Weekly Palm Beach Post Column
Weekly Sunday column in Palm Beach Post
Ask A Plastic Surgeon Feature
What Can I Do For A Facial Rejuvenation Regimen During The Current Crisis?
Posted: Mar 24, 2020 at 12:01 AM
Question: I am in my 60′s and it’s hard enough being stuck at home, but watching my face age makes me feel even worse. I walk a lot and exercise, but that doesn’t help facial aging. I can give up shopping, restaurants and even entertainment for a while, but maintaining a refreshed and youthful face is still a priority, even during an epidemic and changing stock market. Do you have any suggestions?
Answer: You can make valuable use of this time by being proactive about a facial rejuvenation plan. I am doing remote one-on-one consultations for new and established patients who are unable to see me in person due to social distancing protocols. These remote consultations can guide you with a facial rejuvenation plan…
Should I See My Plastic Surgeon to Maintain My Treatments During A Crisis?
Posted: Mar 24, 2020 at 12:01 AM
Question: I have an upcoming appointment for my maintenance treatments. Being stuck at home, it’s even more important that I take care of myself. I don’t want to let my face go as that will only get more depressing with this current health crisis. Is there a way to keep my appointment without having to worry about contracting the virus from other patients or staff at your office?
Answer: The safety of my patients is and always has been of utmost importance. Even prior to the epidemic, my practice has been by appointment only. Unlike some cosmetic practices with high volume “cookie cutter” treatments at the cheapest prices, my practice is based on spending time with patients to tailor treatments to their individual needs. It is more one-on-one without the high traffic waiting room you may see elsewhere….
Credentials Vs. Cost
Posted: Mar 15, 2020 at 12:01 AM
Question: I need several minimal invasive facial rejuvenation treatments. Plastic surgeons seem to have higher fees for Botox, fillers and lasers than other doctors. I’m not having surgery that requires the skills of a plastic surgeon. Wouldn’t it be okay to have minimal invasive treatments from a regular doctor who offers cheaper prices?
Answer: Choosing between credentials and cost is up to each individual patient. It really comes down to how much value you place on your face. With so many overblown lips and “golf ball” cheeks walking around, injector skill, which is closely tied to credentials, is a key consideration for many…
Facial Rejuvenation For Your Class Reunion
Posted: Mar 8, 2020 at 12:01 AM
Question: My 40th high school reunion is in 6 months. I don’t want aggressive surgery with downtime, but have deep smile grooves, puppet lines at my mouth corners and hollow cheeks. I also have wrinkles in my forehead and around the eyes with some sagging in the upper neck and jowls. What procedures can rejuvenate my face in time for my class reunion?
Answer: Six months is typically more than enough time to undergo some minimal invasive procedures that adequately rejuvenate the face.
For deep smile lines, or nasolabial folds, and puppet lines also known as marionette lines, injectable fillers are a common treatment of choice. Cheek hollows are also treatable with fillers…
Infini RF Non-Surgical Facelift After Weight Loss
Posted: Mar 1, 2020 at 12:01 AM
Question: I was advised that the sagging in my face and neck will worsen after losing weight. A plastic surgeon said if I’m losing weight, I should reach my ideal weight before having a facelift. I read about the Infini RF non-surgical facelift which lifts and tightens sagging skin. If I have Infini instead of surgery, do I also need to hold off until I reach my weight loss goal? Does your skin need some time to settle after you lose weight for a better treatment result?
Answer: If you are more than 45 years old and overweight, you may sag more in your face and neck after losing significant amounts of weight. The reason is that elastin fibers diminish with age so the skin doesn’t have the ability to “snap back” in the same way as it does at a younger age…
How Does Bellafill Work To Last 5 Years?
Posted: Feb 16, 2020 at 12:01 AM
Question: I am 56 and tired of getting fillers every 9 months. I recently had Bellafill in my nasolabial smile lines and droopy mouth corners and am so excited that it lasts 5 years. My sister who is 69 also had Bellafill and told me that her Bellafill looked even better after 9 months than it did when she first got it. Is it true that Bellafill can get better over time or does my sister just have a wild imagination?
Answer: After performing thousands of syringes of Bellafill over the last 7 years, half of my patients returning 9-12 months later notice that their Bellafill looks even better than after the initial treatment. This phenomenon was also discovered in the FDA trial on Bellafill which followed patients over a 5-year period…
How Does Bellafill Work To Last 5 Years?
Posted: Feb 9, 2020 at 12:01 AM
Question: I’ve been getting Juvéderm and Restylane injections for 7 years. I’m tired of getting repeat treatments every 9 to 12 months and would like a longer lasting filler. What is it in Bellafill that makes it last 5 years compared to the 1 and 2 year fillers?
Answer: You are correct in that Bellafill is known to last 5 years, whereas temporary fillers like Juvederm and Restylane typically last 1 year or less. The difference between Bellafill and these short-term fillers lies in it’s special patented technology…
Facelift Vs. Incision-Less Whisper Lift™
Posted: FEb 2, 2020 at 12:01 AM
Question: You recently wrote about the Incision-Less Whisper Lift™. How does one know if they are a candidate for your Whisper Lift compared to a facelift?
Answer: The Incision-Less Whisper Lift™ can be performed in patients in their 50′s and 60′s with mild to moderate lower face and neck skin. It is also performed on older patients who have previously had facelift surgery and are looking for less invasive touch-up surgery for mild to moderate aging in the lower jowls and neck…
Does Bellafill Really Last 5 Years?
Posted: Jan 26, 2020 at 12:01 AM
Question: I’m in my mid 50′s and have been getting Juvederm for my nasolabial smile lines for years. I’m happy with it, but now my cheeks are starting to hollow. My doctor says I need 3 times more filler in my cheeks which are a larger area than the smiles lines. A one year filler like Juvederm will be too costly maintenance. I know Bellafill is more expensive than Juvederm, but if it’s that long lasting, it would be worth paying more. Does Bellafill really last 5 years?
Answer: The claims of temporary fillers like Radiesse, Restylane and Juvederm lasting one year are not quite accurate. Nearly half of a temporary fillers can be gone in 6-8 months. In contrast, FDA clinical trials showed that with Bellafill, the 5-year filler, over 80 percent of patients were still satisfied with results, even 5 years after initial Bellafill treatment…
Incision-Less Whisper Lift™
Posted: Jan 19, 2020 at 12:01 AM
Question: I’m 61 and have some jowls, but my sagging neck and the vertical neck bands bother me the most. Is there a way to treat my neck without a full-blown facelift?
Answer: With advances in technology, mild to moderately loose neck skin in combination with platysmal neck bands can be treated with an innovative yet minimal-invasive surgical technology that does not require the standard facelift or mini-facelift incisions. Jowls that drop into the upper neck can also be treated effectively with this technique…
Facelift Vs. Mini-Lift?
Posted: Jan 12, 2020 at 12:01 AM
Question: The sagging of my jowls and upper neck really makes me look aged. How do I know if I need a facelift or if I can get away with a mini-lift?
Answer: In theory, a mini-lift sounds good since it’s less invasive, a quicker recovery and has fewer risks. However, you must be a good candidate to be happy with the results. The optimal way to find out if you need a facelift or a mini facelift is through a detailed consultation with a board certified Facial Plastic Surgeon…
Treatment of Droopy Eyes
Posted: Jan 5, 2020 at 12:01 AM
Question: I’m approaching 60 and my eyes look droopy. People say I look tired or sad. I don’t mind looking my age but want to look rested and refreshed. What are my treatment options?
Answer: Several causes of aging can make the eyes “droopy looking.”
● Loose skin of the upper or lower eyelids….
Dose, Anatomy Or Technique?
Posted: Dec 29, 2020 at 12:01 AM
Question: I’ve had Botox for years from my plastic surgeon. I saw another doctor for a better price. She treated me with a different Botox which lasted only 6 weeks. I then learned the doctor was actually an internist. I assumed she was a plastic surgeon because she advertises Botox, fillers and laser. The Botox I had before always lasted 3 months. Was my poorer result due to the Dysport used or because she wasn’t a plastic surgeon?
Answer: Many factors must be considered in choosing a Botox doctor. First, there are four FDA approved neurotoxins on the market with studies showing nearly identical results. These neurotoxins include Botox cosmetic, Dysport, Xeomin and Jeuveau. In my 22 years in practice, many patients seeing me for the first time believe that one neurotoxin works better than the other…..
Is a Facelift More Effective Than Short-Term Minimally Invasive Procedures?
Posted: Dec 22, 2020 at 12:01 AM
Question: I am 68 with sagging in my neck and lower face, wrinkles around my mouth, deep smiles lines and droopy mouth corners. Some doctors recommend fillers and skin tightening but others advise surgery. Wouldn’t it be better to just do it all at once with a facelift so I don’t have to keep maintaining with minimally invasive treatments?
Answer: It is a faulty public perception that facelift surgery can adequately replace the need for injectables such as Botox and fillers or even lasers. A facelift can lift sagging in the jowl and neck area but it will not halt the aging process. Aging is an ongoing phenomenon and resumes the minute a facelift is over. You must maintain even after a facelift…..
Avoiding Filler Complications
Posted: Dec 15, 2020 at 12:01 AM
Question: I am 63 and would like to have some injectable filler to rejuvenate my face. But I read on the internet about blindness as a complication. Is it really worth having filler if there is a risk of blindness?
Answer: Blindness is a very rare complication not only from injectable filler treatments but also from eyelid rejuvenation surgery. When proper injection technique is used by a skilled and experienced plastic surgeon who understands the anatomy of the facial blood vessels, this risk is extremely low…..
Puffy Vs. Well-defined
Posted: Dec 8, 2020 at 12:01 AM
Question: I have sunken cheeks and hollowing under my eyes. I’ve had a few consults and was told that I could benefit from filler. However, I see many overdone and puffy cheeks. How can I restore volume to my cheeks and lower lid hollows but still look natural?
