Q: I am 68 y.o, and taking Xarelto. Is it safe to have Sculptra injections? I have had Restylane, Juvederm with no problem
A: Sculptra is a localized treatment that stimulates the production of collagen. It shouldn’t get into your bloodstream nor should it interact with a blood thinner like Xarelto. You are probably worried about bruising and bleeding because of the blood thinning effect of Xarelto. Surprisingly, filler patients on Coumadin or Xarelto seem to have the same incidence of bruising as patients not on blood thinners. The most bruising I see occurs in patients on fish oil. That said, it is prudent to take extra precautions in any patient on blood thinners. We can use a blunt tipped cannula rather than a needle, injecting slowly, and exiting the skin carefully. Theses maneuvers decrease the risk of bruising. We also offer pulsed dye laser treatment at no charge within 72 hours of your filler for any bruise. This helps them go away much quicker. So go ahead and try Sculptra. It is a wonderful filler that can help you replace lost volume and sculpt more youthful curves in your face.Please find a board-certified dermatologist to perform your Sculptra rejuvenation and do remember to mention your use of Xarelto; it’s important that your doctor know about any medications you take.
Q: I want more dimension in my face. I want filler in my forehead, possibly chin & a TINY bit in the bridge of my nose too to have even proportions after filler in my forehead. What filler would be the best for this? & what would be the best areas in my face to apply that filler? I actually am fine with my nose.
A: Without photos, it’s difficult to say for sure what would work for you. I would caution you that these are very high risk areas in that there are a lot of blood vessels that connect to blood vessels that supply the eye. So make sure you only go to a very high skilled and experienced board-certified dermatologist or facial plastic surgeon who performs the procedures themselves and will give you a better idea of what needs to be done so you get the improved and balanced look you want with minimal side effects.
Q: I have very thin old lady like lips and I just want my lips to appear a tad wider and fuller, can lip injections help achieve this look ?
A: An expert with hyaluronic-acid (HA) based lip fillers, such as Volbella, Restylane, and Belotero, can create more volume and width to your lips and bring you closer to your ideal. Your upper lip is quite thin and would respond beautifully to HA lip augmentation. Consulting with a board-certified dermatologist will give you a better idea of what you’ll look like after your procedure and how often you’ll need touch-ups to keep your lips looking luscious.
Q: Can lip augmentation give me the heart shaped lips I like?
A: Your lips are nicely shaped and full, but you could add more volume and height to the peaks of your upper lip and plump up the center of your bottom lip, too, with a hyaluronic-acid base filler such as Volbella or Belotero. These changes would create a more heart-shaped look. This added volume will also detract somewhat from the width of your lips. While you won’t look exactly like your ideal, you’ll be a lot closer to it. Consulting with a board-certified dermatologist will let you explore your options and get a better idea of what your final results will be.
Q: I am 34, had 20 units of Botox for my 11s, happy with the results, but wonder what can be done for my under eye area?
A: One of the best dermal fillers for the under-eye region is the hyaluronic-acid based Volbella. It’s very thin and natural looking, so you’d get a great improvement without looking “done.” The other possibility is to follow through with your dermatologist’s advice to get a small amount of Voluma in each cheek. This creates a more lifted look overall, including in the eye area. It improves your under-eye by lifting the skin upward, making it more even with the rest of your face. Choose the look you want; either way, when it’s done well, it’ll look great. Be sure to consult a board-certified dermatologist who is an expert at lifting the face and under-eye area with dermal fillers.
Q: Thinner and young, the doctor only went with 1/2 syringe of Voluma per cheek. Do you think I could use a bit more?
A: In my opinion, you look great as is. If you wish, you could get more Voluma in the upper-cheek region, building up your cheekbone. This would still be natural, but would give you a more elegant and uplifted look. It’s 100% up to you. The nice thing about fillers like Voluma is that you can experiment with a new look and then, if you don’t like it, it’s only a year or so til you’re back where you started. You can even dissolve the look before then, if desired. Be sure to consult a board-certified dermatologist who works with you to get the subtle improvement you ultimately want.
Q: I am 58 and have a botched nose job which left a dent, would fillers fix this?
A: A board-certified dermatologist who is an expert at performing nonsurgical nose jobs with hyaluronic-acid based fillers can disguise your bump and dent. Juvederm or Restylane are good choices for injectable rhinoplasty. Because there’s not a lot of motion in your nose, the fillers could last for six months or even longer. Be sure to consult a board-certified dermatologist who can show you beautiful before-and-after results from nonsurgical rhinoplasty.
Q: Is it possible for my cheeks to plump up after the initial injection of Voluma XC? I just had it done today. I’m hoping the results become more visible in the next week or two.
A: Voluma is a what-you-see-is-what-you-get treatment. If anything, you may be a little swollen directly after your treatment so you may see a little less volume after that subsides. If you’re not happy with the amount of volume you have, you can go back and get another treatment. If this is your first time receiving Voluma, your injector may have been conservative; it’s preferable to add more than it is to subtract by dissolving. Be sure to consult a board-certified dermatologist who’s an expert with sculpting the face using Voluma.
Q: I have had dermal filler in the tear trough area 2 months ago. I wanted to have botox also to correct my frown lines & crows feet, but was recommended to have cheek fillers 1st and then botox. Does it matter which order I get this done?
A: Your doctor may have advised getting a dermal filler in your cheeks first because it will lift your skin at the sides of your eyes slightly and may improve your crow’s feet. However, if your crow’s feet are deep, it really wouldn’t make much of a difference. You can get the Botox first, the fillers first, or both on the same day. It’s your choice. Please consult a board-certified dermatologist who is an expert at rejuvenating the face with Botox and fillers.
Q: I am about to be 33 in one month.I have been to many doctors offices. I want to make a decision. I am very petite and my face is small, my skin is good but its losing volume. I want to get my youthful Full face back and to look very natural.
A: You’re getting different answers because each doctor has products that they prefer, based on the kinds of results they can get by using them or comfort level and experience in using them. In my opinion, Sculptra is one of the best fillers to use in the midface because it’s a collagen stimulator, long lasting and can make a dramatic difference in replacing lost volume. I think you would like the gradual correction and the fact that you are in control of how full you would like to be. We generally do 1 -3 sessions of one vial each in your age group, spaced 4 -6 weeks apart. If you were happy with the results of two treatments, you could stop and do a maintenance vial every year or so. The other dermal fillers you named (Vollure, Volbella, Restyane Lyft) also stimulate collagen to some degree, but less so than Sculptra. Vollure is a wonderful smoother for folds and cheeks, Vobella is mainly for lips and fine lines and Restylane Lyft can add pillows of volume and lift to the cheeks. I frequently layer fillers or use different ones in different areas to get the most beautiful and rejuvenating contours. Instead of trying to figure out which filler is going to give you the results you want, think about the expertise of the physician you consulted. The physician should be able to clearly explain and show you on your face why a particular filler is especially good. Before and after photos are also helpful. I would suggest you consult with a board-certified dermatologist with years of experience with all the different fillers.
Q: Sculptra for the buttocks area. I have voluminous buttocks. Mid 30s, 2 kids, diets. Sides have lost volume. Could it work?
A: Sculptra adds volume to the buttocks area and it could be a good choice for shaping the sides of your buttocks. When using dilutions of Sculptra to create nonsurgical BBLs, it’s important to realize that the volume change will be subtle. Trying to create a dramatic volume change would be prohibitively expensive. Sculptra is best for creating softer, rounder contours or reshaping the buttock in your case — not building up tissue significantly. If you think you need a “voluminous” change to match your “voluminous buttock”, Sculptra would not be a good choice. Please find a board-certified dermatologist to evaluate your buttocks to see if Sculptra can be part of the solution for you.
Q: What’s the best treatment option for my sagging jowl? I’m a 28 year old female.
A: There could be many reasons at the root of your sagging. The foods you eat, stress levels, amount one sleeps and the amount of exercise you get can have a negative impact on your bone and skin quality. If you smoke, your skin dries and thins out at a younger age than in nonsmokers, for instance. As for your immediate problem, Sculptra or Voluma in the midface could add back some of the volume you lost and thus remedy the sagging and early jowls. Ultherapy can also contour and lift the face. Consulting a board-certified dermatologist will let you get some more specific remedies that not only solve this particular problem but ensure that your skin remains in good shape through the coming years.
