Cosmetic injectables expert finds balance between practice, teaching, family

"One of the beautiful things about dermatology is that you can be a very good dermatologist, and it does not consume your entire life," Dr. Werschler says.

His teaching commitments involve worldwide travel and stem from his consulting and research work for various industry partners of the specialty, as well as his regular speaking engagements at dermatology and plastic surgery meetings at home and abroad.

"I have been to 49 states and 12 countries for lectures and/or teaching, and have medical licenses in New York, California, Hawaii, Arizona, Nevada and Washington," he tells Dermatology Times.

Active investigator

His knowledge of injectables has burgeoned because he is very active in clinical trials.

One of the original Botox (Allergan) investigators, Dr. Werschler has developed an independent clinical research organization, Premier Clinical Research, associated with his private practice.

"I have been engaged in some form or fashion in research on just about every cosmetic injectable and topical over the years. We also do general dermatology trials," he says.

When lecturing about toxins and fillers, Dr. Werschler tells the audience that everything physicians need to know boils down to five words: What, how much and where?

"I actually ask them to write down these five words at the beginning of my lecture, and keep thinking about them until I finish," he says.

He says he has learned through his teaching and travels that many physicians who are new to injectables have a basic lack of understanding about facial anatomy, and don't know how to choose and use the best products for differing patient needs.

"If you compare dermatology to plastic surgery training, plastic surgeons have a deeper understanding of the facial anatomy and are better at visualizing outcomes. They learned those things in their residencies and, for most (dermatologists), we didn't," he says.

"We tend to be so focused on repair of sun damage, which is important but is only one component of aesthetic facial treatment, i.e., repair. With the cosmetic patient, there are three major treatment paradigms: enhancement, rejuvenation and restoration. Each is a different clinical challenge, and requires a different method of communication and style of speaking with different verbiage."

Understanding the cosmetic patient requires that dermatologists put aside their focus of caring for a disease state and instead focus on the psychodynamics of the cosmetic patient.

Now is the time

Dr. Werschler says now is an opportune time for the dermatologist to focus on fillers and toxins, because this expands and strengthens a core area of expertise for the cosmetic dermatologist, i.e., non-surgical total facial restoration (NSTFR).