Answer: You are correct in that injectable fillers are typically the treatment of choice for hollowing of the cheeks and under eyes. There are many fillers to choose from including temporary options such as Restylane, Juvederm and Sculptra which require frequent maintenance as well as Bellafill, the 5-year filler, which does not require as high maintenance due to its longer duration…..
Jawline Contouring With Injectable Fillers
Posted: Dec 1, 2020 at 12:01 AM
Question: I am 65 and losing jaw definition from sagging jowls. One doctor suggested filler along my jaw, but she is an internist. Another recommended the same, but is a gynecologist. I’ve never heard of using filler for the jawline. I also prefer a plastic surgeon as too many doctors without qualifications are setting up shop. Can filler really tighten my jawline?
Answer: You are wise to recognize the value of seeking a qualified doctor for facial rejuvenation. It is a faulty public perception to think you only need a plastic surgeon for surgery, but can go to anyone for filler or non-surgical treatments. The use of injectable fillers along the jawline has been around for a long time, but few patients seem happy with the results, unless you are 35 years or younger…..
The Fine Line Between Natural And ‘Done’
Posted: Nov 24, 2019 at 12:01 AM
Question: I’m approaching my 60th birthday and want to treat myself with some facial rejuvenation procedures. I see so many strange results on people’s faces from cosmetic procedures. How do I find the right person who can make me look refreshed and more youthful but still natural?
Answer: Various techniques are available to give natural results. The key lies in finding a skilled facial plastic surgeon who listens and understands your aesthetic goals and tailors treatment to your unique facial structure rather than using a “cookie cutter” approach…..
Does Kybella Really Work for Fat Removal?
Posted: Nov 17, 2019 at 12:01 AM
Question: I have a double chin. I’ve heard about Kybella but don’t know anyone who has had it done. Is Kybella permanent fat removal and does it really work?
Answer: Kybella is indicated for double chin or submental fat under the chin. Kybella works by permanently causing a chemical reaction that destroys fat cells. Yes, the results of Kybella are permanent…..
Posted: Nov 10, 2019 at 12:01 AM
Question: I am 56 and starting to get a turkey neck. I’m not ready for a facelift. What are my less invasive options?
Answer: If you are not severe enough to need surgery, there are several effective non-surgical treatments for rejuvenating your neck……
Latest Non-surgical Facelift Options
Posted: Nov 3, 2019 at 12:01 AM
Question: I’m 67 and don’t want a facelift as I can’t afford downtime. What are my non-surgical options for sagging in my lower face and neck?
Answer: Face and neck sagging is most commonly due to loss of skin elasticity and facial volume. Most patients experience both. A qualified plastic surgeon can recognize where a patient has volume loss vs. loss of skin elasticity. Failure to address both can give a poor result…..
How Much Bellafill Has Your Injector Really Done?
Posted: Oct 20, 2019 at 12:01 AM
Question: I’m 63 and have been getting Restylane and Juvederm for several years. I’m interested in Bellafill because it lasts a long time. I saw a doctor who does fillers even though she’s not a plastic surgeon. She just finished her Bellafill training so hasn’t done much Bellafill but claims she has a lot of experience with injecting other fillers and that there’s no difference with Bellafill injections. Is it okay to let this internist do my Bellafill even though she hasn’t done much?
Answer:This is a common question and an equally common misperception about facelifts. A facelift is not a substitute for fillers, laser and botox. Even with a facelift, your other concerns can only likely be corrected non-surgically…..
Should I Have A Facelift Or Fillers?
Posted: Oct 13, 2019 at 12:01 AM
Question: Botox for my wrinkles, filler for my sunken cheeks and laser for my aged skin texture were recommended to me. I didn’t want a facelift but with so many different non-surgical procedures, wouldn’t I be better off with facelift with everything done at once?
Answer:This is a common question and an equally common misperception about facelifts. A facelift is not a substitute for fillers, laser and botox. Even with a facelift, your other concerns can only likely be corrected non-surgically……
Why Filler Didn’t Work For My Droopy Mouth Corners and “Puppet Lines”
Posted: Oct 6, 2019 at 12:01 AM
Question: I had Juvederm several months for my sagging mouth corners and puppet lines. I’m not happy with the results because the improvement seems very minimal. My dermatologist suggested additional filler but if it didn’t work the first time, I can’t justify spending more money? What are my other options?
Answer:With downturned mouth corners and marionette lines extending from the mouth corner to the jaw line, each patient’s face is different and requires an individualized approach……
Why My Face Looks Angry
Posted: 01:38pm Sunday, Sep 29th, 2019
Question: II am 62 and a happy person with a fulfilling life. In the last 5-7 years, people often ask if I’m angry or upset about something. When I look the mirror, I do seem to look sad and angry, but that is not how I feel inside. I think it’s due to the aging on my face. What can be done to make my face look pleasant again?
Answer:Facial aging can certainly change the way people perceive you. Patients seeking consultation in my office often complain that they look angry or sad when, in fact, they are not ……
Why My Filler Didn’t Work?
Posted: 12:01am Sunday, Sep 22nd, 2019
Question: I’m 62 and had two syringes of Juvederm six years ago in my smile lines and marionette grooves and was happy with the results. Even though the filler only lasted a year, I didn’t get around to having it redone until a few months ago by the same dermatologist. This time, however, the same amount of Juvederm did not make much difference. Why would this happen?
Answer:While each patient is different, there could be several reasons why your Juvederm did not work. You mentioned that you hadn’t had any filler injections in quite a few years. In those seven years, you likely aged more and your smile lines and marionettes lines may have gotten deeper. As a result, you may have needed to use a different filler that is placed deeper in the tissues in order to get the desired results. ……
Why Only A Plastic Surgeon For Your Bellafill Treatment?
Posted: 12:01am Sunday, Sep 15th, 2019
Question: My internist does fillers and has a medspa for Botox and lasers. I’ve researched Bellafill, the 5-year filler, for my deep smiles lines and hollow cheeks and think it’s a good option for me. Does it matter if I go to the spa or to a plastic surgeon for my Bellafill?
Answer:Unlike the temporary fillers on the market, Bellafill is a specialty filler. Because Bellafill lasts 5 years, it is crucial to seek a highly skilled injector who has performed thousands of Bellafill treatments. Even though Bellafill is a non-surgical, minimal- invasive treatment, if something goes wrong or you don’t like the results, you can be stuck with it for 5 years…….
How Many Times Can You Have An Eyelid Lift?
Posted: 12:01am Sunday, Sep 01st, 2019
Question: I had an upper eyelid lift 6 years ago, but still had loose skin afterwards. After revision surgery to correct this, there was still extra skin. A different surgeon advised a brow lift, stating that my sagging brows made my eyelids look heavy. A 3rd plastic surgeon said that the lid heaviness was due to extra skin left on the outer part of my upper lid that was not properly removed. I think he nailed it! I’ve had my lids done twice. Is there an upper limit to how many times one can have eyelid surgery?
Answer:The key lies in your surgeon’s ability to identify the correct cause of upper eyelid heaviness. These causes include excess loose skin of the upper eyelids, poor elasticity of the upper eyelid skin and/or a sagging brow that gives the illusion of upper eyelid heaviness. Identifying the correct cause impacts choice of treatment…….
Minimal Invasive Treatments To Stay Competitive In the Work Environment
Posted: 12:01am Sunday, Aug 25th, 2019
Question: I am in my early 70?s and still work full-time. I enjoy my job but am competing with a generation that is younger. I don’t want to change my appearance but would like my face to look more youthful and refreshed, while still being natural. I’m only interested in minimal invasive procedures since I can’t afford the longer recovery of a facelift. What treatments can I have on a Thursday or Friday and go back to work on the Monday after?
Answer:You have quite a few options depending on what you are a candidate for. In the past, many minimal invasive treatments came with results that were either very short-lived or ineffective. With today’s advanced technologies, one can find effective and longer lasting minimal invasive treatments. While many procedures still exist that don’t work so well, finding a qualified, well-trained plastic surgeon who you trust can be the key to learning the facts about how effective a given minimal-invasive treatment is…….
Posted: 12:01am Sunday, Aug 18, 2019
Question: I am going to have my 70th birthday later this year. I decided to have some facial rejuvenation treatments but prefer not to have surgery due to the risks and need for anesthesia. I’m a happy person but people often say I look angry or upset. My sagging eyebrows make me look that way. What are the treatment options without surgery?
Answer:Sagging brows can have multiple causes. The correct treatment depends on the cause and location of sagging. One must also differentiate between heavy brows and heavy upper eyelids since, again, the choice of treatment varies……
The Difference between a Plastic Surgeon & Cosmetic Surgeon
Posted: 12:01am Sunday, Aug 11, 2019
Question: Some doctors say they are cosmetic surgeons but others are plastic surgeons. I’m interested in minimal invasive facial rejuvenation. It’s important to me to go to someone who is qualified to work on my face. Which type of surgeon is better?
Answer:A recent survey from The Harris Poll confirmed that 59% of U.S. women don’t know the difference between a cosmetic surgeon and a plastic surgeon. 84 percent of these women are also unaware that a medical professional does not have to be board certified in plastic surgery to perform……
Dangers of Having Bellafill By A Non-Specialist
Posted: 12:01am Sunday, Aug 4, 2019
Question: I’m 71 and interested in Bellafill. I saw a doctor in town who recently started advertising Bellafill. Even though she is new to using Bellafill, she has been injecting other fillers for a while. Is there any reason I shouldn’t let her do Bellafill treatments in my sunken cheeks and droopy mouth corners?
