Chew The Fatpad

In 2010 Julie Bass Kaplan, an experienced nurse injector from California, was herself treated with Radiesse in the mid face during a training session. Julie suffered an infraorbital artery vascular occlusion, and went on to experience all the stages of necrosis. When a clinician shares their own personal experience of a complication, as Julie did so graciously in this case, it is a true gift to th...

Following last week's Aesthetics Mastery Show in which Dr Tim summarised the case of Julie Bass Kaplan FNP-BC who suffered a necrotic injury after she was treated with Radiesse, today we tackle the lessons to be taken from this important case. Dr Tim analyses the various risk factors present, including the choice of a non-reversible filler; the injection site; the size of the bolus; the lengt...

Advanced Botox treatments in the lower face can be transformative for your patients but are also much more likely to cause side effects than upper-face toxin. As Dr Tim explains in this week's Aesthetics Mastery Show, the reason is that lower third muscle anatomy is much more complex. As well as a very helpful anatomy tutorial, Dr Tim also puts the spotlight on four advanced Botox treatments...

Botulinum toxin treatments in the upper face are a real 'bread and butter' treatment in most aesthetic clinicians' practice, but are you familiar enough with the anatomy to avoid side effects, whilst also maximising product efficiency? In this week's Aesthetics Mastery Show, Dr Tim takes us on an anatomical tour of the key muscles injected for upper-third Botox treatments, incl...

Delayed onset nodules following dermal filler treatment - also known as lesions, or simply just lumps - can strike fear into the hearts of aesthetic clinicians because they are far from easy to diagnose and manage. Firstly, you have to diagnose whether the lesions are just post-procedural, then whether they are inflammatory or non-inflammatory, then whether they're bacterial or not. Should yo...

In this week's Aesthetics Mastery show, Dr Tim explains why 80% of the ageing we see is due to the relationship between the ligaments and the fat pads, and how we can restore the impact using dermal fillers. He gives us an anatomy lesson on the ligaments' function and location, and fascinatingly demonstrates using magnets and balloons the mechanical process behind why cheek filler lifts...

In this week's Aesthetics Mastery Show, we dive deep into facial anatomy to explore one of the most important facial structures for aesthetic clinicians, particularly in regards to injecting dermal filler: the deep fat pads. Dr Tim gives us a detailed anatomy lesson on the upper, middle and lower third deep fat pads, including how to decide when to inject deep vs superficial fat pads. We also...

Dr Tim returns to teach us about an anatomical feature that is central to successful aesthetic treatments because of their impact on the shape of the face; the harmony between structures; and its proportions. In this week's Aesthetics Mastery Show, we tackle the superficial fat pads. We discuss fat pad depletion with age; the vital impact that fat pads have on the consultation process and edu...

For the next four episodes of the Aesthetics Mastery Show we have a special treat - some never-seen-before footage of a sold-out conference we hosted last year, Dr Tim Live. The event was designed  to walk delegates through what it's like to undertake a whole-face 14ml treatment from start to finish. In the first of four excerpts, Dr Tim marks up his model, Lindsay, and shares his '5 Q A...

It's the stuff of nightmares - you get a vascular occlusion, test your patient and find out that they're allergic to hyaluronidase! As we discuss in this week's Aesthetic Mastery Show, you now have a very difficult decision to make. Do you proceed with the hyaluronidase reversal and risk anaphylaxis, or do you stand by and wait for the inevitable skin necrosis? Some clinicians have...

Vascular occlusion is every clinician's worst nightmare. But are you familiar with the differences between arterial and venous occlusion? In this week's Aesthetics Mastery Show, Dr Tim dives into how to avoid, diagnose and treat venous occlusion, including discussing the probability that dermal filler could cause a pulmonary embolism, or even blindness due to a venous thrombosis. Let us...

Inexperienced practitioners sometimes chase the nasolabial folds, and patients can end up looking odd if their cheek volume loss is not also addressed. Having said that, there is still a place for this important 'hinge treatment' as part of a holistic approach. In this week's Aesthetic Mastery Show, Dr Tim discusses whether or not we should treat cheeks if the patient complains abou...

