Patient Selection

Patient selection is the decision that a defined person, objective, product, timing, and follow-up plan belong together. It is broader than checking a generic contraindication list and narrower than assuming that candidacy for one filler establishes candidacy for every collagen-stimulating product.

Start with the objective

Name the intended change in observable terms: structural correction, contour support, treatment of a labeled wrinkle or depression, or a defined skin attribute. Then decide whether the product’s immediate and delayed phases match that objective.

The treatment objective framework converts broad requests into assessable structural, skin-quality, anatomical, and time-course questions.

Clarify:

the area and the feature being treated
whether immediate correction is required or merely expected
tolerance for a staged result and more than one assessment
acceptable uncertainty in magnitude and duration
relevant alternatives, including no treatment

A carrier-gel product and a reconstituted particle suspension can look different immediately after treatment even when both are discussed as collagen stimulators.

Reconstruct previous treatment

Previous injectable history should be area-specific, not a single yes-or-no question.

Field	Why it matters
Product and variant	Material, carrier, and removability differ
Date and area	Residual material and delayed events may overlap
Plane or technique, if known	Helps interpret palpable or imaging findings
Response and complications	Changes counseling and diagnostic context
Treating clinic or record access	May allow verification when recall is incomplete

If the prior material is unknown, record it as unknown. Do not convert package color, country of treatment, or patient recollection into a confident product identity. Imaging or specialist assessment may be appropriate when uncertainty would materially change the plan.

Review current health and timing

Check the exact local IFU for contraindications and warnings. The clinical history should also identify factors that may change timing, diagnostic clarity, healing, infection risk, or emergency planning, including:

active skin inflammation, infection, or wound near the planned area
recent or planned dental, surgical, or other procedures
current systemic illness or recent inflammatory episode
immunosuppression or clinically important immune disease
bleeding risk, relevant medicines, and supplements
previous hypersensitivity or injectable complication
pregnancy or breastfeeding when the product information does not establish use
inability to access or attend planned and urgent follow-up

Pretreatment consensus recommendations highlight prior filler complications, multiple previous treatments, immunocompromise, recurrent skin disease, active herpes labialis, poor periodontal health, and uncontrolled diabetes as history requiring attention (pretreatment consensus 🔗). These are assessment prompts, not one universal exclusion list.

Identify reasons to defer or redirect

Defer when a transient condition prevents reliable assessment or increases avoidable uncertainty. Redirect when the objective, anatomy, product, practitioner competence, clinic resources, or follow-up access falls outside the planned service.

Common reasons include:

active local or systemic illness
unresolved inflammation or an unexplained prior implant
an objective the product cannot reasonably address
expectations that remain incompatible after discussion
missing product-specific training or emergency readiness
pressure to treat before adequate history, consent, or documentation

Selection output

Before moving to consent, the record should contain:

defined treatment objective and baseline finding
exact proposed product and presentation
relevant prior injectable history, including unknowns
applicable label constraints and off-label status
reasons to proceed, defer, or refer
planned review and emergency access

Continue to consultation and consent only after the product and objective are specific enough to discuss honestly.