Q: Young male. Cheek filler or mid face lift?
A: You definitely do not need any kind of surgery! If you’d like to create a little more lift in your midface, then Sculptra or Voluma on the cheekbones or midface will help a lot. A liquid facelift with these two fillers should last about a year. Consulting a board-certified dermatologist will help you choose appropriate procedures for your age and needs.
Q: I want to get lip, nose, and chin, smile line fillers and Kybella in my jaw. Last question, when you go back to refill, are the old fillers gone gone, or do they just get less. And for Botox how long does it last?
A: You should try to schedule your dermal-filler touch-ups while you still look good, just so you can maintain the benefits you’d attained. Generally you don’t have to touch up fillers like Voluma and Sculptra for up to a year, Volbella in the lips for 6-8 months. Other fillers, like Restylane and Juvederm, every 8 months. Botox needs to be renewed every three to four months to maintain your wrinkle-free skin. As for Kybella, once you’ve completed your treatment cycle and eliminated the fat, the fat’s gone for good. Of course, if you gain weight, you could once more develop a double chin, but its proportions will be smaller in relation to the rest of your body than before your treatment. Consulting a board-certified dermatologist will help you decide which fillers to get and to come up with a maintenance schedule that allows you to look refreshed and beautiful continuously.
Q: I want a non surgical face lift. Some type of injectable filler for my nasolabial and the coner of my eyes. Which filler would be best for me.
A: You’d get a beautiful improvement by finding a dermatologist to smooth out your crow’s feet (the lines at the corners of your eyes) with the neuromodulator Botox. That’s a much more effective remedy than using fillers in that region. Botox actually stops your muscles from creating crow’s feet. Without the pressure of being folded by the muscles, the skin smooths out and becomes wrinkle-free. At times, just a little bit of filler is used in the corners to brighten and lift the eyes.
My choice of filler for nasolabial folds (NLF) is often Restylane Refyne or Defyne. These hyaluronic-acid based fillers are soft and flexible and move with your face as you smile and make expressions. They look and feel very natural and even make your facial expressions more attractive because of their unique flexible structure. Please find a board-certified dermatologist to help you get an instantly refreshed look with injectable therapies.
Q: Top lip unevenness, can fillers correct this?
A: A board-certified dermatologist can create more volume in the areas of your lip that surround the point using hyaluronic-acid based dermal fillers such as Volbella, Belotero, and Restylane. Your lips will smile evenly, just like in the photo you provided as an example. Consulting with a board-certified dermatologist will get you the beautiful results you’re looking for.
Q: Volbella lip fillers 16 months ago look the same. They have not started to go down at all. Thoughts?
A: Congratulations! I wouldn’t be concerned at all that your Volbella still looks beautiful and fresh. While Volbella’s makers claims it can last for up to 12 months, many patients experience longer intervals before Volbella needs to be touched up. Any data on longevity of a product is based on averages of many different individuals. Variation within those individuals can be extreme. You’re fortunate that you’re on the longer-lasting side of the spectrum. Consulting with a board-certified dermatologist will help you come up with the best touch-up schedule for Volbella that’s right for you.
Q: Is Voluma used on hands? If so is it successful and is it the filler of choice, if not why not?
A: Dermatologists select a filler based on the patient’s needs and that particular filler’s qualities. I’ve used Voluma in the hands with beautiful results. It can last up to 18 months. However, it’s a thicker filler and may not always be appropriate for the hands. One of the nicest fillers to use for the hands — and the only one that has FDA approval for this indication — is Radiesse. It’s a thinner filler and therefore works best with the slight volume loss and thin skin that’s characteristic of aging hands. Be sure to consult a board-certified dermatologist who has experience with many different dermal fillers and can layer them, if necessary, to give you the most beautiful and rejuvenating outcome.
Q: Ultherapy 3 weeks ago, either Profhilo or Sculptra to address lost volume in lower face and cheeks?
A: My preferred filler in the lower face and perimeter of the face is usually Sculptra. Sculptra does a marvelous job of restoring volume, but in a very natural way. In the lower face, it is best not to overfill because the face could look boxy or bottom heavy. Sculptra is more like a flat correction there and avoids this problem. If pillowy cheeks are desired, then Voluma is my choice for a soft natural cheek. If sculpted angular cheek bones are desired, then I think Radiesse works best. Profhilo is not a product available in the U.S. and it is not FDA approved as of now. I have no experience with it, nor have I seen any clinical trials regarding this product. It’s best to stay away for now until more is known (and of course until it is legal here). Sculptra is most likely your best choice for lower face and cheeks, as it is also a terrific collagen stimulator, improving the tone and texture of your skin. Your results with Sculptra can last for up to two years. Please find a board-certified dermatologist to get the most beautiful results with Sculptra.
Q: I want my tear troughs touched up with HA filler before I go on vacation next month. The plastic surgeon I saw most recently doesn’t want to do the eye area until *AFTER* the Sculptra. While I can understand why, I hate the thought of my undereyes looking hollow for several more months while the Sculptra develops.
A: Your doctor is trying to save you money and procedure time by recommending Sculptra first. However, the choice is up to you. If you want an improvement now and don’t want to wait for the lift that Sculptra in the cheekbones will give to your eye area, then go ahead and move forward with the HA filler. I agree with you to start with a conservative amount now, as the tear trough area will improve as the Sculptra develops. You don’t want to overfill the tear trough, as it can cause the eye to look smaller, especially when smiling. Too much filler in the tear trough can also lead to delayed healing. However, a quarter of a syringe or less under each eye is safe will help reduce that hollow, tired look. Your board-certified dermatologist should be happy to accommodate you.
Q: Is Voluma a good choice for someone with a round face?
A: If you’re looking to replace lost volume, then Voluma could be an excellent choice, no matter what your facial shape. However, the photo you provided doesn’t give much information and you didn’t state what improvements you want. Your question actually points to the importance of in-person consultations with a board-certified dermatologist. We determine the best therapies based on in-depth, face-to-face evaluations and learning deeply about what concerns you. Your facial type, skin quality, and degree of sagging will all factor into the final decisions to bring you the most beautiful and flattering improvements.
Q: How many Voluma syringes are typically used in the nose?
A: I wouldn’t use Voluma in the nose because its formulation is too thick and more rigid than some of the other hyaluronic-acid based fillers. My choices would be either Juvederm or Restylane. You really don’t want to add much volume to the nose, so one syringe or less should be plenty. Be sure to consult a board-certified dermatologist who can prove his or her expertise in this area, because it requires skill and a highly developed sense of aesthetics.
Q: When I want to shut my mouth, I have this gap on the one side because my top lip is not symmetrical. What can be done?
A: First, it’s perfectly normal to have asymmetry in every area of your face, including your lips. Your asymmetry is not glaring. However, if you’d like to even out your lips more then yes, hyaluronic-acid based dermal fillers would be the ideal solution. Volbella, Restylane, and Belotero are all possibilities, depending on how much volume you want. Volbella lasts up to 12 months. The other fillers need to be touched up every six months or so. Consulting with a board-certified dermatologist will help you correct your lip gap and feel better about the way you look.
Q: How do I go about changing the shape of my upper lip? Would like a higher cupids brow.
A: If you want to raise your cupid’s bow, a small amount of a thin hyaluronic-acid based filler such as Volbella in the philtrum area could do it. However, this is an expert treatment and most injectors won’t be able to help you. Consulting with board-certified dermatologists who are known as expert lip augmenters will help you find the right person for the job.
Q: I don’t like my profile and would like to bring my chins projection out some. I don’t want an implant. But I would like to know how much filler I would need
A: To get a better projected chin, one or two syringes of either Voluma or Sculptra could give you very nice results. You’ll need to touch up every year or so. Be sure to consult a board-certified dermatologist who has demonstrably great results with using facial fillers to create nonsurgical chin augmentations.