It's one of the questions every aesthetic clinician dreads: "How much for 1ml?" As we discuss in this week's Aesthetics Mastery Show, the reason this question stings is because it feels like you're being reduced to a commodity, instead of the complex and valuable clinician you know you are. Dr Tim explains that patients do absolutely care about more than just cost, and gui...

We surveyed 1,856 clinicians in 33 countries and found that 73% had seen a rise in the number of patients complaining that their toxin has not lasted well post-Covid lockdown. On the aesthetics forums, clinicians have been speculating about dodgy batches; stronger muscles post-lockdown; and even if Covid itself has had a part to play in poor toxin longevity. In this week's Aesthetics Mastery...

Lip filler migration is such a disheartening problem for any clinician worth their salt. You inject your patient's lips perfectly on the day, and then watch as your beautiful creations morph into a new shape over time as the filler crosses the vermillion border. In the second half of this week's Aesthetics Mastery Show, Dr Tim gives us practical tips to prevent lip filler migration, for...

We surveyed 1,856 clinicians in 33 countries and found that 73% had seen a rise in the number of patients complaining that their toxin has not lasted well post-Covid lockdown. On the aesthetics forums, clinicians have been speculating about dodgy batches; stronger muscles post-lockdown; and even if Covid itself has had a part to play in poor toxin longevity. In this week's Aesthetics Mastery...

It’s so easy to see colleagues using the latest trendy lip technique and believe it is the answer to all your lip problems. The truth is that one technique does not fit all patient, or even one lip! The real secret to lip mastery is building a combination treatment around the individual patient. As Dr Tim explains in this week's episode of the Aesthetics Mastery Show, this process should happ...

Although we all accept that causing a bruise from dermal filler or Botox injections is high on the list of possible side effects, it's still a heart-sink moment when you're merrily injecting away and you suddenly spot a shiner appearing. In today's Aesthetics Mastery Show, Dr Tim shares 16 simple steps you can take to prevent bruises occurring in the first place, as well as how to m...

What is the best way to diagnose a complication? As we discover in this week's Aesthetics Mastery show, there is a 7-step process that will not only equip you to better diagnose complications independently but also enable you to ask great questions on clinical forums when you need additional help. Dr Tim explains that, when you implement this 7-step process, you will be able to present a shor...

In the final episode of our three-part facial danger points series, we tackle a hidden complication risk - pressure from filler resulting in a lack of blood supply to the skin, and ultimately necrosis. Dr Tim explains why this little-known dermal filler complication occurs, which three 'tight' areas of the face are particularly vulnerable, and what you can do to quickly diagnose and trea...

In this week's episode of the Aesthetics Mastery Show we continue our look at the riskiest areas of the face to inject, this time diving into the 5 arteries that run parallel to where your needle or cannula goes, thus increasing the likelihood and severity of vascular occlusion. Dr Tim examines arteries such as the superior and inferior labial arteries, near lip injections, and the dorsal nas...

In this week's episode of the Aesthetics Mastery Show, we dive deep (literally!) to explore the 6 most dangerous facial areas in which you must NOT inject deep, or risk occluding blood vessels with very serious consequences. Dr Tim guides us through important anatomy such as the supraorbital notch and mandibular groove, and explains why they are so dangerous and what you can do to avoid hitti...

You might be surprised by the anatomical topic of this week's episode of the Aesthetics Mastery Show, because...you might not even know it exists! The zygomaticofacial artery is a branch of the lacrimal branch of the ophthalmic artery, and enters the face through the zygomaticofacial foramen. It is very often left out of text books altogether, but it's important you know about it so you...

Vascular occlusions are every aesthetic clinician's worst nightmare, so we are rightly on high alert to can act quickly if one should occur. The problem comes when our ability to diagnose a vascular occlusion is hampered by the presence of the much more common haematoma. We don't want to be undertaking necessary hyaluronidase filler reversals, but haematomas can cause delayed capillary r...

In this week's episode of the Aesthetics Mastery Show, Dr Tim zooms up on a vital 'hinge' anatomical feature: the piriform fossa, AKA nasolabial fold, AKA 'Ristow’s space'. We discuss: ✅ Why it's important clinicians understand this area ✅ The vital nearby anatomy including the facial artery and its branches, and the infraorbital artery ✅ Why we even bother with na...