Bill Klaproth (host): This is OMS Voices, an AAOMS Podcast. I’m Bill Klaproth, and with me is Dr. Elie Ferneini, who is here to discuss injectables for cosmetics and why you should go to an OMS for injectables. Dr. Ferneini, thank you so much for being here.

Dr. Elie Ferneini: Thank you, Bill. Thank you for having me.

Bill Klaproth (host): Yeah, so let’s dig into this. So, Dr. Ferneini, what makes oral and maxillofacial surgeons uniquely qualified to administer injectables for cosmetic procedures?

Dr. Elie Ferneini: Thanks, Bill. Again, I believe as, oral and maxillofacial surgeons, we are the most qualified to do these injectables for a couple of reasons. Number one, we really have extensive training in the head and neck area. We went to a four-year or six-year residency. Our time is spent all the time just dealing with head and neck, pathology and issues. Also, we’re so knowledgeable about facial anatomy. We’re always in the maxilla, mandible or the head and neck area. So, we really have extensive experience and, training to deal with the patients and also any other complications. Also, with this stuff too, other than our ENT colleagues, we’re the only two specialties where we spend our entire day just dealing with head and neck issues.

Bill Klaproth (host): Yeah, that’s a great point. You are experts in facial anatomy, surgical procedures, facial musculature. So, I got to tell you, I see on TV often people talking about this, these cosmetic surgeries, come to my office and have this procedure done. How does the training and expertise of an OMS compare to other practitioners, people who might just have a storefront and does not have the training that you have? What is the big difference between you and those type of people who offer injectable treatments?

Dr. Elie Ferneini: Well, like you mentioned, we are really the expert in the facial anatomy, correct, because we do surgical procedures. So, we’ve seen these muscles, we’ve seen these veins, we’ve seen these arteries, versus any other colleague who hasn’t done surgery in the head and neck area. They’ve never seen the muscles before.

They’ve never seen the artery. They’ve never seen how these muscles work or function. So, we really have a diverse knowledge about the facial anatomy and our extensive training definitely, puts us aside from our other colleagues.

Bill Klaproth (host): Dr. Ferneini, that is exactly right. Of course, the higher standards of care and precision in treatment is always a benefit. Are there other key benefits of receiving injectable treatments from an OMS versus a non-surgical practitioner?

Dr. Elie Ferneini: Same thing, experience, experience, experience, correct? One of my mentors who trained me, they said, “You can’t learn surgery in the library,” correct? So, you can’t just look at the book and look at the picture and say, “I’m becoming an expert in this area.” For us, as I said, we’re always operating in these areas, so we know exactly, although we look at it in the book, but we also, we look at it on normal patients, and we look at basically on the procedures we do, so we know the anatomy. We have such an extensive training and education that we’re so knowledgeable about the facial anatomy that we’re really much better than our other colleagues.

Bill Klaproth (host): I love how you said that. You can’t learn surgery in a library. And Dr. Ferneini, I’m thinking also, because of your extensive training, you would then administer more precise injections, would that be right? Leading to more natural looking results, better results, is that right?

Dr. Elie Ferneini: Exactly, so what you look at the facial anatomy these days and look at the facial injections, and I’ve published over 20 papers just on facial fillers, everybody’s looking about safety and improving patient outcomes, correct? So, the way to improve safety, basically, is know where your landmarks are, know where your arteries are, know where your vessels are. And again, for us as oral and maxillofacial surgeons, we know exactly where these arteries are to try to avoid them, and the key thing is not only avoiding them, the key thing also, if you have a complication, to know how to manage the complication. So, we, as well-trained providers, not only know our anatomies so we can prevent complications, but also if we get a complication, we are much more equipped to handle and deal with complication to get improved patient outcomes.

Bill Klaproth (host): Yeah, so I’m wondering, you just mentioned obviously you have extensive training and experience in this area. Can you share some success stories or examples of patients who have benefited from injectable treatments performed by an OMS?