Q: Injector plans to use Voluma on high cheek bones. Reading through doctor answers on RS, I am confused about where to inject to achieve contour. Apples of cheeks or high cheek bones? I am having one syringe for each side, I can’t afford more.
A: You have significant volume loss in your face which could be beautifully improved with Voluma in either the cheekbones, apples, or both. If you’re bothered by wrinkles around the lower eyes and eye bags, then your injector’s chosen the right area to focus on first. By building up the cheekbones, you’ll also lift the under-eye trough a bit. Be sure to consult a board-certified dermatologist who is an expert at sculpting the face with Voluma.
Q: What surgery or treatment would be the best for these creases I have under my eye? I’m a 21 year old male.
A: Volbella is one of my favorite fillers for plumping up the under-eye area to make it look smooth and youthful again. Volbella can last for up to 12 months, which makes it a great choice for men who don’t want to make too many trips to the dermatologist’s office. Consulting with a board-certified dermatologist who’s an expert with Volbella will help you feel better about your under-eye area.
Q: How often should one get lip filler? My filler of choice is Volbella
A: Volbella is one of my favorite lip fillers. First, it’s nice and thin and soft, so that it looks and feels very natural. Second, it can last for up to 12 months, which makes it a great value for the patient. You may find you need touch-ups sooner than that; everything depends on your metabolism and your choice. Consulting with a board-certified dermatologist will help you get a really beautiful lip augmentation with Volbella.
Q: Hi, I just got Voluma in my midface and Voluma and Juvederm in marionette lines. I need a professional opinion of you see a difference. I'm disappointed but hoping it'll get better in a couple weeks? The doctor said to wait 3 weeks.
A: You should be able to see a difference in your marionette lines and midface directly after your Voluma and Juvederm injections. Sometimes results are obscured by temporary swelling, but I don’t see any swelling in your case. My suspicion is that your injector was being conservative and needs to administer more product. Be sure to consult a board-certified dermatologist who has experience rejuvenating the face with dermal fillers.
Q: How do I get a fuller face? I was interested in sculptra but the plastic surgeon said voluma was a better fit for me. I feel like I am still missing volume but just can't afford alot. My self esteem has taken a hit because my long-term boyfriend likes a youthful look and seems less attracted to me because my face is aging and it's extremely hurtful.
A: The wonderful thing about hyaluronic-acid based fillers like Voluma is that if you want to add more, you can. It’s best to be a bit conservative when first using fillers, so your injector made the right choice to take the slow approach. However, you are quite youthful and beautiful looking already, so be sure that you are making this change for yourself, not to win your boyfriend’s approval. Aging is inevitable; to some degree we all have to accept it. You can look beautiful and radiant and attractive at any age if you take care of your skin and help resolve the issues that most trouble you (not someone else). Be sure to consult a board-certified dermatologist who makes you feel confident, is willing to work with you over the long term to keep your skin looking gorgeous and healthy through the coming decades, and who is an expert at rejuvenating the face with Voluma.
Q: I am 21 years old and in relatively good shape but unfortunately have genetically droopy cheeks and fat just at either side of my mouth. Ive had advice that cheek fillers may help the appearance but i'll still have that same amount of fat resting at the side of my mouth so i think a cheek lift would be more appropriate. I have included some photos of how my cheeks look normally and how when i lift the skin at the top of my cheeks with my finger.
A: Building up your cheekbones or creating more volume in your midface with Sculptra or Voluma will give you the little lift you’re looking for. You’re too young to be chasing after surgical solutions! Aging, too, will hollow out the lower part of your face a bit, making it look more defined. I also sometime use Ultherapy to contour the face. Consulting a board-certified dermatologist will help you decide how to get the look you want without surgery.
Q: Can my face be made slimmer with Voluma and my double chin reduced with Kybella?
A: Voluma to lift and define your cheeks would help create a slimmer, more heart-shaped look to your face. Other suggestions would be augmenting your chin with Voluma or Sculptra to actually add length. Your masseters are also quite bulky. Botox can relax them, so you have a softer, longer, and more feminine look. And yes, Kybella is great for removing double chins with a series of injections. Be sure to consult a board-certified dermatologist who is an expert at modeling the face with injectable therapies to get a really spectacular look.
Q: I have a longer face and not much definition on my cheeks, although I have high cheekbones. I have an appointment for Voluma, but just curious if I I should go with 1/2 or 1 syringe per side. I want a noticeable difference, but yet I don't want to have a fat looking face either.
A: The difference you’d get with 1/2 a syringe would probably be too subtle to be satisfactory. I’d recommend starting with a syringe per cheekbone. Adding some width to the upper face will create the illusion of less length. The Voluma, when expertly placed, will not cause your face to look fat. Be sure to consult a board-certified dermatologist who is an expert at sculpting the face with Voluma and other dermal fillers so that you’ll get the beautiful improvement you want.
Q: Will Voluma in my cheeks help appearance of deep tear troughs and bags? I’m 32 I can’t stand the appearance of my under eyes.
A: You would probably love the difference that Voluma in your cheeks makes to your entire face. Yes, the added volume would lift the skin away from your tear troughs so that they’re not as visible. It will also create a slight lift to the lower portion of your face, which is slightly droopy. You can enhance the rejuvenating effect under the eyes by using a very soft filler, such as Volbella, in the tear troughs themselves to make them look more uniform. Be sure to consult a board-certified dermatologist who is an expert with liquid facelifts to get a beautiful and flattering rejuvenation.
Q: What is the best way of refining dry, old-looking skin without the use of lasers?
A: You have many options available that can help rejuvenate your skin. Microdermabrasion and chemical peels remove the dull outer layer of the epidermis, revealing newer, dewier skin underneath. Microneedling stimulates your skin to produce more collagen. Dermal fillers such as Sculptra and Voluma restore lost volume and make the overlying skin look smoother and more lucent. Sculptra also improves skin quality by stimulating the production of even more collagen. Please find a board-certified dermatologist to help give your skin a healthy glow again.
Q: Sculptra - can it be used prior to losing weight so the face doesn't sag?
A: Losing weight will definitely result in a loss of fat volume in your face as well. If you look good now, then you might want to wait until after the weight loss has begun. Every person is unique and fat loss may not be equal in all parts of the face (just as we see in the body…some areas reduce faster than others). Therefore, losing some weight will reveal where early shadows and concavities are starting to form. You can add more Sculptra as you lose more and more weight. Please find a board-certified dermatologist to assess and rejuvenate your face with Sculptra, as it takes expertise to accomplish this well.
Q: Would Sculptra or Ultherapy be better for me?
Hi, I am interested in getting tighter skin. I am almost 40.
A: Your primary issue right now is a loss of volume in your face. This can be improved with Sculptra, which not only restores volume but improves your skin quality by stimulating your skin to produce more strengthening collagen and elastin. In addition, you could benefit from some laser resurfacing to give your skin more of a healthy glow. Combination treatment is almost always the best approach to counter the effects of aging and create a beautiful and healthy-looking rejuvenation. My office is in San Diego. Feel free to contact me for an in-person or Skype consultation.
Q: I am 38 year old, no body fat and always had a slim face. I had 2 vials of Sculptra in December and 2 more vials 2 weeks ago. My therapist asked me to come back after 6 weeks for 3rd session. I am worried about overfilling Sculptra. I don't want to look unnatural or change my face shape. If I wait 6 months and have 3rd injection then, will I ruin chances of getting optimal results? I have already noticed some benefit 3 weeks after 2nd session.
A: It’s perfectly fine to wait for Sculptra, if you’re afraid to overfill. Sculptra lasts for two years, so you have plenty of time to add more filler. You may also find that two treatments were sufficient, especially since you received two vials at each session. Please find a board-certified dermatologist to rejuvenate your face with Sculptra for the best results.
Q: How often would a person be required for additional Sculptra injections to maintain their results?
A: Sculptra is a collagen stimulator that keeps you looking lifted and refreshed for up to two-and-a-half years with a series of treatments. However, I usually suggest a top-off at the year mark to maintain your look. After age 30, we lose one tablespoon of fat from the face per year, so volume loss adds up. Please find a board-certified dermatologist who’s an expert at rejuvenating and sculpting the face with Sculptra.