Answer:Who you chose as your Bellafill injector is ultimately your decision. As a BellaDiamond injector, I’ve performed as many as 500 to 600 syringes a year for more than 6 years. If you feel that a new Bellafill injector just starting out with Bellafill can offer you the same level of experience and expertise as a BellaDiamond injector……
Do You Look Unnatural After Filler Treatments?
Posted: 12:01am Sunday, July 28, 2019
Question: I had Juvederm for my deep nasolabial smile lines several months ago. Ever since my treatment which was performed by my internist at a spa, I look overfilled in my smile lines and my cheeks seem more hollow. I went in expecting to look better but I look worse and unnatural. What went wrong?
Answer:What you have experienced is not an uncommon complaint after filler treatments. There are several reasons why this may have happened…..
Do You Suffer From Filler Fatigue?
Posted: 6:54pm Sunday, July 21, 2019
Question: I have been getting fillers in my smile lines, mouth corners and hollow cheeks for years. I am approaching my 70th birthday and seem to need more and more filler, as the years go by, to treat the same areas. It had gotten so costly to get filler injections every 9 to 12 months, not to mention that it’s painful to keep having these treatments so frequently. Is there a better injectable filler option? I don’t mind paying more for a longer- lasting filler.
Answer:What you are describing is referred to as “filler fatigue”. Most patients who have temporary fillers every year don’t continue with regular treatments for as long as….
Less Invasive Techniques for Jowl and Neck Contouring
Posted: 12:01am Sunday, July 14, 2019
Question: I’m approaching my 70th birthday. I was aging well until the past year when I noticed increased sagging in my lower face (jowls) and neck. I don’t want a facelift which is too aggressive and risky at my age. I prefer minimal invasive rejuvenation procedures. With the endless advertisements, how can a lay person know which minimal invasive techniques are effective?
Answer:Rejuvenation contouring techniques of the lower face and neck are among the most popular requests by patients visiting my office…
Is SculpSure For Permanent Fat Removal?
Posted: 10:01pm Sunday, July 07, 2019
Question: I am in my 60’s, slim and mostly fit but I have some isolated fat pockets on my stomach and the sides of my waist. No matter how well I eat and how much I work out, I can’t seem to get rid of them. Liposuction is too invasive. I’ve read about SculpSure, but does it really work or do you have to keep maintaining with repeat treatments?
Answer:SculpSure is permanent fat reduction. The popular areas treated are the abdomen and flanks. But other areas including the thighs, arms, chest and upper back can also be addressed effectively…
How To Save Money On Injectable Fillers
Posted: 10:19pm Sunday, June 30, 2019
Question: I am in my early 70?s and need filler in my cheeks, temples, nasolabial folds, mouth corners and lower lid hollows. I’ve researched the different fillers.
Answer:Most of the facial areas that you describe typically require a volumization filler. Common volume restoration fillers on the market include Juvéderm Voluma, Restylane Lyft, Sculptra and Bellafill…
Kybella – Infini RF Combo For the Neck
Posted: 10:19pm Sunday, June 23, 2019
Question: I have fat under my chin and some sagging neck skin. I don’t want a facelift. Are there any effective non-surgical treatments for my aging neck?
Answer: If you have fatty tissue in your neck or a double chin, you may be a candidate for liposuction or Kybella. While both procedures permanently treat submental fat, liposuction is still surgery and has a recovery period as well as greater risks.
Micro-Cannulas for Filler Injections
Posted: 12:01 a.m. Sunday, June 16, 2019
Question: I’ve heard of a few doctors using cannulas for injection of fillers instead of needles. What are the benefits of cannulas and do they hurt more than needles?
Answer: The injection device used for certain injectable fillers is actually a micro-cannula, meaning these cannulas are very thin. There are many benefits of micro- cannulas for filler treatments.
Best Minimal Invasive Facial Rejuvenation Options
Posted: 12:01 a.m. Sunday, June 9, 2019
Question: I’m in my 70?s and look tired and run down. I don’t want a facelift, but am interested in minimal invasive procedures to rejuvenate my face and treat the fat around my stomach. With so many minimal invasive treatments, how does one know which are any good?
Answer: Minimal Invasive treatments have become one of the mainstays of facial rejuvenation. The truth is that most patients prefer to avoid a facelift and aggressive surgery if possible. Twenty years ago, facelifts were the primary option. With today’s advanced technologies, effective non-surgical and minimal-invasive options that give effective results do exist.
Non-Surgical Facelift Vs. Surgery
Posted: 12:30 p.m. Sunday, June 2, 2019
Question: I’m in my 60?s and have some sagging in my neck and my jowls. I don’t want a facelift. Infini RF skin tightening sounds great but will it give me the same results as a facelift?
Answer: As with any cosmetic procedure, it’s important to have realistic expectations. Studies show that a realistic patient is much more likely to be satisfied with their results. With that being said, Infini RF is not equivalent to a facelift.
How To Save Money On Minimal Invasive Cosmetic Treatments
Posted: 12:01 a.m. Sunday, May 26, 2019
Question: I’ve been getting facial fillers for years, but the maintenance every 6 to 12 months is costly. I let as much time pass between treatments as possible to save money but, as the years go by, I’m aging faster and need more filler. Do you have any recommendations on how I can save money on my maintenance treatments?
Answer: There are cost- effective approaches to facial rejuvenation treatments. Waiting until your Botox or filler is completely gone, however, is not the best way to save money. The following guidelines can help you get the most out of your filler, Botox and laser treatments.
How To Find A Good Injector For Your Fillers
Posted: 8:24 p.m. Sunday, May 19, 2019
Question: I need fillers for my face. I don’t mind getting Botox from my anesthesiologist, but fillers are more complicated. With dermatologists, internists, plastic surgeons and spas advertising fillers, how does one know who to go to? Some doctors don’t even do their own fillers but have a physician assistant or nurse. How does a lay person like me make the right choice?
Answer: With so many medical specialties getting on the bandwagon to do fillers, it can be confusing and overwhelming to choose the right injector. These simple rules can improve your chances of finding the right injector.
Should A Gynecologist Do Fillers?
Posted: 12:01 a.m. Sunday, May 12, 2019
Question: My gynecologist offers Botox, laser and fillers. Her prices are better than other doctors. She’s not a plastic surgeon, but it’s not like she’s doing facelifts. Why would I get filler treatments from a plastic surgeon when it’s so convenient to go to my gynecologist?
Answer: Needless to say, important differences exist between gynecologists and plastic surgeons. A Facial Plastic Surgeon’s education and training, from the outset, is focused on the face. If you don’t mind having filler treatments from a doctor whose scope of training and education has been focused to a very different area of the body, that is your choice.
Drawbacks of Price-Shopping For Fillers?
Posted: 12:01 a.m. Sunday, May 5, 2019
Question: I was getting fillers from my plastic surgeon in Kentucky. Now that I’ve moved to Florida, there are so many doctors offering fillers at variable prices that it’s overwhelming. Since they are just fillers and don’t require the same expertise as a surgical facelift, doesn’t it make sense to see the doctor with better prices?
Answer: Believing that injectable filler treatments require less skill than facelift surgery is a faulty assumption. While basic line fillers for wrinkles may require a bit less skill than volumization, volume fillers are a mainstay and requiring greater understanding of the complex facial anatomy and deeper structures.
Why Choose A BellaDiamond Injector?
Posted: 12:01 a.m. Sunday, April 28, 2019
Question: I’m 58 and have deepening smile lines, “puppet” lines at the mouth corners and some hollowing of my cheeks. I love the idea of having a 5-year filler like Bellafill. I see that several doctors do Bellafill but with a variation in price. Dr. Mandal, according to Bellafill’s website, you are the only person listed in Palm Beach County as a BellaDiamond. Why is it better to have Bellafill treatments from a BellaDiamond injector when I could get it a little cheaper from some of the other doctors offering Bellafill.
Answer: When it comes to your face, if price point is the key factor, and one is less concerned about product safety or a good result that looks natural, such patients tend to go with the best price over the best result and a BellaDiamond injector may not be for them.
What Does Adequate Correction With Bellafill Really Mean?
Posted: 12:01 a.m. Sunday, April 21, 2019
Question: I am interested in Bellafill for the volume loss in my cheeks, temples and under the eyes but am just afraid to look unnatural. How do I know if the amount recommended will be enough, too little or too much?
Answer: One of my main guidelines for determining how much Bellafill to recommend is based on the adequate correction threshold. I define adequate correction as the amount estimated to create a worthwhile result that the patient is happy with.
How To Avoid ‘Monkey Lips’
Posted: 12:01 a.m. Sunday, April 14, 2019
I have thin lips, lipstick bleed and lip wrinkles. I know I need filler but have seen so many overdone lips. Some people even have a “monkey look” to their lower face. How can I assure that I will look natural from filler treatment to my lips?Answer:
Rejuvenation treatments of the lip area can be quite complex, making it especially important to seek a specialist if you want a natural looking result. Placing injections in and around the lips is mostly a technical exercise that can be learned by non-physicians as well as non- plastic surgeons. The key to a natural result lies in combining technical expertise with a thorough understanding of aging lip anatomy and a strong artistic eye.
How Many Different Fillers Are Needed?
Posted: 12:01 a.m. Friday, April 7, 2019
Question: I had a facelift in my early 60?s that I was quite happy with. Now, it’s been 10 years and I seem to be hollowing in my cheeks with prominent smile lines and droopy mouth corners. The hollows under my eyes also make me look tired, and my temples are sunken-in. I know I need fillers, but how many different fillers do I need to treat all of these areas?
Answer: It all comes down to whether you want a temporary filler or a long-term filler. The various temporary filler options include Voluma, Juvederm, Restylane, Radiesse and Sculptra. Long-term fillers include Bellafill – the 5-year filler, fat grafts and stem cell fillers.
How Long Do Temporary Fillers Really Last?
