Tuesday, September 03, 2013

Translating notes from Years of PMU

Consultation

Meeting of the minds
SOAP

S- Subjective  What to they think/want
O-Objective    You tell them what you see based on the comments they mentioned to you
A-Assessment   Feedback based on the first two steps
P- plan of attack   and protocol time cost etc,

Write down notes explicitly  Color written down win the respect of intelligent persons definition of success
greatest asset -The Medical Community
Whats relative
turn away those Pt who you do not feel comfortable
Determine first thing you see
Inventory-scan
happy with size of lips?
Anticipated Augmentation

Do lip color first
Augmentation -with collagen Juvaderm Hylauronic acid
Implants -Silicone
PTFE- Advanta  feel lines marshmellos vascular-grafting 50 years  3ml-6ml spagetti noodles
Pre-Instruction
prep tissue exfoilstion hydration
laser hair removal before
Avoid caffiene  vaso dialates and nerve stimulation
Chemotherapy
Long wearing lipsticks off for 2 weeks
St.Johns Wart
Chemo therapy
Indications for Meds  Zovoirax RX or other 7day pre-op
Herpes must clear with physician
Mutro-valve prolapse
prosthetic values

Clinical Aspect  for Drawing
Procedure -
mask gloves No matter what
alcohol perp-draft prior to drawing
Sani cloth wipe pen
measurement
Pigment cap makeup remover wipe
Sanitizing hand wipes
Tray Covers
Bib covers

LIPS  artistic implanting  natural lip look
closely matches existing lip color    requires 3 visits discuss upfront
clearly ID center of Upper lip  Lip center even center of cupids bow
assess Symmetry  proportion top to bottom
Horizontal  Lines
Maximize size of lips without violating rVermillion Border
consider Nasio labial folds
Document Implantation plan  include freckles
Line and shade more fuller lip illusion of purtrusion
 lighter shade in the center Subtle like light is bouncing leave pouting area open
1.canvas  20min pre numb
2. base is always blue  ` consider the fitz scale  minimum insurance fitz 1-2
Fit 3-4  alittle more   5- More insurance  6 not avail for lip procedure
BEWARE of Titanium - white swirl   can cause Granulomas  difficult pigment to mix well
STRETCH STRETCH STRETCH   5 section top   3 section bottom
pre-numb  All work performed from one side
Index finger  wrapped in gauze hold grip on tissue   alternate top and bottom
trace top -open tissue 2nd topical bottom lip fill in color
3rd pass go over it again
DO NOT GO OUTSIDE THE VERMILLION BORDER past lip white def line dilute    do render lines smile at rest
less is best can always add more

Post procedure   -   put 11 2x2 gauze in regrigerate   4x 1st hour  3x 2ndhour 2x 3rd hour  1x 4th hour

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