Q: Looking for guidance for surgical vs non surgical ways to get less tired looking eyes and eye bags.
A: You could get a nice rejuvenation of your under-eye area with a thin filler, such as Volbella, delivered via cannulas to reduce bruising and create a more uniform look. Though you didn’t provide full-face photos, usually adding Voluma or Sculptra to the cheekbones or midface can further rejuvenate the eyes by lifting the under-eye skin slightly. The filler in your midface will give you a much younger look overall. Consulting with a board-certified dermatologist will help you decide what to do.
Q: Unhappy with lip injections. Want to avoid the duck lips and have them plump and fuller but natural looking.
A: From your photos it seems that your injector chose the wrong area to treat. Lip augmentation with dermal fillers should look soft and natural, not overdone or “duckish.” Take the time to find a top-notch, board-certified dermatologist who is an expert at lip augmentation and make sure you check out their before-and-after photos. The filler you have now can be dissolved with hyaluronidase and new filler such as Volbella correctly placed to give you the fuller, natural-looking lips you want.
Q: Seven years ago, I suffered an injury causing one of my tooth to fall out and a cut to the lining of my upper lip which required stitching preformed at the A&E. Due to the stitching, I have a very lob-sided appearance on my upper lip, rough lip texture and a stone like lump in my lip.
A: Sorry for your troubles. The lopsided appearance of your lips can be rectified with Volbella or another hyaluronic-acid based dermal filler. An expert can insert the filler in such a way that it reveals more of your lip’s natural vermillion (red part), to make both lips look symmetrical. The texture of your lips can be improved with microneedling to stimulate more collagen. Consulting with a board-certified dermatologist will allow your lips to be evaluated in person and the best remedies chosen.
Q: When my face is resting, my lips aren’t super thin, but when I smile I would like my lips to be big and plump- especially the top lip. Some people may disagree, but I love the Kardashian big lip trend. Is this doable on me? I like my smile but would like it more if my lips were bigger
A: Since you’re feeling a little uncertain about how much lip augmentation would be flattering to you, I suggest starting with a thin, soft filler like Volbella. It will add subtle volume and shape to your lips so they don’t flatten out so much when you smile. If you like it, it’s easy to add more or to layer on a thicker filler such as Restylane Silk, Belotero, or Juvederm. The nice thing about dermal fillers is they aren’t permanent so you can update or change your look every few months. If you don’t like the filler or go too far, hyaluronic-acid based fillers can be dissolved with hyaluronidase. Consulting with a board-certified dermatologist will help you get started on a lip augmentation.
Q: Is Juvederm Volbella effective and low risk for tear troughs?
A: Volbella is my favorite dermal filler for the tear troughs because it has a thin, soft, honey-like consistency that looks and feels natural. I use cannulas to deliver the Volbella, which creates less bruising and provides a more uniform result. Consulting with a board-certified dermatologist who’s an expert with Volbella will get you the nice, rejuvenated under-eye area you’re seeking.
Q: Can fillers improve my close-set eyes?
A: You can use injectable hyaluronic-acid based fillers to widen the bridge of your nose. I’m not sure that this would create the illusion of wider-set eyes for the average viewer, but if you liked the look when your nose was swollen, then I say give it a try. Be sure to consult a board-certified dermatologist who is an expert with dermal fillers, as injecting near the eyes requires skill and knowledge of anatomy.
Q: Hi, i am thinking to do a nose filler injection, but my family is very old fashioned and we stay together, will they notice if i have done my nose job?
A: Your family is very familiar with your face and will undoubtedly notice if you make a change, such as getting a nonsurgical rhinoplasty with dermal fillers. One way you can sometimes hide/deflect a cosmetic change like that is to get a haircut the same day. Sometimes the new style convinces your friends and coworkers that your hair accounts for the undefinable improvement in your appearance. The only way you can know for sure is to try it, as long as you are over 18 and can make these decisions for yourself. Be sure to consult a board-certified dermatologist who is an expert with injectable fillers to perform your nonsurgical rhinoplasty.
Q: I am going back to medical school to complete my degree (I only paused my education due to some horrific events). Nevertheless, the years of stress that I have endured are definitely showing on my face!. This does NOT look like the face of an average Black female. So, I need help to restore the lost volume in my mid face and move on to address any other problem areas.
A: I’m sorry to hear about your troubles and glad to know that you’re on track to achieving your dream of becoming a doctor — it’s a very rewarding career! Your photos are not showing up, so I can’t make any comments specific to your case. However, dermatologists have many wonderful treatments to rejuvenate and re-energize your face, no matter how old you are or what skin type or color. Lasers can actually make your skin look and act younger, as well as even out your skin tone. If you’ve lost volume due to stress, that can be replenished with Voluma or Sculptra. Deep creases can be filled with hyaluronic-acid based fillers or eliminated with Botox. Give yourself a treat and start consulting with board-certified dermatologists in your area. Find one you trust for this initial rejuvenation and with whom you can continue to work so you’ll look energized and healthy, despite the stress of attending medical school.
Q: Can I achieve these results without surgery? Non surgical nose job? Fillers? Jawline contouring?
A: Nonsurgical facelifts can dramatically improve the look and contours of your face: Botox to slim the masseters and make your face more heart-shaped, Voluma to create more lift and definition in the midface, Juvederm to smooth out the crookedness in your nose and add volume to your lips. Botox to raise the nose tip. The results may not be exactly like your ideal, but they could be close. Be sure to consult a board-certified dermatologist who is an expert at contouring and reshaping the face with fillers and Botox.
Q: I have nasolabial lines and and sagging on the corners of my mouth. I am 22 but look 32 due to especially my lower face. What can I do to correct this non-surgically?
A: You don’t have very prominent nasolabial folds, but they can be smoothed out with Restylane Refyne or Defyne. Adding volume into your midface overall with Voluma can give you a bit more lift and make you look younger. But mostly I’d suggest starting prejuvenation with lasers or chemical peels to keep your skin quality high as you continue to age, to minimize future sagging, and give you a refreshed and energized look. Be sure to consult a board-certified dermatologist who can design a simple rejuvenation program for you and help you age beautifully.
Q: I got a Brazilian butt lift 3 years ago, my butt has become smaller and smaller since I do not have fat left to do another bbl I wonder if sculptra will give good result PLEASE DO NOT SUGGEST butt implants I will never put that on me!!
A: Sculptra is great for filling out and smoothing the buttocks and is often used together after cellulite removal with Cellfina. It adds a subtle amount of volume and lift and it can be used as a BBL. However, Sculptra will not give you a lot of volume and takes a series of treatments.. You can have several sessions of Sculptra until the size is sufficient, but a large buttock will require many vials and can be quite expensive. I agree with my colleague that you appear to have enough excess fat for fat-graft BBL. Potential areas to harvest are your upper arms, thighs, and possibly lower abdomen. Please find a board-certified dermatologist in your area so you can decide which route you want to take to achieve your ideal figure.
Q: Is Sculptra for temples safe? Is it a fairly straightforward procedure?
A: Sculptra does a wonderful job of filling out lost volume in the temples. It’s a collagen stimulator, so it will stimulate your body to produce more of your own, strengthening collagen and elastin. The results can last for up to two years, though you may want to touch up at the year to year-and-a-half mark. It’s a fairly straightforward procedure, as long as the physician knows the anatomy well to avoid blood vessels and place the product strategically in the temple for the best result. Proper dilutions and quantities are important with Sculptra and your physician should be experienced in its use. Usually 2-3 sessions are needed to build the look slowly. Please find a board-certified dermatologist to administer your Sculptra. The temples are not an area you want to trust to an amateur.
Q: Do you recommend Voluma for lips if I want a natural looking and feeling pout?
A: Voluma is a hyaluronic acid-based filler that’s used to add volume to the face and create temporary cheekbone and chin augmentations. Voluma is not appropriate to the lips because it’s too hard and would look unnatural. I believe you are thinking of Volbella. Volbella is in the Juvederm family, too, but is a very thin, soft, and subtle filler that creates really lovely and natural-looking and -feeling pouts. Be sure to consult a board-certified dermatologist who is an expert at using Volbella for lip augmentations.