Posted: 3:56 p.m. Friday, March 29, 2019
Question: I really want Bellafill, the 5-year filler, but I understand that with the kind of fine lips lines I have, I have to go with a temporary filler. I’m familiar with Juvéderm and Restylane which are the options recommended to me. How long will these fillers really last in the lip wrinkles around my mouth?
Answer: Temporary fillers can typically last anywhere from a few months to up to 2 years, depending on the choice of filler. It’s important to note that terminology like “up to” means that a filler could last one year or less, depending on the patient, as there is no way to guarantee or predict how a particular filler will behave in a particular patient’s tissues.
Different Types Of Necklifts
Posted: 12:01 a.m. Sunday, March 24, 2019
I have sagging in my neck and it’s getting worse with age. I’ve been reading your articles for many years. You’ve written about several different options for loose neck skin. How does one know which is the right neck procedure for them?Answer:
Each patient is different and what procedure they need will also vary from one person to another. There are several different ways to address a sagging neck, depending on the type of aging you are experiencing.
Does Bellafill Work on Cheek Wrinkles?
Posted: 12:01 a.m. Sunday, March 17, 2019
Question: I have always been overweight and finally lost 50 pounds over the past year. While I’m happy with being thinner, my face has lost a lot of volume. The aging over my cheeks seems especially pronounced because I also have wrinkles over my cheeks since the weight loss. Will Bellafill help my cheek wrinkles?
Answer: Fillers, in general, can improve certain types of cheek wrinkles, but it depends on the patient’s unique problem. This is true not only for Bellafill as well as temporary fillers, with the main difference being that Bellafill lasts 5 years compared to the one year temporary fillers.
Why Two Syringes of Bellafill May Not Do It
Posted: 12:01 a.m. Sunday, March 10, 2019
I have hollowing in my cheeks and am 68. I saw a dermatologist who recommended Bellafill because it lasts five years. He did two syringes of Bellafill on me. It looked good at first but it’s been two months and I don’t see any difference. Did the Bellafill not take on me?Answer:
I have hollowing in my cheeks and am 68. I saw a dermatologist who recommended Bellafill because it lasts five years. He did two syringes of Bellafill on me. It looked good at first but it’s been two months and I don’t see any difference. Did the Bellafill not take on me?
Direct Neck Lift Incisions
Posted: 12:01 a.m. Sunday, March 3, 2019
Question: I read your article last Sunday about the direct neck lift. It seems like a good alternative for the right person. Unlike a facelift, the incisions in this procedure are in the front of the neck. Is this a newer procedure and how visible is the scar once it is healed?
Answer: The direct neck lift procedure has been around for decades. It wasn’t as popular in the last 20 years because the cosmetic industry has been trending towards minimal-invasive procedures with no scars at all. However, the pendulum has swung more towards the center as plastic surgeons strive to achieve a balance between non-surgical and surgical procedures in order to give patients the most optimal results.
Direct Neck-Lift Procedure Avoids A Facelift
Posted: 12:01 a.m. Sunday, February 24, 2019
Question: I have a “turkey gobble” neck. My face looks fine but my neck really makes me look aged. I don’t want a facelift as it’s too aggressive. I also don’t want the extensive recovery, anesthesia and risk associated with it. Is there any other option that is not as invasive as a facelift?
Answer: If you prefer not to have a facelift, there are several options. You may be a candidate for the Infini RF which non- surgically lifts and tightens sagging skin of both the face and neck. Infini RF works best on patients with mild to moderate sagging but can give some improvement with more significant sagging.
What Cosmetic Surgeons Don’t Tell You
Posted: 12:01 a.m. Sunday, February 17, 2019
It is time for me to have some work done to rejuvenate my face to help improve the wrinkles, sagging and sunken-in look. It will be my first time having a cosmetic procedure on my face. I’ve had a few consultations. I keep getting many different opinions, some of which are contradictory. How does one know the truth about these cosmetic facial procedures?Answer:
Considerable misinformation exists in the cosmetic industry. This is, in part, due to differences in experience and expertise amongst different plastic surgeons since no one can be the expert on everything. In addition, many doctors who are not plastic surgeons are taking their shot at making a living by offering cosmetic procedures, despite their lack of training or board certification in plastic surgery.
The Role of Skin Elasticity in Necklift Surgery
Posted: 12:01 a.m. Monday, February 11, 2019
Question: I am in my mid 70?s with sagging neck skin. One plastic surgeon advised a necklift. Another said I might not get the best result from surgery since my neck has poor skin elasticity. Why was there such a difference in opinion from two board certified plastic surgeons?
Answer: Firstly, it is not uncommon to get completely different opinions regarding a cosmetic procedure, even if both doctors are board certified plastic surgeons. There is a wide variation in knowledge base, experience and skill level even between 2 similarly trained, board certified surgeons. Some plastic surgeons focus on the body whereas others mainly work on the face. If you are looking for face or neck work, you may want to consider a Facial Plastic Surgeon who specializes in that area of the body.
Unlike Facial Aging, Bellafill Gets Better With Time
Posted: 12:01 a.m. Sunday, February 3, 2019
Question: I have deep smile lines, grooves at my mouth corners and sunken cheeks and temples. I’ve been told that fillers are the best treatment option. There are so many fillers on the market. Bellafill peaked my interest since it’s very safe and lasts 5 years. I also heard that Bellafill looks better with time. How is it possible for any filler to get better as time passes?
Answer: LBellafill is indeed the 5-year injectable filler which has been proven, in over a 1000 patient FDA clinical trial, to not only be highly safe but also to give effective results that can last 5 years.
Does Laser Resurfacing Give The Same Results As Infini?
Posted: 12:01 a.m. Sunday, January 27, 2019
Question: I have sagging in my neck and lower face and some fine lip lines. One plastic surgeon discussed laser resurfacing but another advised Infini. Is laser resurfacing the same as a radio frequency device such as Infini?
Answer: Laser resurfacing and Infini RF have some very significant differences. While there is a little overlap in the types of aging concerns that these two devices can successfully treat, Infini RF tends to cover a broader range of concerns with less downtime. Laser resurfacing, with even the newer devices, typically comes with some downtime.
The Truth About Thread Lifts
Posted: 12:01 a.m. Sunday, January 20, 2019
Question: I’m in my 70?s and have a lot of sagging in my neck and lower face. I really don’t want the risk and downtime of an aggressive operation such as a facelift. The new thread lifts on the market sound quite appealing? What kind of results can I expect from thread lifting?
Answer: The idea of thread lifts for the face is nothing new. These lifts originally came out over 10 years ago and involved passing a long suture under the skin to lift sagging tissues. Thread lifts rose quickly in popularity but also went off the market just as fast. Failure of thread lifts in the past was not just due to inadequate results, but also from complications such as skin bunching and, even worse, extrusion of sutures out through the skin.
Benefits Of Treatment Series For Injectable Fillers
Posted: 12:01 a.m. Sunday, January 13, 2019
Question: I have a tight timeline and want my cheek hollows treated with fillers. Some surgeons have recommended doing the cheeks in more than one treatment. I had my smile lines filled a year ago and it was all done in a single session. Why is it necessary to break up my cheek volumization into more than one treatment?
Answer:There are several important reasons why an injectable filler treatment may be broken up into more than one treatment session.
Hollow Cheeks: More Than Meets The Eye
Posted: 12:01 a.m. Sunday, January 6, 2019
Question: I’m 67 and my cheeks look sunken in, making me look tired and sad. I’m interested in fillers, but how do I find a plastic surgeon who won’t make my cheeks look overdone or too puffy?
Answer:One of the keys to looking natural from filler treatments is finding a surgeon who is not only skilled and experienced with surgery but also with fillers. It often surprises patients to learn that not all plastic surgeons have the talent to create natural results with injectable fillers.
Multiple Facial Cosmetic Procedures At The Same Time
Posted: 12:01 a.m. Sunday, December 30, 2018
Question: I’m in my mid- 70’s and perfectly healthy. It’s been recommended that I have an eyelid lift, cheek fillers, Infini laser for sagging jowls and neck as well as Botox for my forehead wrinkles. What is the best order to have these procedures completed within a few months?
Answer: All of the procedures you mentioned can be done safely within a few months. For some, the order in which you have them can be important….
The Many Uses of Bellafill: A 5-Year Filler
Posted: 12:01 a.m. Sunday, December 23, 2018
Question: I’m 78 and have hollows under my eyes and in my cheeks. I also have deep smile lines as well as puppet lines near my mouth corners. I need fillers and am most interested in Bellafill since it lasts 5 years. Which areas on my face can be improved with Bellafill?
Answer: In addition to Bellafill’s 5-year duration, an important benefit is that it can be used in many different facial areas. With temporary fillers, you may need one type of Juvederm for eyelid hollows and a completely different type of Juvederm for sunken cheeks. In contrast, Bellafill can be used for most, if not all, of the areas you have concerns about…
Fake News in Facial Plastic Surgery
Posted: 12:01 a.m. Sunday, December 16, 2018
Question: I’m 69 and I’d like some facial rejuvenation procedures, but I get scared when I hear the stories about long recoveries and results that either make you look unnatural or too different. How can a lay person such as myself make a decision on the right rejuvenation options?
Answer: There is a considerable amount of “fake news” in the plastic surgery industry. This misinformation is passed along not only through the media, other plastic surgeons and doctors, but also the pharmaceutical industry. This “fake news” is seen with many different types of procedures.
Non-Invasive Treatments For Heavy Neck
Posted: 12:01 a.m. Sunday, December 9, 2018
Question: I’m 67 and have sagging neck skin. I’ve also been told that I have neck fat under my chin. I’m starting to see a hint of those vertical muscles bands in the front of my neck. I don’t want aggressive surgery or general anesthesia. I’m not interested in looking 20, but I would like to look a bit more refreshed and youthful. Are there any non-invasive options that could help?
