There are three chief factors that comprise a successful enhancement with fillers: ‘good physician, good patient, and good product’. However, the ‘good physician’ is at the crux of any procedure. Since the advent of modern fillers, impressive improvements have been achieved in facial rejuvenation and beauty enhancement. Sometimes the results are far superior to those achieved by conventional surgery — with minimal downtime.

The ‘good physician’ is the central player who influences the other two variables of any successful injecting session: the good patient, and the good product. Not everyone is a filling candidate. The physician is responsible for selecting the right patient by identifying those who are at risk, turning them down, and selecting those who may benefit from treatment.

The physician also has the sole responsibility of choosing the product to be injected. The most important characteristic of a good product is its safety, and before considering the effectiveness of any treatment, the good physician will put the product’s safety above all else.

There is a tendency to blame a product whenever a complication arises. Each time a physician perforates the skin envelope, he/she can potentially introduce microorganisms at the injection site. How many inflammatory reactions and nodules are actually secondary to a sub-clinical infection? An expert in a workshop who does not wear sterile gloves, using a ‘non-touch technique’ should think of the young trainee who is watching him or her. Hence, the responsibility of the filler manufacturer to provide valid education and training to physicians in the use of their products.

In the field of continuing medical education, the physician is faced with the challenge of conflict of interest and competition for sales among filler manufacturers. He/she must make a point to get reliable information on the products, as well as the commitment of the manufacturer to provide first-class medical training to physicians. The slogan, ‘Become an injector in a one day course’ should be a red flag for anyone serious about ‘curing without harming’.

In the age of the Internet and the rapid-fire dissemination of medical information, the modern physician is inundated with a constant and varied flow of information. The physician is faced with seeking out relevant, evidence-based studies that will enhance his/her practice and expand his/her knowledge.

In the city of Cologne, an original study was conducted on information received by physicians during a single month. ‘Mass market’ information was collected from sales representatives, postal mailings and internet marketing, and then given to medical experts for evaluation: only 5% was found to have a real scientific basis.

Common sense and intuition is, and will remain, the best ally of physicians. Common sense states that the safety of patients should be placed above their aesthetic wishes. This common sense and intuition is honed through the physician’s education and the quality of their continuing education. Both physicians and patients need education and reliable information as new products and innovative techniques are continually being introduced.

Hopefully, a variety of quality courses are offered at congresses and in workshop format by filler manufacturers. Our commitment to learn weather we are beginners or expert remains the cornerstone to deliver ‘great filler results’.