Q: I've been toying with the idea of getting something done to my face now that I'm 24. I also lost 40 pounds in the past two years and feel like my face is sagging down so I bought one syringe of juvederm voluma xc, 1/2 a syringe for each cheek. Will this make much of a difference? I'm just afraid since I already have such a wide face, it'll make it look even bigger.
A: Congratulations on your weight loss! One half a syringe of Voluma on each cheek at your age will make a subtle, but nice difference and give you that little lift you’re looking for. The Voluma can be placed over your cheekbones, so it won’t widen your face at all, just give it more depth in the front. I’d recommend chemical peels to even out your skin tone and give you a more youthful look, too. Be sure to consult a board-certified dermatologist who can evaluate you in person so you can take control of your aging process now, while you’re still young.
Q: Can't smile fully? Basically my lips are really small and thin.
A: It’s normal for the lips to thin out during a smile. If your lips are thin to begin with, they can almost seem to disappear. You can get a big improvement on the shape and volume of your lips by using a hyaluronic-acid based dermal filler such as Restylane, Juvederm, or Volbella. As for your smile itself, you may be over-clenching muscles that could be relaxed with a little Botox. Consulting with a board-certified dermatologist will allow you to get a full evaluation of your lips and smile and receive the remedies that will make you feel better and smile more confidently.
Q: My lips have always been slightly uneven. But they have gotten worse over time what can be done to make them normal? Also larger.
A: You could get a lovely improvement in the shape, symmetry, and volume of your lips with a hyaluronic-acid based dermal filler, such as Volbella (most subtle and lovely), Restylane Silk or Juvederm (added volume). One plus of adding volume to your lips is that it makes your entire face look younger. Consulting with a board-certified dermatologist will help you decide just how much fuller you want to go.
Q: Would getting lip fillers effect my gummy smile? Would they reduce it? Can I do that and Botox at the same time?
A: Lip fillers such as Volbella and Restylane can do an amazing job of adding volume and shape to your lips, especially when administered via mini cannulas. However, they won’t do too much for your gummy smile. You can use Botox for a gummy smile in conjunction with lip fillers for a beautiful improvement. Consulting with a board-certified dermatologist who’s an expert with both fillers and Botox will get you the best results.
Q: Would another syringe of Volbella cause my results to look overfilled?
A: From the photos you provided, your eyes look good as is, so adding another syringe of Volbella would probably be too much. But this all comes down to your personal preference. What is the ultimate look you’d like to obtain? Do you have photos of yourself at a younger age? Or of a celebrity whose look you like? You could make other improvements, such as restoring volume to your midface or building up the cheekbones, that would create an even more youthful-looking eye area. It’s important to work with a professional who understands facial anatomy deeply so that you don’t succumb to the latest trends that might not work for you. Consulting with a board-certified dermatologist will give you a better idea of what procedures actually improve your looks.
Q: Hi ive been seeing a lot of new articles about Sculptra butt injections ! are they FDA approved and do they work ?
A: Sculptra is FDA approved as a dermal filler for the face and hands. It’s safe in the buttocks, too, though that’s an “off label” use. Getting FDA approval is a lengthy and expensive process and so companies generally concentrate on testing the treatment areas that are most likely to be popular. Doctors then use their best judgment as to whether to treat other areas with the product. Sculptra in the buttocks must be diluted and several treatments are necessary. The results can be beautiful, but it can be expensive, depending on how much volume is needed, and also requires great expertise. Please find a board-certified dermatologist who has experience smoothing and plumping the buttocks with Sculptra.
Q: I am considering having done sculptra for buttocks augmentation. I have a few concerns about the long run side efects . I was talking with a few plastic surgeons (one of them i trust a lot but he doesent use sculptra) , they where telling me that on the long run because of skin aging and the gravitation pulling the skin the scars formed by sculptra aren t going to look good (let s say in 5 years) . Is this true?
A: Sculptra stimulates your skin to produce new collagen, thickening it and building volume. I’m not worried about 5 to 10 years later because Sculptra’s effects last about two years. I have been using it safely without problems for well over 10 years and have seen no long-term problems. Sculptra can create a mild to moderate volume in the buttocks and is not a good solution if a large look is desired. However, if you just want to be a bit curvier, Sculptra is a great option. Please find a board-certified dermatologist who’s an expert with Sculptra in the buttocks to help you get the look you want.
Q: Diluted Voluma filler for facelift, does this effect the duration of the overall results?
A: Sculptra needs to be reconstituted (this is not dilution), as otherwise you can’t inject the powder it comes in. Voluma is different, as it already comes in an injectable form, and therefore I do not dilute Voluma. It is already a perfect consistency for adding volume to the face. If I needed something thinner, I would choose another product. No studies have been done to determine if dilution will affect how long your Voluma results last. Next time, consult a board-certified dermatologist who is an expert in using Voluma for facial rejuvenation.
Q: With Voluma what can happen if I do not wait the 24 hours before exercise?
A: Voluma shouldn’t move or be displaced by aerobic exercise — particularly not almost a day after treatment. It’s not easily displaced. The 24-hour warning is a better-safe-than-sorry recommendation, but is not based on hard science or vast (if any) experience. Consulting a board-certified dermatologist for your Voluma rejuvenation will get you the best results.
Q: Am I young enough for non-surgical facelift? Am I a candidate for facelift? Which treatment(s) best suits to me?
A: Your cheekbones are flat, which makes it easy for gravity to pull your tissues downward. You can create more volume in your face and strengthen the skin by using the hyaluronic-acid based dermal filler Voluma. You can even used it to build up the cheekbones slightly, which will help mitigate the effects of gravity. I also like Sculptra when working on the cheekbones, especially in men, because of the natural looking results. Consulting a board-certified dermatologist will give you some great ideas of nonsurgical remedies for your early aging; and yes, you are much too young for a facelift.
Q: What's the cost of a liquid face lift?
A: Liquid facelifts have no definitive cost because they are tailored to your individual needs. You may need Botox and various dermal fillers including Sculptra, Voluma, Juvederm, and Restylane. You should start consulting board-certified dermatologists who can evaluate your needs in person and give you an estimate.
Q: Can you use another type of filler after getting Volbella for lips?
A: Volbella is one of my favorite hyaluronic-acid based dermal fillers for lip augmentation because it creates very soft, natural-looking and -feeling changes. However, it can definitely be too subtle for those who are looking to plump their lips dramatically. Half a syringe was just a small amount of filler. It’s up to you whether you want to continue Volbella or move on to a thicker filler; layering dermal fillers is a common practice, especially when you want to sculpt the face or lips more precisely. You could move on to Restylane Silk, Defyne, Refyne, or even Juvederm. Consulting with a board-certified dermatologist will help you make the best choice to get the look you want.
Q: What would you do to fix lower face issues? Will princess Voluma or Juvederm, Radiesse etc help?
A: It looks like you have some skin laxity issues on your skin. If you’d like to improve your neck and lower face, the most effective treatment would be something we call ThermiSculpture — a combination of liposuction of the chin with ThermiTight, which tightens the skin using radiofrequency energy. If you want to wait until you’ve lost more weight, you can create a mini lift in the upper face in the meaintime that will help lift the lower face, too. Using dermal fillers and collagen stimulators, such as Sculptra, Voluma, and Juvederm, can create a liquid facelift that may raise your mood as well as your face. It won’t be as dramatic a change as surgery, but it does freshen up your look and give you a confidence boost. Be sure to consult a board-certified dermatologist who has experience rejuvenating the face nonsurgically to get the most satisfying results.
Q: The last year or so I’ve noticed my face looks more deflated and aged than in my early 20s. I’ve also recently lost about 10lbs due to stress. I am especially not happy with my mouth and mid face area but I am not knowledgeable enough about fillers/face anatomy to put into words what I want done to my face.
A: You do show some volume loss in your photos. However, this may be partially due to looser skin after your weight loss. Give yourself a little time and see if your skin snaps back. If not, you could begin chemical peels to improve the texture of your skin and promote some more collagen growth. Or, if you do opt for fillers, Voluma is one of the most effective ways to add volume to the face. Because you are young and you don’t have much volume loss, you might also explore other fillers such as Restylane Defyne, that are a little thinner and softer. Be sure to consult a board-certified dermatologist who can explain the different options available to you.
