Question: What filler is good for improving the area under the eyes with the tear troughs?
Answer: The only filler that I will ever use in the tear trough area that is available today is the hyaluronic acid fillers as I feel the other fillers are literally contraindicated in this area due to high risk of problems. It is even tricky with the hyaluronic acid fillers in many patients to get a very nice smooth complete correction in this area. Frequently 2 different injections sessions would be needed if the patient has a significant amount of volume loss in the tear trough area and I will therefore split them up several months apart. I personally have not had any significant problems in this area but I would recommend that anyone seeking filler injections into the tear trough find an experienced injector to perform this relatively difficult maneuver.
Question: What fillers can be used for plumping lips and how long can results expect to last?
Answer: Almost any filler could be used for plumping lips but I highly recommend that patients avoid any filler other than hyaluronic acid fillers since these have such a wonderful safety record, are very soft, and customizable and most importantly if there is some sort of a complication they can be reversed with hyaluronidase.
Question: I have been planning for a face lift this past year but just lost my job. I would like a lower-cost alternative. What types of non-surgical face lifts do you do?
Answer: Well there is a variety of different devices that can perform non-surgical facial rejuvenation but the most exciting new technology is Ultherapy which is ultrasound-based and has been FDA approved for lifting of the brows which no other non-surgical device has even been given a lift indication by the FDA. Other alternatives would be Botox and fillers which can give patients a very refreshed and rejuvenated appearance, somewhat like a face lift. These modalities are not going to be as effective as a surgical face lift but certainly are a lower cost alternative.
Question: Do any of the non-surgical face lift alternatives provide results as long-lasting as a traditional face lift?
Answer: The short answer that question would have to be no, simply because the non-surgical face lift alternatives are not going to be nearly as rejuvenating as a surgical traditional face lift. Several non-surgical modalities exist, but at Quintessa Medical Spa we were selected to be one of the phase 1 centers for Ultherapy which is an ultrasound-based device that causes facial lifting and I discuss the results with patients as being permanent due to the fact that it does change the underlying tissue but they will age out of it. Due to the fact that the Ultherapy is not going to be as rejuvenating as a surgical face lift they will age out of it sooner than a surgical approach. Ultimately, though the advantage of a non-surgical face lift is the fact that it is non-surgical and therefore has no down time or recovery. There risks of any sort of complication are also nearly eliminated.
Question: What products do you use for microdermabrasion? I would like my hands and face done but I have allergies to a variety of facial products. Can you test for allergies ahead of time?
Answer: For a microdermabrasion we do not necessarily have to use any products at all. In fact a standard microdermabrasion does not use skin care products since it is simply a mechanical exfoliation of the superficial layers of the skin. At Quintessa Medical Spa we do; however, frequently combine microdermabrasion with either a chemical peel or nutritional serums. If you do have allergies to products I would recommend you see a dermatologist so that you can determine exactly what you are allergic to and then any sort of future skin testing would be unnecessary as we could just simply read the ingredients in any of the products that are available.
Question: I often notice spas and clinics offering microdermabrasion. I would rather have a professional do it. I have a raised scar on my abdomen that I would like smoothed. Is microdermabrasion the recommended procedure for an abdominal scar?
Answer: I would not say that microdermabrasion is the recommended treatment for a raised abdominal scar and I will not even go as far as to say that microdermabrasion would be particularly affective at the treatment of a raised abdominal scar. But, it certainly has the possibility of improving the appearance of that scar. With that being said, there are certainly other modalities that can improve the scar such as fractionated laser resurfacing, whether that is an erbium laser like the Sciton ProFractional laser or a CO2 laser these can be used for treatment of surgical scars and we have seen amazing improvements in the appearance of scars on the face and body.
Question: I am an African-American with a darker skin tone. I have uneven pigmentation around my face and neck and would like to know if a chemical peels or dermabrasion procedure would work as well on me as it would for a lighter skinned person?
Answer: Unfortunately, a chemical peel or dermabrasion would be contraindicated in dark skin such as yours. You would have a very high likelihood of ending up with worse pigmentation problems than you started with. You are; however, a good candidate for skin care that can significantly improve the overall tone, texture, and coloration of your skin.
Question: Are chemical peels still used today? You do not hear much about them anymore. What are they good for treating and are other things, like injectables, better?
Answer: Chemical peels are definitely used today though I feel that the majority of the chemical peels performed are typically very superficial and in more of a day spa setting. With that said, there are a variety of chemicals that can be used for chemical peeling and these can do a wonderful job of improving rough texture as well as improving discolorations in the skin and can bring an overall glow to the skin. Many chemical peels can be performed with little-to-no down time but the more aggressive peels that are more affective frequently come with 1 to 2 days of down time or even up to 5 or 6 days of down time due to the peeling process. What technology has given us is the ability to treat many of these skin conditions without any down time or if down time is involved we tend to get improved results over chemical peels with a similar number of days of down time. The only down side of the newer technologies is that they are relatively expensive and this cost obviously needs to be passed on to the patient but we certainly feel that the additional cost is outweighed by the either lack of down time and/or improved results.
Question: I am 61 years old, male, and in very good health. I have used Botox for almost 5 years to erase the wrinkles on my forehead. It works wonderfully but I think I am ready for a more permanent solution. My hair is receding and I wonder if the endoscopic brow lift will leave a noticeable scar because of the hair loss in this area.
Answer: I would have to personally examine you to determine the best course of action but in past years I would have said that the scar from the endoscopic brow lift is not an acceptable alternative though more recently I feel that this may actually be untrue due to the fact that these scars heal exceptionally well and even patients with receding hair or even baldness I do discuss the option of performing an endoscopic brow lift due to the fact that this surgery is performed through such small incisions and they heal incredibly well. I do alter my incisions for patients with receding hair in that I perform a horizontal incision as opposed to a vertical one so that it tends to line up with natural skin creases. Otherwise, the surgical procedure is identical to one that is performed on patients with a normal hair line. Ultimately, you need to consider the risks and benefits of continued Botox use versus endoscopic brow lift to determine what would be best for your personal circumstance.
Question: What are the potential complications associated with Botox and how common are they?
Answer: There are several minor complications associated with Botox, the most common of which would be associated with the actual injection which would involve redness in the area of the injection or bruising. Both obviously go away rather quickly. A more serious complication would be that the Botox inadvertently relaxes a muscle that it was not intended to causing a side effect such as a droopy eyelid or an eyebrow that won’t raise. This unfortunately cannot be reversed but fortunately the side effect typically wears off relatively quickly within about 6 weeks. Ultimately, Botox is exceptionally safe and in experienced hands is extremely consistent with incredibly low risks of complications.