Question: Can Restylane contour the face for more of an oval shape?
Answer: Restylane can definitely contour the face to create any sort of shape that is desired, but if you really have an issue with significant volume need, you may want to consider either facial implants or fat grafting since it would become quite expensive to use multiple syringes of Restylane to overall change the shape of one’s face. Most of the time we are using syringes of Restylane to improve upon slight depressions and folds and we can use anywhere from one to six syringes of Restylane to improve upon these areas and in effect change the contour of the face, but remember that 1 teaspoon is 5 cc, so this is just a little over 5 cc of product, whereas when we do fat grafting we may use anywhere from 10 up to 60 cc of fat doing full face rejuvenation. That is 10 times more volume of which a third to a half of this volume will be retained long term. So, as you can see Restylane is going to have a limited effectiveness to truly change one’s facial shape, but it is an excellent option for those that just need a little bit of tweaking in areas that are concerning.
Question: I’m African American and wondering if there are any special considerations when it comes to injectable fillers for ethnic patients.
Answer: There really is not any special considerations regarding injectable fillers for African-Americans versus other ethnicities since all we are doing with injectable fillers is improving the contour of facial folds and wrinkles and whether it is light skin or dark skin the contour is still the same and we would treat ethnic patients identical to lighter skinned patients.
Question: I’ve had different injectable fillers over the past few years and I’m wondering if fat transfer can be used as an alternative and if the results will last longer.
Answer: It really depends on where the injectable filler has been placed over the past few years as to whether or not I would recommend fat transfer as an alternative for longer lasting results. If you are getting injectable fillers in the cheeks then fat transfer can be an excellent option since portions of the fat will be permanent; however, if you are getting fillers in the lips, I recommend to most patients that they consider continuing the filler since it is highly customizable, extremely safe, and very unlikely to give you any sort of side effects, whereas fat transfer in the lips does have risks of creating lumpiness and irregularities and frequently will require more than one treatment. Ultimately, I think you need to sit down and have a consultation so that the risks and benefits of the fat transfer and the expectations from this can be discussed.
Question : Can laser hair removal be used for thick body hair? I am male, 41 years old, and have a very hairy upper back. Would I need to shave my back prior to treatments?
Answer : Yes, laser hair removal is very successful at treating thick body hair including hair in the upper back. We do need to shave or clip the hair down to the level of the skin prior to the treatment, but after the treatment the hair shaft itself typically falls out and we then re-treat six to eight weeks later as new hair is growing in. A total of six to eight treatment sessions are necessary for adequate hair reduction.
Question : I would like my pubic hair removed using laser hair removal. I read online that 4-6 treatments are necessary. Is this correct? How long is each session? Do the treatments cause any tenderness in the area?
Answer : Pubic hair can certainly be treated with laser hair removal, but typically we are looking at a good six to eight treatments to give adequate reduction where patients are satisfied with their results and even then most patients are going to need touch ups every six months to a year. Depending on the surface area, the treatment sessions can be as little as 15 minutes and you will have some tenderness in the area for a day or two.
Question : I had Juvederm injections under my eyes, but I did not like the results because my eyes now look uneven. Would fat injections under my eye solve this problem?
Answer : I would have to evaluate your particular anatomy and problem area to determine whether or not fat grafting would be appropriate but, in essence, you are just trading one filler for another since both Juvederm and fat would be considered volumetric enhancements of the face. So, in other words, if fat grafting would be useful to improve your uneven look then more Juvederm would also be good at creating the same effect.
Question : Will I experience more wrinkle reduction from a true facelift or from Botox injections?
Answer : It really depends on what area of the face you are describing as to whether or not a facelift will be better than Botox for wrinkle reduction. When I personally think of a facelift, I really think of a treatment that is improving upon laxity of the face, such as areas of jowling and laxity under the chin. In the case of Botox, I am treating hyperdynamic muscles, or muscles that are overly active, creating deep wrinkles. So, in essence, these two treatments can actually complement one another since one can be used for the treatment of facial laxity while the other is used for hyperdynamic muscles.
Question : I have some broken capillaries at the tops of my cheeks. Can these by treated with the laser and is this safe given how close it is to my eyes?
Answer : Yes, broken capillaries on the upper cheeks can easily be treated with a laser and, in fact, quite successfully. There should be no danger to the eyes since we protect these with goggles during the procedure.
Question : Does ultherapy remove fat or just tighten the skin? Are the results permanent?
Answer : In reality, Ultherapy neither removes fat nor tightens the skin but, in fact, targets the deeper layer of the face in the area of the SMAS where there is a significant amount of collagen. The ultrasound waves heat the collagen to the point where they denature and this creates a healing response where new collagen is deposited, which in turn then tightens. When we treat an entire face with the Ultherapy device, we will do upwards of 8000 small thermal injury zones where new collagen is going to be deposited and each zone will create a small amount of tightening. When these are all added together, we get brow lifting and cheek lifting and improvement in jowls and laxity under the chin. In my opinion, the results are similar to other devices such as laser resurfacing or even surgical results in that the tissue heals and now we start the aging process from a new reference point so, in effect, the patient that undergoes an Ultherapy treatment will always look better than if they had never undergone a treatment, but they will eventually age out of the improvement that was obtained.