Q: Want a subtle lip enhancement, not sure what to get?
A: Volbella is one of the latest hyaluronic-acid based dermal fillers and it’s currently my favorite for lip augmentation. It has a very smooth and soft texture that makes it perfect for subtly lifting and plumping lips. Volbella is long-lasting — up to 18 months or more. Consulting with a board-certified dermatologist will help you get the lips you desire with Volbella.
Q: Can filler be used to shape my upper lip border without increasing lip volume?
A: Your case seems to be a perfect one to remedy with the hyaluronic-acid based dermal filler Volbella. Volbella has a thin, honey-like consistency that makes it perfect for adding shape and definition to the lips using mini cannulas. Consulting with a board-certified dermatologist who is an expert at lip-shaping with Volbella will get you that subtle new definition you want.
Q: What is the the difference between Volift and Volbella for lip treatment?
A: Volbella is one of my favorite hyaluronic-acid based fillers for the lips because it creates a very natural looking and feeling augmentation, owing to its thin and soft consistency. It can also last for up to 18 months. Vollure (Volift) creates a more dramatic plumping of the lips, which some patients prefer. Consulting with a board-certified dermatologist will help you decide which hyaluronic acid filler best suits your needs.
Q: I was wondering if fillers can help me achieve super thick thighs after so many treatments. Also is there a limit to how many times I can go get filled. I am planning on getting a Brazilian butt lift and I know my legs won't match my butt so I wanted to fill them in nicely as well. I guess the real question is can I gain inches with fillers such as sculptra?
A: Theoretically, you can fill out your thighs with the collagen stimulator Sculptra. However, it would be a subtle improvement and would be best to even out curves or create a more beautiful and smooth surface. Adding inches to your thighs would be prohibitively expensive. Please find a board-certified dermatologist in person to find out if Sculptra would give you the kinds of results you desire.
Q: I've been recommended it as an option for my acne scars by a doctor I have had needling and prp. I have tried lots of treatments including non invasive laser, co2, needling with not much improvement and some cases new scars and worse skin. I feel like my collagen has broken down which has resulted in sunken cheek on one side and box scars on the other.
A: Deep acne scars can be very difficult to treat, as you’ve experienced with multiple treatments. You’re right, the inflammation of acne does break down the collagen and elastic fibers. The treatments you’ve had should have helped, but may need to be deeper. I like the Infini microneedling system for acne scarring because it can go deeper and the needles deliver radiofrequency at the tip. A fractionated laser can also reach this depth. For the sunken appearance, volumization with filler would help to lift the cheeks. This will also help to stretch the skin and make the scars more shallow. Useful fillers for volumizing are Sculptra, Voluma, Restylane Lyft or Radiesse. For surface scars, I prefer a soft filler like Belotero, which won’t show through when superficial placement is needed. In skilled hands, other fillers are sometimes used, like Restylane Silk, Volbella or Bellafill. If you’re not getting the results you want, please find a board-certified dermatologist who has expertise in scars, as your case is complicated.
Q: I had 9 vials of Sculptra...How would I maintain it...I had a runners face...I am 49 years old.
A: Your Sculptra liquid facelift should continue to make you look volumized and lifted for about two years. However, because you are a lean runner and all of us lose an additional teaspoon of fat per year, I usually recommend a maintenance treatment once per year. You wouldn’t need 9 vials at this point, usually just one or two. Receiving yearly maintenance treatment, essentially “topping off the gas tank”, will keep you full and youthful for years. If you’d like to bolster collagen production, you could begin to get regular light chemical peels or non-invasive laser treatment to treat sun damage and keep the surface looking smoother. Also be sure you are on a medical-grade skin-care regimen, and always wear sun protection and a hat when outdoors — including when you’re on your training runs. Please find a board-certified dermatologist to work with you so that your skin will continue to be healthy and strong over the years.
Q: Is thin skin (almost no fat) a good structure for injecting fat?
A: One of the benefits of a fat graft is that the transplanted fat actually incorporates itself into your skin and resvascularizes there, which will strengthen and plump your skin. So, actually, it’s quite good for thin skin to have a fat graft! One caveat is that some of the fat will die. In fact, I actually think most people get a better result when volumizing their skin using a dermal filler such as Voluma, or a collagen-stimulating dermal filler such as Sculptra. The only way to be sure of which is best for you is to consult a board-certified dermatologist.
Q: 46 no confidence & want help to look younger prefer non-surgical if possible? Laser,liquid facelift idk.
A: There are quite a number of highly effective nonsurgical methods of restoring volume and lift to your face. To improve the quality of your skin and stimulate the production of new collagen and elastin, I’d recommend a series of laser treatments. This will also help remove some of the fine lines and wrinkles. You can use Voluma to add back the volume that has been lost in your face due to age. Voluma will also make your skin look thicker, plumper and younger. Botox would quiet down those dynamic wrinkles around your forehead and eyes. If you still have some wrinkling or creasing after these procedures, a little Juvederm or Restylane Defyne or Refyne can fill them in. Be sure to consult a board-certified dermatologist who can work with you over time to create a satisfying rejuvenation and maintain it for years to come.
Q: I would like my lip to be even when I smile. Is there anything I can do about this as it is making my face look long?
A: Plumping up your lips will create a shorter visual distance between the top of your upper lip and the bottom of your nose. Just a little extra volume in the lips using hyaluronic-acid based fillers such as Belotero, Juvederm, Restylane, Restylane Silk and Volbella can light up your entire face. Consulting with a board-certified dermatologist will help you make the improvements you desire.
Q: Is this little bump a sign of infection two days after Vobella inside my lip?
A: Probably what you are feeling is just the Volbella itself. It sometimes takes awhile before dermal fillers absorb water and settle into the lips. You can try gentle massage over the next few days and see if the lumps dissipate. If you have any pain (beyond minor discomfort) or oozing, however, you should consult your board-certified dermatologist right away.
Q: Sculptra before Ultherapy for skin tightening? On the body how does this work?
A: Combining skin-tightening with a collagen-stimulating filler such as Sculptra can give tighter skin and a more youthful skin rejuvenation and lift. Either Sculptra or Ultherapy can be performed first, depending on each individual case. If the skin is very thin, Sculptra is often my first choice. After, a series of Ultherapy may or may not be needed. If sagging is the dominant problem, Ultherapy may be the preferred choice. If both problems are present, we sometimes perform Ultherapy first, followed immediately by Sculptra in order to address both issues. Please find a board-certified dermatologist to start you on your facial rejuvenation journey tailored to your individual needs.
Q: How often for maintenance Sculptra? Can't go by looks since you see yourself everyday.
A: Your satisfaction with a Sculptra facelift isn’t unusual! Sculptra is a marvelous product that triggers the production of new, strong strands of collagen in your skin that create a supportive matrix. The lift and contour you are seeing should last about 2 years or longer. However, because you will be aging during that time, too, there will be continued volume loss. Beginning at age 30, its normal to lose one tablespoon of fat from the face per year. My usual recommendation is to be evaluated at one year and very likely receive a maintenance treatment. At that time, you would probably need only one vial per year to keep looking great, rather than wait until it’s all gone. We can turn back the clock, but not stop it, so yearly maintenance is a great strategy to keep looking your best for decades. Please find a board-certified dermatologist to help you maintain long-term benefits with your Sculptra lift.
Q: Voluma on a patient with eczema - is it risky?
A: There shouldn’t be any interaction between your eczema and Voluma, so long as you receive treatment when you are not in an active phase of the disease. Ideally, the dermatologist who is rejuvenating your face with Voluma is the same one who is treating your eczema. If not, be sure to consult a board-certified dermatologist when you are ready for Voluma injections to be sure you are not treated in an area that is prone to flares.
Q: What's wrong with my lips and how can I fix them? How much will they cost me?
