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Kirsty, a well-presented, stylish woman aged
28 years with enhanced long eyelashes and heavy make-up, is complaining of asymmetry in her cheeks. She has accentuated cheeks and chin, voluptuous lips and a defined, sharp nose.
On questioning, Kirsty explains that she had hyaluronic acid filler injected at the site of concern three months ago and was never happy with the result. She had gone back to see her doctor several times, but they were unable to correct the asymmetry. Kirsty was impressed by your patients’ reviews online and hopes you can improve her facial asymmetry. 1.How would you manage Kirsty and what other information do you need? 2.What are some concerns and questions you may have at this point? 3.What physical examination would you perform and how would you manage Kirsty? 4.What treatment do you propose? 5.How would you determine the dose to be given and the titration? 6.What is your follow-up plan for Kirsty? #Week20_Case5
Hiromi, aged 46 years, is an administrator who works for a large multinational company. She has an established career with a good income. She lives alone. She is lively and cheerful with no stresses. Hiromi has a healthy diet regimen and goes to the gym regularly. She has good sleep and does not snore. She is a non-smoker and occasionally drinks wine at social gatherings. There are no other medical issues of note.
Hiromi recently underwent a health assessment for people aged 45–49 years, for which all blood tests returned results in the reference ranges. Despite her good health and lifestyle, Hiromi has lots of wrinkles on her face and looks tired. She is becoming overtly concerned about it. She has heard about antiwrinkle injections and has come to see you to find out more about them.
1.How will you examine Hiromi? 2.What treatment options would you suggest? 3.What counselling will you undertake with Hiromi before proceeding with the therapy? 4.Are there any contraindications to botulinum toxin? 5.Would Akina be a candidate for botulinum toxin injection? #Week20_Case4
Gino, aged 34 years, is a computer engineer with an established career. He lives alone.
Gino enjoys being social and attends weekend parties and goes to the pub with friends. On one occasion,
a female friend casually commented that his growing baldness made him look like a tired, 50-year-old businessman. Gino has been depressed since and constantly thinking about his baldness. He has started to feel a lack of confidence as a result. He is avoiding meeting clients face to face and is no longer spending time with his friends. He now spends hours in front of the mirror or looking at old pictures of himself, when he had a nice hairstyle in his younger days. He has started drinking alcohol more frequently as a result
of stress/anxiety about his baldness.
On the recommendation of his best friend, Gino attends your clinic as you have a special interest in hair loss management. Gino is seeking a solution for his baldness and is enquiring about treatment options to grow his hair back. 1.What history would you seek from Gino? 2.What examination would you perform? 3.What are the potential causes of baldness? 4.What is the most likely diagnosis? 5.What tests would you advise initially? 6.How will you manage Gino now? 7.What are the surgical treatment options available for Gino? #Week20_Case3