Dr. Elie Ferneini: A nice thing about us, you know what? The nice thing about injectable trainings, you know, like I tell people I do a lot of cosmetic surgery, these patients become your friend, correct? Because they come to you on a regular basis for different procedures. And facial fillers in general improve patient self-esteem. So, I’ve had a patient of mine who had a zygomatic fracture which wasn’t repaired, and ways to deal with this long term is either doing a malar implant, which you can do, or doing facial fillers, so you can basically do what we call a cheek augmentation, where you put some filler in the cheek area to augment the area to make both cheeks symmetric, which will help with this stuff. Another patient of mine had the same surgery, but he had cancer surgery, where basically he had a big defect in the chin area, and ways to also treat that’s either putting a chin implant or just within a five-minute procedure in your office, putting some fillers in the chin, which contours the chin and make it look natural.

Bill Klaproth (host): You know, when you bring up cancer, some people, they don’t like the look of their face, right? Other people actually need to do this because of a surgical procedure or cancer, and again, you’re an expert in dealing with that. Would that be correct?

Dr. Elie Ferneini: We are, and they said, as doing cosmetic surgery, a lot of these patients that can be mentioned come in for cosmetic procedures, and the nice thing was starting doing facial fillers, and these patients would come in for facial fillers, but then because they trust you, they would end up having a facelift or a blepharoplasty or other surgical procedures done in your office.

Bill Klaproth (host): Right. So, for someone listening to this podcast who says, “Okay, I’m going to go see an OMS for this.” What should they consider when choosing an OMS for their injectable treatments? And how can they ensure that they receive the best care?

Dr. Elie Ferneini: Obviously, like anything else with any other provider, make sure you look at their training, correct? Even as oral and maxillofacial surgeons, we have diversity of training, correct? So, for example, I do a lot of cosmetic procedures, so I’m probably more qualified than somebody who doesn’t do a lot of cosmetic procedures. So, it’s all about repetition, correct? So, to go to a person who obviously all of us are well-trained but go to a place where these procedures are done on a regular basis. You know, like going back to you can’t learn surgery in a library. You can’t also do something once a month and become efficient at it. So, again, go to a place where these procedures are performed on a regular basis. And also, it’s not only you, also having your staff who’s well-trained, to know how to talk to the patient and how to also evaluate the patient if they have any phone calls, whether they’re asking any questions or any issues.

Bill Klaproth (host): So, I’m wondering about the initial patient consultation process. That sounds like it’s really important because you said you get to know these people. You become friends with these people. So that initial consultation sounds like it’s really important.

Dr. Elie Ferneini: It’s very important, Bill, because it’s the same thing. We always keep on talking about, you know, informed consent with the patient. So, when I see a patient in my office the first time, I literally spend half an hour to 45 minutes explaining to them their whole head and neck areas. And I basically address each area from their skin, to their skin type, to their deficiencies. Because we want to educate your patient, too, on what you can do to improve them, and facial fillers is one aspect of our discussion today. But cosmetic surgery is a multifaceted modality, and you’re going to need other procedures, too, to maximize outcomes.

Bill Klaproth (host): And then I’m thinking also, after the procedure, post-treatment care I think would be better with an OMS as well. Would that be correct?

Dr. Elie Ferneini: Correct, because same thing, we know exactly what some of these complications can occur, and we know what to give the patient for post-op instructions in a way to maximize our outcomes.

Bill Klaproth (host): Absolutely. Well, this has been really great, Dr. Ferneini. Thank you so much for your time. Before we go, is there anything you want to add at all?

Dr. Elie Ferneini: The only thing I would add, I just think we as oral and maxillofacial surgeons are fully equipped with training and experience to inject patients with facial fillers. And I hope our colleagues get involved in this specialty.

Bill Klaproth (host): Absolutely. Very well said. Dr. Ferneini, thank you so much for your time today. We appreciate it.

Dr. Elie Ferneini: Thank you, Bill.

Bill Klaproth (host): Yeah. Once again, that is Dr. Elie Ferneini. And for more information and the full podcast library, please visit MyOMS.org. And if you found this podcast helpful, please share it on your social media and please subscribe so you get every episode with insights into the world of oral and maxillofacial surgery. Thanks for listening.