Answer: Several factors can contribute to the aging neck. These include sagging neck skin, submental neck fat under the chin as well as separation of the platysmal muscle bands at the front of the neck. The choice of treatment depends not only on whether you have one or more of these factors contributing to your aging neck, but also on how extensively aged these tissues are.
Treatment of Under Eye Bags
Posted: 12:01 a.m. Sunday, December 2, 2018
Question: Iím 68 and have fat bulging under my eyes. Would I need surgery for fat removal or is there a minimal invasive option?
Answer: Visible fat bags in the lower lids do not automatically mean that you need a lower eyelid lift. Itís important for your doctor to look at the surrounding tissues to determine the optimal treatment approach.
A patient who has visible lower lid fat, but, at the same time, has deep hollows under the fat may only need an injectable filler in the lower lid hollows to soften the gap between…
Why Not A Facelift Instead of Minimal-Invasive Treatments?
Posted: 12:01 a.m. Sunday, November 25, 2018
Question: I’m 72 and have deep smiles, sagging at the corners of my mouth, hollowing in my cheeks and loose neck skin. Ultherapy skin tightening along with fillers was recommended to me by two doctors. When I add up the costs of these minimal invasive procedures that I will have keep maintaining, isn’t it cheaper to get it all done in one shot with a facelift?
Answer: It is a common misconception to think that a facelift would be an adequate substitute for injectable fillers, laser and/ or Botox treatments. The main goal in facelift surgery is to reposition and pull back sagging tissues in the lower face and neck…
Does Bellafill Really Last 5 Years?
Posted: 12:01 a.m. Sunday, November 18, 2018
Question: I’m 75 and have been getting fillers for many years. I’m tired of refilling every six to 12 months. I’ve read about Bellafill. Does Bellafill really last five years? When the filler Voluma came out, they said it lasted two years but that’s only true if you keep coming back for touch up treatments every six months or so. Is Bellafill the real deal or just another gimmick?
Answer: I’m in my sixth year of performing Bellafill as a BellaDiamond injector. The status of BellaDiamond injector is given to that top one percent of Bellafill injectors who are doing 300 or more syringes every year. While I also do many of the other temporary popular fillers like Restylane and Juvederm, Bellafill is the most commonly requested filler in my practice due to its high safety profile and long duration of results….
Unfounded Fears of Long-Term Fillers
Posted: 12:01 a.m. Sunday, November 11, 2018
Question: I really want Bellafill. I see that you are a BellaDiamond injector and do a lot of Bellafill. I imagine that you could only have so much success with Bellafill because the results speak for themselves. My research shows that Bellafill is very safe. Why aren’t more doctors using it?
Answer: This is a great question. There are several important aspects of Bellafill that neither consumers nor doctors are properly educated on.
First, many doctors confuse Bellafill with two older fillers, Artecol and Arteplast, which were only available in Europe and had a high rate of problems. To keep us safe, the FDA never allowed Artecol or Arteplast into the U.S…
‘Minimal-Invasive’ Does Not Mean ‘Minimally-Trained’
Posted: 12:01 a.m. Sunday, November 4, 2018
Question: I had filler injected over the sides of my cheeks bones. My cheekbones look wider and higher, but the cheek part underneath is more sunken-in and my eyes look more narrow. Even the hollows under my eyes seem more pronounced. Why does the rest of my face look worse when my actual cheek bones look better?
Answer: Your concerns are not unusual if your injector did not carefully evaluate the areas surrounding your cheekbones. Patients often come to my office seeking a secondary consultation after another injector overtreated one facial area, leaving the surrounding untreated areas out of balance…..
Facelifts For Deep Smile Lines
Posted: 12:01 a.m. Sunday, October 28, 2018
Question: I have deep smile lines and puppet lines. I don’t want fillers since they don’t last and I have to keep doing them. When I use my hands to pull the skin back on my face, the lines go away. Would a facelift do the job so that I don’t have to maintain with fillers?
Answer: A common public misconception is that facelift surgery can fix most of our facial aging including deep lines. Another false belief is that surgery is a substitute for fillers and that you don’t have to maintain…..
The Power Of Combo Rejuvenation: Infini RF and PRP
Posted: 12:01 a.m. Sunday, October 21, 2018
Question: I have some sagging in my lower face and jowls and don’t want a facelift or any kind of significant surgery. I read in your last article that doing minimal invasive procedures in combination can work. Are there any rejuvenation treatments that would help my sagging tissues without surgery?
Answer: You are not alone in your concerns about surgery. One of the most popular minimal invasive treatments in my office is the Infini RF. While I commonly use it for non-surgical skin tightening and lifting, patients also benefit from the simultaneous improvement Infini has on fine lines and aged skin texture….
Combination Therapy Vs. Facelift Surgery
Posted: 7:20 a.m. Sunday, October 14, 2018
Question: Another plastic surgeon advised laser, fillers and Botox for my facial aging. My facelift from 10 years ago was a single procedure. While I don’t want a second facelift, would I be better off with one instead of doing multiple other procedures?
Answer: A common misconception is that facelifts can achieve the same results as fillers, lasers and Botox. While one can…
Non-Surgical Treatment Of Sagging Neck
Posted: 8:49 a.m. Sunday, October 8, 2018
Question: I’m in my 50’s and have some sagging in my neck with loose skin and those vertical bands are just beginning to look visible in the front of my neck. I’m not ready for a necklift or any kind of surgery yet. Is there any non-surgical option for me at this stage?
Answer: While I cannot make a determination about your specific case without evaluating you in consultation, generally speaking…
Posted: 6:20 a.m. Sunday, September 30, 2018
Question: I had Bellafill in my cheeks and temples and Restylane Refyne in my mouth corners. I got some mild bruising in my left temple but major bruising on my right mouth corner. Once the bruising went away, I liked the final results but I don’t want to go through dealing with two weeks of bruising when I have more fillers. What can I do to prevent this?
Answer: While you can get bruising from any injectable filler placed in any part of the face, there are several ways …
Good Candidates for Infini RF, The “Non-Surgical Facelift”
Posted: 6:15 a.m. Sunday, September 16, 2018
Question: I have sagging in my jowls and neck. I really am not ready for a facelift because it seems so invasive with so many incisions. How can I know that if I have a less invasive procedure, like Infini, that I would be happy with the result? I’m not looking for miracles and don’t need to look 25. I just want to look better and refreshed.
Answer: When considering any non-surgical procedure, realistic expectations are important and a key part….
The Right Aesthetic Eye For Optimal Results
Posted: 6:00 a.m. Sunday, August 26, 2018
Question: I want fillers in my cheeks, Dr. Mandal, and you have done fillers in my smile lines which I’ve been quite happy with. I referred one of my friends to you, but she feels that there are so many people injecting fillers these days that she doesn’t need to travel 25 minutes to see a specific plastic surgeon. You have an such an eye for sculpting the face that I would not consider going to anyone else. How can I make my friend understand why it’s important to have someone highly qualified, even when it comes to fillers?
Answer: You are correct in recognizing how important it is to seek out a highly qualified….
Frequency Of Injectable Filler Treatments
Posted: 6:00 a.m. Sunday, August 26, 2018Question: I had Bellafill injected into my hollow cheeks and my plastic surgeon had told me that the treatment would be broken up into two treatments, one month apart. My swelling after the first treatment is gone and I’m wondering why my surgeon won’t do the second part of the treatment sooner than four weeks?
Answer: Bellafill is a collagen stimulator. The Bellafill crystal stimulates your collagen which responds in a minimum of 4 to 6 weeks for the average patient. Even if your swelling from the first treatment resolved quickly, your final result is likely to be more accurate….
Lower Eyelid Swelling After Eyelid Treatments
Posted: 6:00 a.m. Sunday, August 26, 2018Question: I had an upper eyelid lift 10 years ago for baggy upper eyelids. I had a good result, but there was swelling under my eyes that looked like fluid bags and didn’t go away for a long time. Now I’ve aged in the last 20 years and a plastic surgeon advised a second eyelid lift. I’m terrified about the swelling after surgery since the first time I had swelling for over 6 months. Will I experience the same prolonged swelling and fluid bags under my eyes?
Answer: The eyelid tissues are a very delicate area. Whether you have surgery or even a minimal-invasive procedure, this area, especially the lower eyelid, is more prone to bruising and swelling than other facial areas. In some patients…
Sagging After Upper Eyelid Surgery
Posted: 6:12 a.m. Sunday, Aug. 23, 2018
Question: I’m in my late 60’s and had an upper eyelid lift by another plastic to remove hanging skin and heavy bags. It’s been 6 months and I still have some sagging skin and bulging on the outer part of both eyelids. I feel my surgeon didn’t do a thorough job. Can a revision surgery remove the remaining loose skin?
Answer: While I cannot speak for your particular case without examining you, generally speaking….
Investing In Your Face
Posted: 6:00 a.m. Sunday, August 19, 2018Question: Why should I bother with maintenance treatments like Botox, fillers and lasers when I can just get a facelift and fix it all in one shot?
Answer: In today’s contemporary world of facial rejuvenation, investing in your face can keep you looking youthful yet natural in your mature years. However, it’s important to get past some of the many false, but long-held notions, about the facial rejuvenation process…
Hanging Skin and Sunken Eyes after Eyelid Surgery
Posted: 6:00 a.m. Sunday, August 12, 2018Question: I’m 54 and a plastic surgeon did an upper eyelid lift for the hanging skin of my upper lids and lower lid surgery to remove the fat bags under my eyes. It’s been 6 months and while most of the upper eyelid skin is gone, I still have extra skin on the outer part of my upper eyelid. The fat in my lower lids is also gone, but I look too hollow under my eyes. I don’t look much better and maybe even more aged than before. I went back to my plastic surgeon and he said nothing can be done. Is this really true?
