometimes provide a more accurate picture,” she points out.

It’s also possible that your provider will ask you to email them some photos of yourself ahead of time. “You can see certain things on video, but there's only so many ways that a patient can turn their head and give you a really good view,” explains Dr. Levine. “Photographs can help me get a better idea of how they actually look from more traditional angles.” Plus, if you send older images of yourself, you can show your provider exactly how your face has changed over time, which can help them make a more precise diagnosis.

What else goes on during virtual consultations?

Now that you’ve downloaded the right phone app(s), prepared your questions, gathered photos, and secured lighting, it’s go-time. When you connect with your physician, they’ll likely ask you to showcase your lines and wrinkles. “I have them animate their face in different ways during a consultation to determine best treatment options and areas of improvement,” says Dr. Levine. 

Making even the most insignificant-seeming facial expressions can help your provider better understand your concerns. “These movements help to determine whether wrinkles are dynamic (or movement-related) versus static wrinkles,” explains Dr. Gymrek. “Static wrinkles are present all the time and are not movement-related.” As an example of facial expressions, Dr. Ip asks his patients to furrow and raise their brows and squint. That said, each provider’s methods, as well as costs for consultations — sometimes complimentary, sometimes with a fee — can vary.

What can I expect after their virtual injectables consultation?

Typically, the office will schedule an in-office appointment immediately after the consultation has wrapped up. If you need more time to weigh your options, patients can call the office on their own time to make an appointment for a later date. In some cases, the offices may follow up with the patient to put a date and time on the calendar. “We ask them if they want us to give them a followup call,” says Dr. Ip of his patients. “If they're just here for information, we try to respect that. We're not trying to harass anybody — people know when they want to have a procedure done. When they're comfortable, they call back.”

Will online visits with providers continue after the Coronavirus pandemic?

Although the COVID-19 restrictions brought upon many difficult and unique challenges, one silver lining was figuring out a way for patients to quickly access their providers without seeing them face-to-face. For many providers and patients, online interactions will carry on.

“It’s a really great way to connect to people who want to know what they can do without having them come to the office,” says Dr. Levine, who plans on continuing virtual consultations into the future. “It's important for people to understand what they need, their plan, and get a rough idea about costs before they commit to making an [in-person] appointment.”

Dr. Ip agrees. “I’ve been doing a lot of virtual stuff before COVID,” he explains. “With [technology], I can do the whole initial consultation virtually, for out-of-towners, or even for people who don’t want to drive through L.A. traffic. Virtual [appointments] are here to stay. People are comfortable with it. It saves everybody time.”

However, beyond the obvious point that you’ll need to eventually head into your provider’s practice to get treated, there’s still value to real-life appointments. “I strongly believe in having a patient-physician relationship that fosters trust, and that can be very difficult to build when my first and only meeting with the patient is virtual,” Dr. Gymrek notes. But no provider would ever want you to put your health at risk in the name of a consultation. “If a patient is not comfortable leaving their home during the pandemic, I respect that completely,” she adds.

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Dr. Jennifer Levine is a paid Allergan® consultant.