Recommendations for Aesthetic Treatment Orders
For aesthetic treatments, physicians should use a 25-gauge needle or large-bore cannula when injecting albumin-PRF to avoid blockages, and eliminate bubbles before heating the upper layer of PRF to ensure optimal results. 1
Pre-Treatment Assessment and Planning
Patient Evaluation
- Assess facial anatomy, considering differences between male and female patients
- Evaluate skin thickness, presence of inflammation at injection sites, and any pre-existing conditions
- Document any marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, or thick sebaceous skin 2
- Identify exact locations of facial concerns (wrinkles, volume loss, skin texture issues)
Contraindications
- Avoid treatment in patients with:
- Neuromuscular disorders (myasthenia gravis, Lambert-Eaton syndrome)
- Active inflammation at proposed injection sites
- Excessive weakness or atrophy in target muscles 2
- History of hypersensitivity to treatment components
Treatment Protocols by Procedure Type
1. Autologous Platelet Concentrates (APCs)
Preparation Guidelines:
- For PRP double spin protocol: 320 rpm for 5 minutes, followed by 1000 g for 10 minutes 1
- For PRF: 700-800 rpm for 3-4 minutes (no anticoagulant) 1
- For Alb-PRF preparation:
- Ensure heated albumin gel cools before mixing with liquid
- Use firm luer-to-luer connection and mix slowly
- Eliminate bubbles and dead space in connector before mixing 1
Injection Technique:
- Use a 25-gauge needle or large-bore cannula to inject Alb-PRF 1
- For facial rejuvenation: administer via point-by-point intradermal injections
- For acne scarring: combine with microneedling for enhanced results 1
- Treatment schedule: typically 3-6 sessions at 2-4 week intervals
2. Botulinum Toxin Injections
Dosing and Administration:
- Standard dose for glabellar lines: 20 units
- Do not exceed recommended dosage and frequency
- Exercise caution in patients with marked facial asymmetry 2
- Document pre-treatment facial expressions for comparison
Safety Considerations:
- Monitor for adverse reactions including headache (12%), eyelid ptosis (2%), and upper respiratory tract infections (3%) 2
- Advise patients to report any unusual symptoms, including difficulty swallowing, speaking, or breathing
- Inform patients about potential eye dryness and to avoid driving if experiencing muscle weakness or blurred vision 2
3. Dermal Fillers and Combination Treatments
Administration Guidelines:
- For combined PRF and hyaluronic acid treatments:
- Cellular matrix approach shows 20-24% improvement in facial appearance compared to 8-11% with PRP alone 1
- Document treatment areas with photographs before injection
- For nanofat and PRF combination:
- Higher satisfaction rates (>90%) compared to traditional treatments 1
- Particularly effective for facial soft tissue depression and skin texture
Post-Treatment Management
Follow-up Schedule:
- Evaluate results at 2 weeks, 3 months, and 6 months post-treatment
- Use standardized assessment tools:
- Wrinkle Severity Rating Scale (WSRS)
- Global Aesthetic Improvement Scale (GAIS)
- FACE-Q for patient-reported outcomes 1
Adverse Event Management:
- For localized reactions: monitor for pain, swelling, erythema, or bruising
- For more serious reactions (difficulty swallowing, breathing problems): seek immediate medical attention 2
- Document all adverse events thoroughly
Documentation Requirements
- Comprehensive pre-treatment photographs
- Detailed consent forms explaining potential adverse effects
- Treatment records including:
- Product used and lot number
- Injection sites and technique
- Total volume administered
- Patient response and immediate outcomes
Quality Assurance
- Aesthetic procedures should only be performed by well-educated, well-trained medical doctors with excellent medical background 3
- Maintain an "Aesthetic Policy and Procedure Manual" with specific details on patient assessment, indications, contraindications, warnings, precautions, and injection techniques 4
- Regular staff training on updated protocols and emergency procedures
Common Pitfalls to Avoid
- Eliminating bubbles before heating upper layer of PRF is crucial to prevent treatment failure 1
- Avoid intermediate osteotomies halfway up the nasal bone in rhinoplasty procedures as they risk visible irregularities 5
- Never exceed recommended dosages of neurotoxins, which can increase risk of adverse effects 2
- Recognize that PRF has shown 3-fold higher "excellent" outcomes compared to PRP for acne scar treatment 1
By following these structured recommendations for aesthetic treatment orders, practitioners can achieve optimal outcomes while minimizing risks and complications for their patients.