Answer: While I cannot speak for your particular case without examining you, what you describe is not an uncommon finding after blepharoplasty or cosmetic eyelid surgery….
When Eyelid Lift Surgery Isn’t Enough
Posted: 9:29 a.m. Sunday, August 5, 2018Question: I had heavy skin on my upper eyelids and fat bags under my eyes. A plastic surgeon performed an upper and lower eyelid lift to remove the excess skin and fat. I was left with hanging skin in the outer part of my upper lids.
Answer: When it comes to rejuvenation of the upper and lower eyelids, it’s important not to use a “cookie cutter” approach. Extra skin of the upper eyelids does not automatically mean that upper eyelid surgery…
Bellafill Can Go A Long Way Compared To Temporary Fillers
Posted: 3:33 p.m. Sunday, July 29, 2018Question: I had several Bellafill syringes for my deep nasolabial smile lines and was quite happy with the results. I noticed, however, that Bellafill comes in 0.8cc syringes compared to the 1cc Restylane syringes. Does that mean that compared to 3 syringes of Restylane, I would need more syringes of Bellafill to treat the same areas?
Answer: Having performed well over 2,000 syringes of Bellafill over the past 6 years, I find that one syringe of Bellafill goes a long way. While there may be a little less Bellafill in each syringe compared to…
Alternative To Facelift Surgery
Posted: 6:00 a.m. Sunday, July 22, 2018Question: I’ve had a facelift and eyelid lift once at age 52 and then again at age 73. Now, I just need some tweaking for the little bit of sagging in my jowls and neck, but don’t want surgery anymore. I’ve heard of Ultherapy but have also read that it can thin out your skin and make you lose volume in your face. Is there any other non-surgical option that would be effective?
Answer: While there are several non-surgical skin tightening devices on the market, including Thermage and Ultherapy, I have found Infini RF to not only be safe but also the most effective in the right candidates. I have been using Infini RF for nearly 5 years and continue to perform an average of 3 to 7 Infini treatments on a weekly basis in my practice.
Plastic Surgeon Or Dermatologist For Filler Treatments?
Posted: 12:00 p.m. Sunday, July 15, 2018Question: I don’t want surgery but am interested in fillers for my hollow eyelids and deep smile lines. Since these treatments are non-surgical, would I get the best results by going to a dermatologist who treats skin aging instead of a plastic surgeon?
Answer: There are significant differences between what dermatologists and plastic surgeons do even though there is some overlap in a few cosmetic procedures. Typically, dermatologists, as experts in skin, focus on…
Will I get a better result with cheek implants or cheek fillers?
Posted: 9:00 a.m. Monday, July 9, 2018Question: I have hollow cheeks and two plastic surgeons recommended cheek implants instead of fillers since I wanted a permanent solution instead of maintenance treatments. Will I get a better result with cheek implants or cheek fillers?
Answer: Cheek implants have been around for decades, but are less popular than injectable fillers. Cheek implants involve surgery, have a risk of infection and can extrude. In contrast, cheek fillers …
Should I Try A Short-Acting Filler Before Having A Long-Term Filler?
Posted: 7:30 a.m. Thursday, July 5th, 2018Question: I’m really interested in Bellafill since I’ve had Juvederm, Restylane and even Sculptra, but they don’t last long enough. Since I’ve never had filler in my cheeks, would it be better to do a trial with a temporary filler first to be sure that I like the results before moving on to Bellafill?
Answer: The answer to your question comes down to (1) how confident you feel with your doctor’s injector skill and (2) how comfortable you are with the quality of the long-term filler …
What is The Difference Between Bellafill And Bellatero?
Posted: 10:15 a.m. Tuesday, June 26, 2018Question: I would like fillers for some of the deep lines in my face? Is Bellafill different from Bellatero or are they the same product?
Answer: There is a big difference between Bellafill and Bellatero. Firstly, Bellafill is a 5 year filler which works by stimulating your body’s collagen. The filling you see from Bellafill, in the long run, is the result of your own natural collagen. Bellafill is ideally suited for facial volumization in filling hollow cheeks, temples, lower lid hollows, deep smile lines and droopy mouth corners…
The True Value Of A Maintenance Plan
Posted: 8:02 p.m. Sunday, June 17, 2018Question: Wouldn’t I have been better off spending a large lump sum of money on a facelift to fix it all at once and not have to go back for maintenance treatments every year?
Answer: There is a public misconception about facelifts. In truth, facelift surgery, no matter how aggressive and extensive, does not fix everything! Even after a facelift, wrinkles, aged skin texture and facial volume loss still remain and must…
Don’t Be Fooled Into Thinking Fillers Are Quick And Simple Treatments
Posted: 1:34 p.m. Monday, June 11, 2018Question: Since a plastic surgeon will be more expensive and there are so many injectors these days, what’s wrong with going to another filler doctor?
Answer: Your areas of concern can sometimes be quite tricky to address. While deep smile lines can be successfully treated by a less experienced injector, some patients require layering of two different fillers which is more complex. Other patients may need…
Getting The Same Treatment Down The Street For Less
Posted: Wednesday, June 6, 2018Question: If I can save a thousand dollars by having such a quick and simple treatment by someone who is still a doctor, why not go with the cheaper price, especially since it’s not like I’m having surgery?
Answer: Your dilemma is a common issue faced by many patients seeking non-surgical treatments. However, it’s important to look beyond price point. Your situation is a bit different from finding the same Prada handbag on sale at 30 percent off at Neiman Marcus compared to…
Treating Lumps and Bumps From Fillers
Posted: Sunday, May 27, 2018Question: I’m in my 60’s and had fillers put in my marionette lines and nasolabial folds 4 years ago. But I got a bump in my smile line several months later. I never went back to show the doctor who injected me. The bump did eventually go away after a year. I’d really like to have more fillers but am worried about getting another bump. How can I avoid this problem from happening in the future?
Answer: There is no way to 100 percent eliminate the chances of developing a bump from injectable filler treatments. Even in the presence of perfect injection technique, using the safest fillers on the market, the risk of bumps, even if rare, does exist. Understanding and accepting this low risk is part of being a realistic patient with realistic expectations when having this medical procedure.
Injectable Fillers For Natural Looking Lips
Posted: Sunday, May 20, 2018Question: I’m in my 60’s and my chin has begun to look more and more pointy. It makes me look aged. One plastic surgeon suggested surgery but that seems too aggressive. Is there a less invasive option to soften the hard look of my pointed chin?
Answer: As we come to better understand facial volume loss, I commonly treat a “witches’ chin” non-surgically. Quite often patients experience volume loss between the lower lip and anterior jawline (lower chin border).
Injectable Fillers For Natural Looking Lips
Posted: Sunday, May 13, 2018Question: I have fairly thin lips. I also have deep enough wrinkles above and below my upper and lower lips such that I’m experiencing lipstick bleed where the lipstick runs into many of the lip lines themselves. What can be done to rejuvenate my upper and lower lip area?
Answer: Lip rejuvenation often involves treatment of multiple aspects of the lip as well as multiple types of aging concerns. Each patient is different as is the manner in which their lips will age.
Filler Fatigue From Temporary Fillers
Posted: Sunday, May 6, 2018Question: I keep hearing more and more about filler fatigue. I hear this happens when you get too many filler treatments. Can you explain better what filler fatigue really is?
Answer: Generally speaking, filler fatigue is commonly seen with temporary fillers which go away in shorter periods of 6 months to one year. I have not observed filler fatigue with longer lasting fillers such as Bellafill. Filler fatigue happens because patients get tired of returning for repeat maintenance treatments which can be quite costly when a filler only lasts 6 months to a year or two. Studies confirm that these patients tend to drop off the schedule after receiving a certain number of treatments. It’s also easy to get busy with life and forget when it’s time to return for your maintenance filler treatment.
How To Get Natural Results from Injectable Fillers
Posted: Sunday, April 29, 2018Question: I really need filler in several areas of my aging face, but I’m afraid to look unnatural like so many of the women I see. Is there a way that I can get natural looking results from injectable fillers?
Answer: I use several important approaches to give my patients as natural of a result as possible. The type of technique used depends on the facial area being treated with injectable fillers.
Do Fillers Last Longer in Forehead Frown Lines Than Botox
Posted: Sunday, April 22, 2018Question: I have strong frown lines between my eyebrows that I get Botox injections for. Since fillers last longer than Botox, can they be injected into these lines for a longer lasting result?
Answer: The answer is both yes and no. The frown lines between the brows, also known as glabellar lines, are caused by the force of overactive glabellar muscles on the skin.
Special Techniques For Rejuvenating Stubborn Mouth Corners
Posted: Sunday, April 15, 2018Question: I have droopy mouth corners. People always ask me why I’m sad, even though I’m a pretty happy person inside. A dermatologist did Restylane for my mouth corners, but I only got a small improvement. Then I went to a plastic surgeon, thinking he would be more skilled, and got Radiesse injections which weren’t much better. Is there anything that effectively improves puppet lines and downturned mouth corners so that I don’t look so sad?
Answer: While some ptotic (“droopy”) mouth corners are a simple fix using injectable fillers, others can be quite tricky to lift. Because multiple factors can contribute to a sagging mouth corner, identifying the correct cause is key to successful rejuvenation of a stubborn and ptotic mouth corner.
Two Approaches To The Aging Nasolabial Fold
Posted: Sunday, April 8, 2018Question: I have deep smile lines that run from each nostril to my mouth corners. I’ve had them since childhood but now in my 60’s, they are much deeper and really age me. A plastic surgeon injected filler into them and while they looked better for a while, the filler made my smile lines look fuller than my cheeks. I looked a bit strange. With the filler gone now after a year has passed, I look more natural but my deep smile lines are back. Is there a way to soften smile lines without looking unnatural?
