[@PeterAttiaMD] I Want to Look 10 Years Younger — What Next? | Tanuj Nakra, M.D. & Suzan Obagi, M.D.

Link: https://youtu.be/6gt0Bt_Buu4

Short Summary

Number One Action Item/Takeaway:

Prioritize understanding the patient's psychological and emotional state and motivations alongside their physical anatomy before recommending any aesthetic procedures.

Executive Summary:

A successful aesthetic consultation involves a two-pronged approach: a quick, initial analysis of the patient's anatomy and a deeper dive into their psychological and emotional state to understand their true motivations and goals. This allows the practitioner to tailor treatment plans to the individual's specific needs, build trust, and ensure that any procedures performed are appropriate and beneficial in the long run, even if it means recommending simpler, reversible options initially or suggesting therapy first.

Key Quotes

Here are 4 quotes extracted from the transcript:

1. "Every single individual has a totally customized situation anatomically, physiologically, and psychologically. And so our job is to try and figure that out when the patient doesn't have the ability to express."
2. "So the scenario you described is actually very common...tears may start flowing because the patient is now in a safe zone talking to a medical professional who's actually listening to them."
3. "We're trying to build that trust and build that relationship on the front end so that this individual who's trying to get from A to B, we're going to take them there safely. Whether it's, you know, over a couple of months or 10 years, we're going to try to get to that goal."
4. "I tell them if I lift you now no one's going to notice that you look better but if I make your skin look better people are going to notice you look better before I even do the surgery."

Detailed Summary

Here's a detailed summary of the YouTube video transcript, focusing on the key topics, arguments, and information discussed:

• Initial Patient Presentation & Analysis:

  • Patients often struggle to articulate their aesthetic concerns, often relying on past photos and vague descriptions like "I want to look like I used to."
  • The speaker emphasizes that initial analysis begins immediately upon seeing the patient.
  • Key aspects of this analysis include:
    • Skin quality and condition
    • Underlying bone structure
    • Facial proportions and symmetries
    • Areas of volume loss
    • Dynamic movement of facial muscles (forehead, etc.)
    • Influence of heaviness on the eyes on muscle tone

• Four Key Aging Changes:

  • The speaker lists four major categories of age related changes:
    • Skin Changes
    • Volume Changes
    • Gravitational Changes
    • Bone/Structural Changes

• The Importance of Psychological Assessment:

  • Beyond physical examination, understanding the patient's psychology and motivation is critical.
  • It's framed as "detective work" to uncover what truly drives the patient's desire for aesthetic changes.
  • Some patients may have unrealistic expectations or underlying mental health concerns that need to be addressed first.
  • The importance of recognizing the patient's mental and emotional state, especially in cases of significant life changes (e.g., divorce).
  • Sometimes delaying certain procedures is in the patient's best interest, focusing on reversible, low-risk options to build trust.
  • Referral to mental health professionals is considered when appropriate.

• The Consultation Process:

  • A thorough consultation is emphasized, often requiring 45 minutes to an hour.
  • The goal is to educate the patient about their individual anatomy and aging patterns.
  • The speaker will guide the patient through what she is seeing on the exam.
  • They will point out asymmetries that the patient has never noticed.
  • Multiple treatment options, ranging from minimally invasive to more substantial surgical procedures, are presented.
  • The speaker emphasizes tailoring the treatment plan to the individual patient and what they are realistically ready for.
  • It is critical to explain procedures and their possible complications so the patient can make an informed decision.
  • The specialist does not offer their opinion of which treatment they think is best until the end of the consultation.

• The "5 Rs of Rejuvenation" (Susan's Approach):

  • Another specialist in the video provides her take on the consultation.
  • She communicates with the patient through a simple, easy to understand method called the "5 Rs of Rejuvenation"
    • Relax: Relaxing overactive muscles (e.g., Botox)
    • Refill: Restoring lost volume (e.g., fat grafting, fillers)
    • Resurface: Improving skin quality (prioritized over lifting in some cases)
    • Redrape: Lifting the skin (devices or surgery)
    • Renew: Ongoing maintenance and preventative measures
  • She prioritizes building a strong foundation through a good at home skincare routine and then supplementing in office for an extra boost.

• The Importance of Maintenance (Renewal):

  • The aging process is ongoing, so maintenance treatments (e.g., neuromodulators, fillers) are necessary to sustain results.