A: Your bottom lip is disproportionately large in comparison to your top lip (the ideal ratio is 3:2), and you have slight asymmetry. These can be corrected with hyaluronic acid-based dermal fillers such as Volbella, Juvederm, Belotero and Restylane. They can last between 6 months and a year or more, depending on which you choose and how much of a change you would like to make. Consulting with a board-certified dermatologist will allow you to the get the answers you need.
Q: What type of lip injections do you recommend? Would like to get rid of cupid's bow?
A: Your cupid’s bow is not particularly pronounced. Any of the dermal fillers we commonly use for lip augmentation, such as Volbella, Juvederm, or Restylane could beautifully reshape your upper lip. Volbella lasts the longest — up to a year or more — but gives the most subtle results. Consulting with a board-certified dermatologist will help you decide which to use.
Q: What are the longest lasting and best lip fillers if I aim to increase lip size?
A: My personal favorite dermal filler for lip augmentation is Volbella, simply because it is very natural looking and feeling, plus it lasts up to a year or more. However, if you’re looking for more dramatic volume, then Belotero, Juvederm, Restylane or Restylane Silk may be better choices. These will last about 6 months each. Consulting with a board-certified dermatologist will allow you to explore more about the benefits of each of these fillers so you can choose the one that will give you the effect you want.
Q: How soon after a Picosure Focus treatment can I get a Voluma injection?
A: Feel free to have your Voluma treatment after your last laser therapy. Neither therapy will have an adverse affect on the other. However, if you usually feel tender after your Picosure session, you can also wait a day or two before moving on to Voluma. Consulting your board-certified dermatologist will help you decide how to schedule your treatments.
Q: How long is too long between Sculptra procedures?
Was used in a demo in April by a doctor who teaches about Sculptra. It's now October!
A: The dermal filler and collagen stimulator Sculptra lasts for about 2 years. Therefore, you will not be “starting over” if you get your second treatment six months later. Your Sculptra is still there, and has begun to stimulate your skin to produce new, strong strands of collagen. You can go ahead and begin layering treatments over that base layer. Although the first layer will start to be metabolized sooner than subsequent layers, we can compensate for that with yearly maintenance Sculptra treatments. First though, complete your series until you achieve the desired result. Please find a board-certified dermatologist to finish your Sculptra treatments to get the most beautiful and uniform remodeling.
Q: I just turned 25 and over the past 2 years my face has completely melted away to the point where people I haven't seen in a while don't even recognize me and I barely recognize myself. I've lost fat just about everywhere in my face, but I have also watched my jaw muscles wither away to nothing, causing my face to become long and narrow. In your opinion, would Sculptra or bellafill provide enough volume to address my concerns?
A: Sculptra, Voluma, and autologous fat are all wonderful choices for adding volume to the face. I often layer the first two products for the best results, with Sculptra on the perimeter and Voluma for full, soft cheeks. Autologous fat is also a good choice, but I suspect you may be very thin and not have enough extra fat. Bellafil is not a good choice for volumizing. Because it is permanent, there is a chance your weight will increase later in life and then your face would look overfilled. Bellafil is best for acne scars or very deep folds only.
I am concerned about the overall wasting of your face. It is understandable if you have lost considerable weight, but if it’s just your face, I’d suggest first consulting a medical doctor to make sure you do not have lipodystrophy or other medical issues. If healthy but thin, you can move on to looking for a board-certified dermatologist to add volume to your face with dermal fillers such as Sculptra, Voluma or autologous fat. An expert will make the choice of which filler(s) to use to get you the result you want after an in-person examination.
Q: What should I do to get rid of the deep parentheses lines on the sides of my mouth?
A: You would do well with hyaluronic-acid fillers, such as Juvederm and Restylane, to fill in your parentheses lines. To keep your skin looking good over the long term, you might also consider regular chemical peels or resurfacing with Fraxel or another laser. These procedures stimulate the production of new collagen and elastin, which will help keep your skin healthy and strong. Be sure to consult a board-certified dermatologist who has a number of anti-aging modalities to offer you.
Q: Amount of filler for chin augmentation?
A: You can use this site to estimate the cost of a dermal filler chin augmentation in your area. You don’t need much product, maybe 1 mL, to bring your chin into alignment with your lips. Voluma, Bellafil, and Sculptra are all good choices. Voluma and Sculptra can last around 2 years, Bellafil may last longer. Be sure to consult a board-certified dermatologist who is an expert at creating chin augmentations with dermal fillers.
Q: Wouldn't adding Voluma to the upper cheeks push/lift the face upwards and crease up the under eye area? I was playing around with my face trying to see if I added more volume to the apple of my cheeks or the upper anterior part, it would "push" or "lift" the face upward which in turn actually creases and wrinkles up my under eye area if you know what I mean. Is this what happens?
A: Adding Voluma to build up your cheekbones is not equivalent to pushing on the apples of your cheek. The hyaluronic-acid based filler is injected deeply into the skin, where it plumps it up and strengthens it. The volume actually pulls the eyelid skin slightly outward, rather than bunching it up. Be sure to consult a board-certified dermatologist who knows how to build more volume in the face and smooth out wrinkles with Voluma.
Q: Hi I'm a 29yr old female and I'm thinking about doing liposculpture but I'm not sure if I'm able to achieve my dream body with liposculpture or liposuction.
A: The answer to your question really depends on your expectations and your anatomy. While you look like a great candidate for liposculpture, you may not have the same skeletal shape and musculature as the young lady in the photo you admire. Even though you may not be able the achieve exactly her figure, liposculpture will give you a flatter tummy and curvier waist. Consulting with a board-certified dermatologist will let you be evaluated in depth so that you’ll know approximately what your final shape will be.
Q: How long does Volbella last in tear troughs? I was overfilled and would rather not have hyaluronidase.
A: You don’t mention how long ago you received Volbella to fill in your tear troughs. If it was just a couple of weeks ago, you may still be swollen and are not yet seeing your results. If it’s been longer than that and you are still looking overfilled, the duration of Volbella depends in part on how much was used. A rough estimate is that it will likely last between 9-12 months. Your dermatologist should offer you hyaluronidase for free to correct a poor result. It is a safe and effective treatment option. You should still be left with sufficient Volbella to correct the hollow tear troughs, but won’t have the overfilled look that upsets you. Please call your board-certified dermatologist to have your tear troughs corrected.
Q: Will two syringes of Volbella compare to one syringe of Juvederm?
A: If you’re looking for the dramatic volume that you got with Juvederm, Volbella is not the right filler for you. Volbella has a thin, honey-like consistency that’s very soft and subtle. It is excellent for creating slight volume that looks and feels very natural. Even two syringes won’t create significantly larger lips. Try Volbella if you’re looking to add a more subtle and natural difference to your normal lip shape and volume. Stick with Juvederm if you like larger lips. Consulting with a board-certified dermatologist will help you decide.
Q: How long until I can wear make up after Voluma upper cheek?
A: You don’t really need to wait for more than a couple of hours to apply makeup after Voluma injections. Try not to massage your face while applying the makeup, however; use a gentle touch with your hands and brushes. Be sure to consult a board-certified dermatologist who is an expert at rejuvenating the face with dermal fillers.
Q: I have slim face, tear trough fillers don't last. Should I build up cheeks with Voluma for tear trough fillers to work?
A: It sounds like you may not have received enough filler under your eyes to completely even out the troughs. Dermal fillers shouldn’t move after they’ve been injected. You could ask your dermatologist for more filler, and for a longer-lasting HA filler, such as Volbella. Building up your cheekbones with Sculptra and/or Voluma could also help. Be sure to consult a board-certified dermatologist who is an expert at rejuvenating the face with dermal fillers to avoid more frustration.
Q: Is Sculptra safe for a buttocks augmentation?
A: Is Sculptra Safe for Buttocks Augmentation? Sculptra Beautifully Shapes Buttocks
Answer: In the hands of a board-certified dermatologist with expertise in augmenting the buttocks with Sculptra, this procedure can give you beautiful results. However, it’s an advanced procedure that requires diluting the Sculptra to the right degree and placing the product very carefully. It may also need to be combined with other therapies, such as Ultherapy. As for cost, it can get quite expensive, depending on how much of a change you wish. It’s also important to realize that the augmentation will be subtle, not dramatic. Sculptra should last for up to 18 months or more. Please take your time consulting with board-certified dermatologists to find the one you believe will give you the most beautiful contours.