Answer: The lines and depressions that extend from your nostril edge to the curves of your mouth are commonly referred to as nasolabial folds (NLF). Many people develop deeper grooves or lines in this area as their face ages. Although a deep NLF is a common facial rejuvenation concern, diagnosing the true cause of these grooves is key to effective treatment and a natural result.
Surprised Look After Botox
Posted: Friday, April 1, 2018Question: I got botox for my forehead creases one week ago and now my brows look too high and arched. Can this be fixed or am I stuck with this look until the Botox wears off?
Answer: An overly arched brow, often known as the “Dr. Spock” brow can commonly be corrected. This look is not necessarily due to an error on the part of the injector. The forehead and brow muscles can be very complex in their connections.
Infini RF to Lift, Bellafill to Fill
Posted: Friday, March. 25, 2018Question: I have sagging in my neck and lower face but also have hollow cheeks. I heard that Infini RF stimulates lost collagen to lift and tighten the skin like a non-surgical facelift. Since the volume loss in my cheeks is also due to collagen loss, will Infini RF make my cheeks look fuller too?
Answer: Infini RF does, in fact, work by stimulating collagen and elastin in your tissues, but this device targets the skin itself and works within the skin tissue layer. Infini RF causes a “two-dimensional” collagen stimulation effect to give tightening and lifting across sheets of skin.
What good is a facelift if your eyes look old?
Posted: Friday, March. 18, 2018Question: I had a facelift 5 years ago and while my jaw and neckline look tighter, when I look in the mirror, I look just as old and tired as I did before. My plastic surgeon didn’t address my eyelids. I have heavy upper eyelids and deep hollows under my eyes. What can be done to make me look more refreshed and less tired?
Answer: As aging progresses, you’ll notice that you don’t just age in one area of your face, but you are likely aging in many different parts of the face.
Facial Sculpting with Bellafill, Kybella & Infini RF: Volumize, Remove, Lift
Posted: Friday, March. 9, 2018Question: I’m 71 years old and have hollowing in my face, fatty jowls and neck as well as loose skin. I don’t want a facelift. Is there a way for me to get some reasonable rejuvenation in my face without surgery or a long recovery?
Answer: If you do not wish to have surgery and are willing to accept some worthwhile improvement, but perhaps not to the exact same degree as facelift surgery, then you may have some non-surgical options.
Pros And Cons Of A Facelift
Posted: 6:00 a.m Friday, March. 2, 2018Question: I saw a surgeon who recommended fillers, Botox and laser for the many wrinkles all over my face. The total cost of all these procedures was going to be the same a facelift? Wouldn’t it just be easier to get a facelift with one recuperation?
Answer: While a facelift, on the right candidate, can be a very satisfying procedure, facelift surgery is not a substitute for botox, fillers or lasers.
Treatment Of Stubborn Cheek Wrinkles
Posted: 5:52 p.m Friday, Feb. 23, 2018Question: I have deep wrinkles over my cheeks. In my 60’s, I used to get Juvederm which improved my wrinkles. In my 70’s, I finally lost 25 pounds and while I feel better at my new weight, my cheeks are hollow and the cheek wrinkles look worse. Juvederm doesn’t seem to work anymore. Is there a treatment that will help my deep cheek lines?
Answer: Based on the description of your situation, it sounds like with the weight loss, you also lost volume in your face. As your cheeks hollow, the wrinkles over the cheek tend to get deeper.
Can Fillers Be Dissolved If I Don’t Like The Result?
Posted: 6:00 a.m Sunday, Feb. 11, 2018Question: I had my cheeks and under eye hollows injected with Juvederm. While I went to a plastic surgeon’s office, the surgeon had his nurse injector do the treatment claiming he’s too busy performing surgeries. Now I have bumpiness under my eyes and unevenness in my cheeks. Can the filler be dissolved?
Answer: Your situation is not uncommon and, in fact, is a growing concern. Not only has the minimal invasive facial injectables market become flooded with doctors who are not board certified in plastic surgery along with nurses and non-doctors performing injectable treatments…
The Boom in Male Cosmetic Procedures
Posted: 11:03 a.m Friday, Feb. 2, 2018Question: I’m a 55 year old man who has not aged well. I’m interested in facial rejuvenation but don’t feel comfortable talking to my male friends about my concerns. I’m wondering if many men, these days, are having facial rejuvenation treatments?
Answer: It used to be that most men didn’t seek out cosmetic procedures because of cosmetic taboos and a social pressure to “age gracefully”. Times have changed. Men are living longer and showing increasing signs of aging.
Is It Safe To Have Two Different Fillers in the Same Area?
Posted: 6:00 a.m Sunday, Jan. 28, 2018Question: I had Juvederm placed in my cheeks 6 months ago. While I look better, enough was not done and I still have some volume loss. I’m interested in a longer term filler like Bellafill since some of the Juvederm is already going away. Do I need to wait for all of the Juvederm to go away before I get a different filler in the same area?
Answer: I routinely don’t wait until 100 percent of a previously injected filler has gone away. There are several reasons for this approach. First, there is no way of knowing if a filler has fully been resorbed by your body. Even a one year filler can still be present in your tissues 2 years later. I’ve seen it happen! There is just no reliable way to test for the presence of residual filler in your face.
Pitfalls Of Price Shopping For Cosmetic Procedures
Posted: 6:00 a.m Sunday, Jan. 21, 2018Question: I’ve called around and found that there are many different prices for the same procedure. Why wouldn’t anyone get a filler for a better price especially when two different facilities are using the exact same filler?
Answer: Having a cosmetic procedure is not the same as buying retail merchandise. While it makes sense to buy an authentic Prada purse on sale at 30 percent off compared to the full price, there is much more to a cosmetic procedure than buying merchandise.
Lower Eyelid Lift Vs. Injectable Fillers
Posted: 3:50 p.m Friday, Jan. 12, 2018Question: I’m 69 years old and have bags and hollows under my eyes. One plastic surgeon recommended surgery to remove the bags. Another said I could have the problem fixed with fillers in my hollows. It’s so confusing. How do I decide which surgeon is right?
Answer: While your eyelids can primarily age as a result of fat protruding into your lower eyelids or from hollowing under the eyes, there are many patients who experience both bulging fat as well as hollowing. An experienced facial plastic surgeon with a keen eye can recognize the difference.
Bellafill’s Time Has Come!
Posted: 5:19 p.m Friday, Jan. 5, 2018Question: I’m interested in Bellafill because it lasts so long, but is it true that long-term fillers are not as safe as temporary fillers?
Answer: I was recently in China and Hong Kong this past November after being invited as a faculty speaker to an aesthetic medical conference. While in China, Suneva Medical, the U.S. based company that manufactures and distributes Bellafill, introduced me to the director of the Chinese partner company that plans to distribute Bellafill in China and Hong Kong.
Are Stem Cell Fillers The Same As Fat?
Posted: 9:47 p.m Friday, Dec. 29, 2017Question: I’m looking for something long term to fill in my hollow cheeks and temples. I’ve been reading about stem cell fillers which are commonly taken from fat. Is it true that injecting stem cells is the same as injecting fat?
Answer: There is a significant difference between stem cells fillers and fat grafts. When fat injections are used to restore facial volume, an “ideal” result is when only half of the fat injected is retained in the long term.
Laser Whisper Lift Vs. Infini RF
Posted: 6:00 a.m Sunday, Dec. 24, 2017Question: I’m interested in having some lifting and tightening of my sagging jowls and neck. I don’t want a facelift or aggressive surgery. How do I know if I would be a candidate for your Laser Whisper Lift or Infini RF, both of which, I understand, are less invasive?
Answer: While both procedures are much less invasive than a traditional facelift, the Laser WhisperLift is surgery whereas the Infini RF is non-surgical.
Bellafill Looks More Natural
Posted: 6:00 a.m Sunday, Dec. 17, 2017Question: I’m debating over whether to have Bellafill or a temporary filler. I know Bellafill lasts 5 years but wonder if I should try a temporary filler first to see if I like the results?
Answer: Firstly, if you are going to have Bellafill, it is important to seek an expert Bellafill injector. Of course, seeking a skilled injector is important for any filler treatment, but even more so when using long-term fillers.
Does Kybella Really Work on Fatty ‘Turkey’ Necks?
Posted: 4:49 p.m Friday, Dec. 8, 2017Question: I’m 65 years old and have a turkey neck with alot of fat – no neck wrinkles, just very fatty and heavy under the chin. While there is alot of talk about Kybella being used for neck fat, I’ve also heard that it only works in a minimal way to reduce fat.
Answer: Kybella is FDA approved for submental fat reduction. In my experience with it, Kybella is quite effective in reducing fat under the chin. However, as with any cosmetic procedure, important factors must be considered when selecting the proper candidates for Kybella treatment.
Proper Patient Positioning During Injectable Filler Treatments
Posted: 6:00 a.m. Sunday, Dec. 3, 2017Question: I have gotten filler treatments in my cheek and lower eyelid hollows. Since I moved to Florida, I’ve seen 5-6 plastic surgeons/dermatologists, but no one seems to quite do it right. I notice a lot of doctors lay my face and body back in the chair when doing the fillers, but you stress the importance of sitting upright during your treatment. Is positioning really that important?
Answer: In my 22 years of using injectable fillers, patient positioning, primarily of the face and eyes, can be the key to a successful result.
Filler Choices for ‘Baggy’ Eyelids
Posted: 6:00 a.m. Sunday, Nov. 26, 2017Question: I have bags under my eyes, making me look tired. Is there a filler that can help me look more rejuvenated and less tired?
Answer: There are several effective fillers that exist. However, what’s most important is making a correct diagnosis to identify the true cause of under eye “bags.”
