Dealing with Unhappy Customers

Dear Cosmetic Courses,

Please help: I recently treated two patients (friends of mine) with Botox and they both left happy. 5 weeks later they called me wanting a top up. I would usually review up to 3 weeks after but I’d like your advice on this: should I just give them a top-up to keep them happy? Did I do something wrong initially?

Keep Calm and Carry On

Here at Cosmetic Courses, of course we always train our delegates to the very highest standards and, in a perfect world, everybody would always be happy and you’d never make any mistakes. Unfortunately, however, sometimes even when you’ve done everything absolutely right you’ll find you just can’t please every patient 100% of the time.

It is always difficult when people leave happy but return later with some element of dissatisfaction.

You can help lessen the likelihood of this happening, however, by making it absolutely clear during an initial consultation before each and every treatment what they should expect or what the limitations of our medicines are.

Our Trainer, Registered Aesthetic Nurse Libby Stewart, always tries to explain to patients that the duration of efficacy of Botox is designed to be twelve weeks. The initial response isn’t seen for three to five days with the best effect being at two weeks. This is why we arrange the review appointment at two weeks and usually give a window of up to the three week date to allow for holidays, sickness, etc. to perform the perfecting treatment.

We explain to the patient that this protocol is there to protect them from potentially developing anti-bodies to the toxin that may prevent a positive response to the medicine in the future, whether it is used for cosmetic or medical purpose. Libby says, “I usually make a little joke and say something like – if you need this medicine in the future for an incompetent bladder, you won’t thank me for having over- treated a little wrinkle!”

By emphasising to patients that the medicines’ efficacy is designed to last 12  weeks, they should understand that it is perfectly possible to see a slight return of movement from the six week period as the chemical denervation of the muscle starts to decrease and the original neurone mechanism is restored. It will be a gradual process to the return of full movement. If your patients understand the method of action of the medicine right from the start you are less likely to get this sort of query.

The most difficult thing for you is if the patients are friends. Sometimes with friends we miss out as thorough a consultation as we might give to a patient who we know less well. But it is your responsibility as an Aesthetic Practitioner to make sure that they are as informed and documented as thoroughly as any of your regular patients.

You will have to be firm as your patients probably will want you to add more product but don’t be swayed.

Stand by your professional instinct and instead use this as a good learning experience:

  • Was your muscle placement as good as it could have been?
  • Was your depth correct?
  • Was your product fresh, correctly diluted, and had it been stored at the correct temperature?
  • Had you diluted your product slowly causing no bubbles?
  • Had you chosen the right dosage to still the muscle movement?

I’m sure that in your case the answer to all these questions is “yes” but  going through these things in your mind will help you evidence the actions of your treatment and know that you have followed best practice. This will make it easier to stand your professional ground with your patients.

We hope that helps a bit. Let us know how things pan out. We are always interested in how our delegates are getting on.

For more help and advice from the Cosmetic Courses team, please do not hesitate to contact us on 01845 230 4110 or [email protected] . Details of all our leading medical aesthetic training courses for registered doctors, dentists and nurses can be found at .