21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

Patients are often nervous about scheduling a consult with a cosmetic dermatologist. I understand. It’s always a little anxiety producing to do something new especially when, generally speaking, you are probably coming in to see me because you are having an issue with your skin, hair or nails. As a sometime patient myself, I am acutely aware of how vulnerable it can be to be assessed by a stranger. This is why the first thing that I want to explain about what to expect during your consult is that it is a judgment free zone. I am not one of those doctors who is looking for flaws so that I can upsell you a procedure. Instead, my practice philosophy is something that I like to refer to as honest aesthetics.

Patients are often nervous about scheduling a consult with a cosmetic dermatologist.

What is Honest Aesthetics?

One of the main things that motivated me to become a cosmetic dermatologist is that I like to help people. My tools for doing so are lasers, injectables and skincare. I know that when my skin is glowing and my hair is healthy, I carry myself differently. I have more energy, self confidence and vigor. It’s one of the many things that I love about my job — it affects the inside as much as the outside. Given that my work is so powerful, I make it my motto to tread lightly. My job is to augment your natural beauty, not change it.

I typically spend about half of the consult pointing out all of the things that make you beautiful. As a society, we are so focused on what doesn’t work. Social media can be a wonderful tool, but it can also make you feel inadequate. I like to remind patients that beauty trends come and go.  Honest aesthetics is about listening to what bothers you, and then selecting the appropriate treatment or treatments that will address your specific needs.

Treatment is Never One Size Fits All

As mentioned, the first part of the consult is passive for me. I am there to hear what bothers you. Part of this is reading between the lines. Oftentimes, a patient will come in thinking he or she needs X procedure because a friend or social media influencer had it done, and now looks great. However, my treatment plans are never one size fits all. After listening closely, I then perform a thorough physical exam to assess your:

  • Skin texture & tone
  • Sunspots
  • Areas of hyperpigmentation
  • Redness
  • Broken blood vessels
  • Acne and/or acne scars
  • “Crepey”, uneven skin texture
  • Wrinkles (resting and dynamic)
  • Skin laxity if any
  • Volume loss

Based on your individual anatomy, lifestyle and needs, I then select the appropriate procedure or combination of procedures that will deliver on your goals. Typically, this begins with the right skincare regime.

Skin is the Canvas

The skin is your body’s largest organ. Furthermore, it is the canvas upon which any other procedure we do rests. Keeping it hydrated, flexible and smooth is important aesthetically, but it is also important for your overall health. I am a huge fan of medical grade skincare as I have witnessed first hand its transformative powers. These have also been proven through numerous research studies.

Medical grade skincare is skincare that is purchased from a physician, such as myself, and tends to be stronger, more efficacious and, oftentimes, more expensive than its over-the-counter (OTC) cousin. However, I will always be straight up about which products are best medical-grade and the ones where you can go OTC. Sunscreen is a great example of the latter. I prefer many of the medical grade sunscreens because I think they feel better on the skin, but there are many truly effective options that you can buy at your local drugstore.

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Lasers for Amplifying Your Natural Beauty

The other cornerstone procedure in my practice is lasers. I have extensive training in and experience with a wide array of lasers. One of the reasons that I became so fascinated with lasers early in my training is due to their versatility and specificity. There is a laser for basically any skin condition. Excel V is my go-to for anything that involves redness such as broken blood vessels, rosacea and those red moles that so many patients develop with age. I love using the 1540nm to address fine lines and wrinkles, and even employ it to delay the aging process in my younger patients. I term the latter “prejuvenation”.

Both of these lasers can also improve your overall skin texture which is one of the fastest and easiest ways to amplify your personal beauty. Patients often underrate how important skin texture is to improved well being. But you know how good you feel after a hard workout or a great facial? That’s because your skin is hydrated, plump and glowing. It is basically the fountain of youth. It is my goal during your consult to find the tools that will help you tap into this fountain so that you can look and feel like the best version of yourself.

To find out more about skin care and lasers at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.


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