Woman receiving an injection

By now most people have seen the all-too-noticeable effects of too much or poorly performed injections:  gigantic, awkward lips, enormous cheek mounds, frozen expressions.  Unfortunately, these unusual, disproportionate features have become more and more commonplace and one can draw a direct correlation between these features and the increasing number of “practitioners” of injectables.

“More” is not always the answer.  And, the old adage “when the only tool you have is a hammer, everything becomes a nail,” applies here.  No longer are these in-office procedures being performed by highly trained surgical specialists of face and neck.  Now, nurses, mid-level providers, and general internal medicine providers, most of whom were never trained to do these procedures, are providing these services.  And, the aesthetic consequences are being seen throughout everyday life.

Universally, our eyes and our lips are our most attractive facial features.  They need to be harmoniously balanced with all the other features of our face.  That way our gaze is not distracted.  

Take for example the female lips.  If they are too big, or too thin, or too flat, they can distract.  So, while augmenting the size and shape of those lips, the surgeon must understand how the upper lip should be shaped relative to the lower lip.  Similarly, there are height and size differences between the lips that must be addressed.  And, of course, the patient’s ethnic background must be accounted for as different ethnic facial features require different proportional changes.  

In my practice, I spend a great deal of time explaining these differences.  And, often it requires that I talk patients out of lip augmentation, for example.  In the same vein, I often warn patients that if you visit some practices with money in hand they will perform the procedure you request regardless of whether the procedure is right for you.

Schedule Your Visit

Contact Garlich Facial Surgery today.

Get Started

As well, in my practice, I don’t rely on a mid-level provider to perform my injections.  Nurse practitioners and physician assistants have provided an invaluable service to the medical community.  They have expanded access to outpatients, to patients on hospital floors and to patients in the operating room.  They are well-educated and ultimately do well for their patients. Often, in a surgical practice, they expand the work that can be provided by a surgeon.  But, when it comes to making decisions for my patients as to whether injectable fillers, cosmetic surgery, or nothing at all, should be performed, that decision is mine and mine alone.  My training and my years of experience go into each Botox injection, each injectable filler injection, each recommendation for cosmetic surgery, and each time I let a patient know that no treatment is needed.

So, the question is “who is doing your injection?”  But, the question should also be “Is that injection right for you and should it be performed at all?”  At Garlich Facial Plastic Surgery, there is only one person answering those questions, and that’s me.


Contact Garlich Facial Surgery today at 678-343-2190 today.