The procedures we perform in facial plastic surgery require both art and craft. Experience benefits our patients and helps us improve both our technical skill and artistic judgment. Extensive science is behind the “10,000 hour rule” that it takes that amount of practice to become expert in a given skill. This practice, however, must be “deliberate practice” to develop specific skills, and at least initially, under the supervision of a skilled mentor.
Anders Ericsson has written wisely on the complexities of this practice. To improve in medicine, one needs to know the outcomes or results of your treatment over many patients and many years. In surgery, I believe it takes at least a decade to become excellent, but that is only the beginning of the journey to becoming a master. One of the best examples I know is my friend and mentor, M Eugene Tardy, who followed all of his rhinoplasty patients over many years. He was able to observe problems that arose from some techniques that removed too much support for example. Anyone in our field benefits from extensive experience, but it must be focused and thoughtful. We do our best to mentor our fellows and give them the tools to start on this path.
The Larrabee Center for Plastic Surgery Now Offers Volbella
We are fortunate in the Larrabee Center to have some of the most experienced staff in the field. Our “rock star” is Maryln Wilson, RN. Marylyn has been an injection nurse for decades and has developed an amazing injection skill but also the crucial aesthetic judgment to make the right decisions about which product to use and how much to inject in a given area. Fillers have changed a lot over the years, but the ability to place them precisely where they will provide the best contour is a skill that can be learned only with long experience. Lisa Marchac, RN is also a very talented and experienced injector and has had the benefit of learning from Marylyn in addition to her own extensive prior experience. One has only to look around to see patients who have been over-injected or injected inappropriately. Marylyn and Lisa both epitomize the Beauty of Experience both in their artistic injections and thoughtful mentoring.
Our newest injectable is Volbella. This hyaluronic acid filler is now FDA approved. “JUVÉDERM VOLBELLA® XC found to increase lip fullness and soften the appearance of lines around the mouth through one year.” It has been very well received by patients for enhancing lip appearance in a soft natural way.