THMA Consulting

Aesthetic Medicine is Minimally Invasive — Not Minimal Risk.

The recent death of Kendal Ascher following a dermal filler procedure is a devastating reminder that severe complications from aesthetic injections are rare — but they are real.

Even the most reputable, experienced injectors can face catastrophic outcomes.

For years, we considered skin necrosis from a vascular occlusion to be the “worst case scenario.” As treatment areas expanded into higher risk zones — nose, forehead, temples — we began to see reports of visual disturbances and even blindness.

Now, we are hearing about fatal pulmonary embolism associated with filler treatments. After a literature search there are only a handful of articles that reference death from PE - related to location of the larger blood vessels and the excessive volume of filler used to achieve the desired outcome.

Have our practices evolved faster than our safety standards? We need to ask ourselves these questions:
• Are we practicing within our scope
• Are we qualified to treat off face and high risk areas
• Are we prepared to recognize and manage complications
• Do our discharge instructions include red flag symptoms of pulmonary distress

Aesthetic providers must understand that high risk and off face procedures require advanced anatomical training, cadaver based education, and competency assessment — not a single workshop or online module.

Aesthetic medicine is minimally invasive — not minimal risk. Safety is not a tagline. It is a professional obligation.

Reference:
Bingoel, A.S., Dastagir, K., Neubert, L. et al.(2022) Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis. Aesth Plast Surg 46, 1388–1397 (2022).

Shaheen, S., Al Habbaa, A., Riad, M. S.et al. (2023). Fatal pulmonary embolism following injectable gluteal filler usage: A case report. The Egyptian Heart Journal, 75, 83.

It was a Sunday beautiful morning for the Brain Tumour Foundation of Canada walk in Halifax. A lot of love, support and hope was felt from the opening welcome from Dr Adrienne Weeks, Assistant Professor & Director of Research - Division of Neurosurgery, Dalhousie U.

Thank you to all who supported Team THMA. We reached 164% of our goal.🎉🎉

We are looking forward to extending our fundraising at the THMA Consulting Symposium Oct 2-3 at the Halifax Convention Centre. We will be hosting a silent auction with all proceeds going to the Brain Cancer Foundation.

If you would like to donate an item let me know 🥰
Every dollar raised goes back into research and support for families.

Love your THMA Family ❤️

Non‑compliance has been costly for this Toronto clinic, and it serves as a reminder to all of us.
We must work strictly within our scope of practice, uphold the standards of our profession, and protect the trust our patients place in us.

*Be an education influencer, not an Instagram influencer.
*Respect patient confidentiality at every turn.
*Advocate for your patients, your profession, and the integrity of aesthetic medicine.

As a unified voice, we can rise above the noise and distractions that bombard us daily on social media. Our specialty depends on leaders who choose ethics, safety, and professionalism.

My 36‑year journey in aesthetic medicine has introduced me to some of the most extraordinary people—many of whom have become lifelong friends.

One of those people is Dawn Sagrillo ReFresh Aesthetic Center We met nearly 30 years ago through , and from day one our values aligned:
elevate education, protect patient safety, and support injectors with integrity.

That alignment matters now more than ever, especially with the pressure social media places on new injectors to “move fast” instead of building true clinical competence.

Dawn has created a high‑level, anatomy‑focused educational experience for both novice and experienced injectors who want to deepen their understanding of facial structure and safe injection practice.

Led by Dr. John Fezza and an exceptional faculty, this program offers something rare in our specialty:

• Small, intimate groups
• An instructor at every table
• Relaxed, supportive environment
• Open, honest discussions
• Panel Q&A covering anatomy, technique, and complications

If you’re committed to elevating your practice with anatomical precision and safe, thoughtful technique, this is an opportunity you don’t want to miss.

THMA is thrilled to announce that The Face Institute is officially joining our network of Clinical Training Centres across Canada.

This partnership is led by Mark Harbora, NP, a respected THMA Clinical Trainer since 2022. Mark has consistently demonstrated exceptional commitment to safe, evidence‑based aesthetic education, and we are proud to see his leadership expand into this new role.

At The Face Institute, Mark will be offering a range of high‑value educational opportunities, including:

Networking Workshops
One‑on‑One Mentoring
THMA Foundation Program

And potentially… a THMA Symposium in 2027 — an exciting possibility already generating a buzz.

This addition strengthens THMA’s mission to elevate injector education nationwide through structured learning, mentorship, and clinical excellence.

Exciting News from Distinct Medical Aesthetics ✨

Our team has grown in two beautiful ways.

First, we’re celebrating Jacklyn’s newest addition — a healthy baby boy. The entire THMA family is overjoyed for her and her growing family.

We’re also thrilled to share that Gina Maalouf, RN has officially joined Jacklyn’s clinical practice. Gina has been a valued THMA Clinical Trainer since 2022 and brings exceptional expertise in Foundation training, advanced toxins, HA fillers, and biostimulator treatments.

She will be offering 1:1 and small‑group mentoring for both novice and experienced aesthetic providers, in collaboration with Jen Holman, NP (Real Beauty Rx).

📍 Training & mentorship opportunities are now open.
If you’re ready to elevate your skills with expert guidance, send us a message to reserve your spot.

Informed Consent in Aesthetic Medicine: Advancing Ethical & Legal Standards

Jennifer Splane NP PhD(c) MN BN BSc is the Co-owner and Aesthetic Provider at The Welle Medical Clinic in Rothesay, New Brunswick.

Informed consent is a critical clinical and medico-legal process in aesthetic practice. It requires more than documentation—it demands a thorough, patient-specific discussion that ensures understanding of risks, benefits, alternatives, and expected outcomes. Effective consent supports patient safety, reduces the risk of adverse events, and strengthens clinical accountability.

This presentation will define the legal and ethical principles that underpin valid informed consent in clinical practice and identify the required elements of comprehensive informed consent, including risk disclosure, alternative options, and documentation standards.

Informed Consent in Aesthetic Medicine: Advancing Ethical & Legal Standards | THMA - National Training and Mentoring Academy for Aesthetic Medicine Informed Consent in Aesthetic Medicine: Advancing Ethical & Legal Standards by THMA - National Training and Mentoring Academy for Aesthetic Medicine on Patreon. Join THMA - National Training and Mentoring Academy for Aesthetic Medicine's community for exclusive content and updates.

Aesthetic medicine is evolving at a pace that few specialties can match. New technologies, changing patient expectations, and increasing regulatory oversight are reshaping how we practice—and how we should be trained.

Yet despite this rapid growth, one issue remains: not all education in our specialty is created equal.

Too often, aesthetic training is influenced by trends, anecdotal experience, or unchallenged opinions. While clinical experience is valuable, it cannot stand alone. Without a foundation in evidence, variability increases, risks rise, and patient safety can be compromised.

Evidence-based training integrates clinical expertise with the best available research—ensuring aesthetic providers understand not just how to perform a treatment, but why it works. That distinction is critical.

When providers understand underlying mechanisms—such as the pharmacology of neuromodulators or the rheological behaviour of dermal fillers—they are better equipped to make sound, defensible clinical decisions that move beyond “trend-based” practice.

In aesthetic medicine, complication management continues to evolve. With emerging research and the integration of technologies such as ultrasound, protocols are no longer static.

Training programs must be built on clinical evidence, grounded in real-world practice, and aligned with safety, ethics, and regulatory expectations. Education grounded in evidence results in increased patient safety and provider confidence.

Ongoing, evidence-based education is not a luxury—it is a professional obligation. The future of aesthetic medicine depends on the quality of education we choose today.

What does evidence-based mean to you?