Q: I'm 61 and skin is in good condition, but I do have sagging, especially in my lower face and jawline and neck. The correct long term solution is a face/neck lift procedure. But in the meantime, since I cannot afford the downtime right NOW, what can I do such a sculptra to help me feel better about myself, but not ruin the ability to get a facelift in another year or so?
A: Sculptra is an excellent choice for building up your midface, temples and cheekbones to create a mini lift. It also stimulates the production of new collagen, which will revitalize your skin. If you can’t afford the downtime of a facelift, there are many nonsurgical options to improve your face. Many patients are so happy with their results, that they forget about surgery. Consulting with a board-certified dermatologist will let you explore options in addition to Sculptra, such as laser resurfacing, Ultherapy, ThermiTight, and Silhouette InstaLift thread lifts. Sculptra lasts about 2 years; you can have a facelift when it is in place.
Q: Can sculptra be used to augment actual bone structure?
A: Sculptra is a versatile dermal filler that is also a collagen stimulator. It is thick and viscous, making it a perfect filler to create nonsurgical augmentations, such as chins, jawlines, and cheekbones. Consulting with a board-certified dermatologist who is an expert in re-contouring the face with Sculptra will get you optimal results.
Q: With Volbella lip injections do you need to do several times to get long lasting results?
A: Before-and-after photos would be helpful to understand what is going on in your case. It sounds like one syringe wasn’t sufficient for the amount of volume you desire. Volbella is long-lasting — up to 18 months — but it is a soft, thin hyaluronic acid-based filler that gives subtle and natural-looking results. If you didn’t take a photo of your lips before the injections, it might be difficult to evaluate the changes now — particularly since you went through a period of swelling. The nice thing about Volbella is that you can always add more. But if you want dramatic volume, you may want to consult with your board-certified dermatologist and try something like Restylane or Juvederm. They don’t last quite as long, but they add more volume.
Q: I injured my upper lip a few years ago and ever since my vermillion border has faded and the lip has dropped on one side. Can volbella fix the vermillion border and asymmetry or will it enhance it.
A: The hyaluronic-acid based dermal filler Volbella would be a great choice to help you feel better about your lips. It can add volume and shape to smooth out the irregularities that are bothering you. It has a very thin consistency, so the look is quite natural. It can also be used to fill in the perioral lines. Consulting with a board-certified dermatologist will give you a better idea of the kinds of improvements you can expect with Volbella.
Q: My upper lip looks very thin. And when I smile it almost disappears. Please suggest me better option. And I don't want my upper lip seems like swollen one I want it completely natural.
A: If you want a natural-looking enhancement to give more shape and volume to your upper lip, Volbella is an excellent choice. It has a thin, honey-like consistency that feels soft. It will be just enough to bring more balance to your lips. Consulting with a board-certified dermatologist will let you learn more about Volbella and find out how it can help you.
Q: I have almost no top lip with kind of hang. When I press down right below my nose the rest of my top lip pops out and it’s beautiful! I had a filler done years ago but it didn’t help.
A: I’m not sure why dermal fillers didn’t help plump up your top lip the last time you got them. They should. You need to spend time finding an expert, though, to be sure you receive the right filler, the right amount, and injected in the right places. I never recommend surgery for the lips; it rarely looks natural. A hyaluronic-acid based filler such as Belotero could give you a big improvement. Consulting with a board-certified dermatologist is the first step toward getting the lips you want.
Q: Minor mid-face volume loss from rapid weight loss: Sculptra or Fat transfer?
A: Congratulations on your weight loss! Personally, most of my patients prefer Sculptra or Voluma to replace mid-face volume rather than autologous fat. The dermal fillers look just as natural as fat, plus they stimulate the production of new collagen, which makes your skin look and act younger. Also, of course, you don’t have to undergo a separate liposuction procedure, as you do with fat transfer. Fat transfer is excellent when there is marked volume loss because then it is very cost effective when 20 – 50 ccs of volume are needed. For mild to moderate volume loss, it is more expensive and time consuming than fillers. Fat may last up to 3 years, but Sculptra can last nearly that long. However, don’t decide yet which treatment is best for you. Find a board-certified dermatologist whom you trust, who offers both options, and get an in-person evaluation, and then make the choice that works best for your needs and lifestyle.
Q: Under eye wrinkles, crepey skin mostly when I smile. 43 years old. What can I do to fix it?
A: You’re at a perfect age to begin resurfacing your skin and boosting collagen and elastin production with laser therapy, such as Fraxel. This can keep your skin healthier and younger looking/acting and will also smooth down some of those under-eye wrinkles. If necessary, you can also fill them in with a very thin hyaluronic acid fillers, such as Volbella or Restylane Silk or Belotero. But I’d start with the laser; it may give you all of the improvement you need. Consulting a board-certified dermatologist will help you decide which way to go.
Q: Does Voluma stimulate collagen?
A: Voluma XC is injected into the subcutaneous tissue directly beneath the dermis to add volume and support. Subcutaneous tissue is the last layer of the skin. While Voluma doesn’t directly affect the surface of the skin (epidermis), it does improve its look by creating a stronger support. Voluma is not a significant collagen stimulator. If you’d like to stimulate more collagen, you can use lasers and/or Sculptra. Be sure to consult a board-certified dermatologist who can offer you many different methods of getting the rejuvenation you desire.
Q: What can i do for my asymmetrical lips?
A: Creating symmetry in your lips is an easy fix in the hands of an expert. The hyaluronic acid-based dermal filler Volbella can be used to reveal more of the vermillion of your lower lip. This will make your lips match and create a more balanced look. Consulting with a board-certified dermatologist will let you know more about this very satisfying process.
Q: Is it better to add volume in stages with Volbella or add it in one stage with a thicker filler like Ultra Plus?
A: When it comes to lip fillers, less is definitely more. I always like to start slow, and add more later if desired. That’s a preferable strategy to trying to do it all at once and possibly overfilling. Because your lips are already large, you need to be extra careful not to overfill or you could look unbalanced. I’d suggest starting with Volbella. It is a nice, thin hyaluronic acid-based filler that adds subtle volume to the lips. In expert hands, you can re-contour your lips so they look younger without looking overdone. Then, if that’s not enough, you can add more later or switch to Juvederm. Don’t rush the process; find the filler and amount of volume that works for you. I do not recommend using Voluma, as that will make your lips stiffer rather than soft and natural. Consulting with a board-certified dermatologist will allow you to explore your options in more depth and come up with a plan to give you just exactly the amount of volume you need without going overboard.
Q: Are Ultherapy results permanent?
A: Ultherapy can do an excellent job of tightening the skin on the face and neck that has just begun to sag. It uses ultrasound energy to heat and shrink the collagen layer, and stimulate the skin to produce fresh new collagen. Results can last for several years. Not even a facelift is permanent, simply because we are all at the mercy of gravity and age. We can turn back the clock, but the clock keeps ticking! You will notice tighter and more youthful skin about 3 months after your Ultherapy treatment that will continue to tighten for 3 more months. Most studies indicate results will last 1 ½ to 2 years. Combining Ultherapy with fillers, neuromodulators like Botox and good skin care will extend the duration of your results as well as the beauty of the results. Please find a board-certified dermatologist who is an expert in using Ultherapy to lift the face.
Q: I have a long narrow face that's starting to become more bottom heavy and lacks dimension. What do you suggest? Fillers?
A: You do not need surgery. Your cheekbones are flat, which is why your tissues are sagging, even at your young age. Building up your cheekbones with Voluma and/or Sculptra would give you a more heart-shaped face, plus create a mini lift that would be rejuvenating. The squareness of the lower face is often due to over active masseter muscle use from teeth grinding. A neuromodulator for this area further contours the face and makes it even more lovely and heart-shaped. This combination, fillers in the cheek and Botox, Dysport or Xeomin in the masseters, is a winner! Please find a board-certified dermatologist who can show you beautiful results with creating cheekbones using Voluma and Sculptra.