Expanded Uses of Kybella
Posted: 6:00 a.m. Sunday, Nov. 19, 2017Question: I have very fatty jowls and bulging fat in my lower eyelids. I heard about Kybella for treating neck fat. Can Kybella be injected into the jowls and under my eyes?
Answer: Kybella is FDA approved for fat reduction in the submental area under the chin. Kybella works by permanently killing the fat cells so that those fat cells don’t grow back.
Misconceptions About Bellafill
Posted: 6:00 a.m. Sunday, Nov. 12, 2017Question: While I would really prefer to have a long-term filler like Bellafill which lasts 5 years, in my research, I’ve learned that it is made up of PMMA. I’ve also learned that two other fillers called Arteplast and Artecoll were also made of the PMMA and caused a high rate granulomas and other problems. What makes the PMMA in Bellafill any different from that in the other two fillers?
Answer: The active ingredient in Bellafill is PMMA, also known as polymethylmethacralate. This PMMA is what stimulates your body’s own collagen and gives a 5 year result.
What Are The Different Types Of Restylane?
Posted: 6:00 a.m. Sunday, Nov. 5, 2017Question: I’m getting Bellafill in my cheek hollows, but for my lip lines, I’m told that I a need fine line filler like Restylane. It’s so confusing as there are so many types of Restylane. How do I know which Restylane is right for my lip wrinkles?
Answer: There are currently 5 different types of Restylane on the U.S. market and it can be confusing for the lay person to understand the difference. Unlike Bellafill which is a 5-year filler, works by stimulating your body’s own collagen, and can be used in many different tissue levels of the face, the Restylane products are hyaluronic acid that only
Do You Have Treatment Fatigue From Temporary Fillers?
Posted: 11:48 a.m. Friday, Oct. 27, 2017Question: I’ve been getting filler injections around my mouth, smile lines, cheeks and temples for 7 years. I like the results but it’s hard to keep up with my treatments. It’s not only costly, but time consuming to get injections every 6 to 18 months. Even worse, each time I delay treatment, I look older again and end up needing more filler and spend more money to restore my youthful look. I have a very busy life and don’t have time to keep refilling. Isn’t there a better solution?
Answer: I just finished speaking at a plastic surgery conference in St. Petersburg, Russia last week and am now in Shanghai, China teaching other physicians on injection techniques I’ve developed for creating natural results with long-term facial fillers.
Non-Surgical Treatment of Witch’s Chin
Posted: 6:00 a.m. Sunday, Oct. 22, 2017Question: I’m in my 60s and noticed that, as I’ve gotten older, my chin is starting to hang and look more pointed. This makes my lower face look more like that of a witch. Is there any surgical procedure that can remove the excess tissue over my chin?
Answer: What you are seeing with your chin is most likely not due to growing tissue. What happens with age is that bone and fat loss occurs in the areas above and around the chin, resulting in the appearance of a hanging chin.
The Truth About Filler Nodules
Posted: 6:00 a.m. Sunday, Oct. 15, 2017Question: I want to get fillers in my deep smile lines and droopy mouth corners that are starting to look like puppet lines. My friend got a lump after filler treatment and it took a while for it to go away. I saw a plastic surgeon who gave me options ranging from a 6-month filler to one that lasts many years. With a long-lasting filler, if I get a nodule, will the lump stay longer compared to that from a temporary filler that doesn’t last as long?
Answer: Not necessarily. There are many factors that contribute to lumps and nodules. These include injection technique, tissue depth at which the filler is injected, choice of filler, the risk of nodules as well as area of injection.
Myths About Long-Term Injectable Fillers
Posted: 6:00 a.m. Sunday, Oct. 8, 2017Question: I’m tired of refilling with temporary fillers. I’ve tried Juvederm, Restylane, Radiesse and Sculptra and they all go away too fast. I love the idea of a 5-year filler like Bellafill but I’m worried that, as my face ages and my skin thins out, the filler will become visible since it lasts so long. Is this true?
Answer: You should not be concerned that Bellafill or any other safe long-term injectable filler will become visible over time. This is simply…
Difference Between Facelift Vs. Mini-Facelift
Posted: 6:00 a.m. Sunday, Oct. 1, 2017Question: A facelift typically involves more aggressive anesthesia as well as bigger incisions in front and behind the ears, temples and scalp as well as under the chin. Facelifts primarily target sagging of the lower face and neck as well as the vertical neck bands in the neck center.
The Natural Threshold vs. Full Correction
Posted: 9:54 p.m. Friday, Sept. 22, 2017Question: I have sunken cheeks, deep smile lines and sagging mouth corners. I need fillers badly but when I see so many unnatural looking people with fillers, I get scared. As aged as my face looks, it would bother me more if I looked unnatural. How do you give patients a natural look?
Answer: Next to assuring patient safety, achieving natural results for my patients is a priority in my practice. Rather than focus on complete correction of a specific aging concern…
Stem Cell Fillers Or Bellafill?
Posted: 11:41 a.m. Friday, Sept. 15, 2017Question: I’ve been getting temporary fillers for years. While I’m happy with the results, not only is it costly to have them redone every 6 to 12 months, but I’m a very busy person and it’s time-consuming. I’d like to get Bellafill or stem cell fillers. What type of wrinkles can be treated?
Answer: When temporary fillers were all we had on the market, people had little choice. With the availability of Bellafill and stem cell fillers, long-term results are now possible.
Creating Natural Facial Results
Posted: 6:00 a.m. Sunday, Sept. 10, 2017Question: I want to get injectable fillers for my hollow cheeks and droopy mouth corners but honestly, I am afraid of looking unnatural. There are so many people I see with over-plumped cheeks and enlarged lips. Every plastic surgeon seems to advertise a “natural result”. Are there special techniques you use to keep your patients looking natural?
Answer: Yes, I absolutely use some very specific techniques to create natural results. The use of such techniques is the difference between going to a specialist vs. an amateur. In fact, I was just in Barcelona speaking to other doctors at an aesthetics conference and educating my colleagues on these effective techniques in facial volumization.
Don’t Forget About Your Hands
Posted: 6:00 a.m. Sunday, Sept. 3, 2017Question: I saw you some years ago. With the fillers you did, the laser treatments and the surgery, I still look youthful and love that the results have held up so well for all of these years. I do feel embarrassed with my old hands, however, which immediately give away my age since they don’t match my youthful face. Can anything be done about my hands with lasting results?
Answer: Although I specialize in the face and neck, aging hands give away one’s age no matter how youthful the face looks. That’s why hand rejuvenation has become an integral part of my facial rejuvenation practice.
A 20-Year Veteran’s Approach to Lip Wrinkle Treatments
Posted: 6:00 a.m. Sunday, Aug. 27, 2017Question: I had many lines above my upper lip. A plastic surgeon treated me with Restylane. While some of the deeper lines look better, the fine lines are still there. Worst of all, my upper lip skin looks over-plumped and unnatural. How could I have prevented this?
Answer: The routine use of injectable fillers for the treatment of lip lines is an over-simplistic approach. Not all wrinkles and lines are the same. Thus, the treatment for upper lip lines is going to differ in each patient.
Key Points For Treating The Aging Lower Lid Hollow
Posted: 6:00 a.m. Sunday, Aug. 20, 2017Question: I went to a doctor who was not certified by any plastic surgery board. I thought it would not matter since I was just getting fillers and not plastic surgery. The doctor put filler in my sunken lower eyelid area to make my dark circles look better, but now I look like I have a huge overfilled area extending from my eyelids to my cheek with no facial definition. What went so wrong?
Answer: Your story is a classic one. A patient coming to see me for the first time, after having an unsatisfactory filler treatment by a less skilled “filler” doctor, is not an uncommon occurrence.
Stem Cells: The Future of Injectable Fillers
Posted: 6:00 a.m. Sunday, Aug. 13, 2017Question: I know stem cells are being used in medicine for regrowing tissue and helping certain diseases, but how do stems cells work for facial rejuvenation?
Answer: The use of stem cells in the cosmetic industry for facial rejuvenation is a relatively recent development. Stem cells for regenerative purposes are being used in traditional medicine for longer.
Avoiding Aesthetic Errors In Facial Volumization
Posted: 6:00 a.m. Sunday, Aug. 6, 2017Question: How do you know where to place the fillers to give a natural result and prevent a mistake? I would think it becomes especially important when doing fat injections or a long-term filler like Bellafill which lasts 5 years.
Answer: I just returned from Vancouver where I was speaking at an aesthetics plastics conference in which experts in our field spoke from all around the world. The title of my presentation was coincidentally “Avoiding Aesthetic Errors in Facial Volumization”.
Skilled Injectors Part II
Posted: 6:00 a.m. Sunday, July 30, 2017Question: Thank you, Dr. Mandal, for the very informative article you wrote last Sunday on fillers and blindness. I had fillers injected into my face a year ago and went blind in one eye. My plastic surgeon sent me to a neurologist and a cardiologist, but no one ever figured what caused me to go blind, until I read your article. The day of my filler treatment, by the time my husband brought me home, I could not see at all through my right eye. I went to a reputable plastic surgeon and can’t believe he had no clue that his treatment could cause blindness. I’ve had fillers to my face many times in the past without a problem. How did things go so wrong this time?
Answer: I’m sorry that you suffered this serious complication from an elective, cosmetic procedure. It’s unfortunate that the surgeon did not realize blindness is a known adverse effect of injectable filler treatments.
Why You Need An Expert Injector
Posted: 6:00 a.m. Sunday, July 23, 2017Question: I’m looking to have filler injections for my deep nasolabial folds and hollow temples. There is a large variation in price depending on who you go to. These days, so many doctors who are not plastic surgeons are doing fillers. Some non-plastic surgeons have even busier filler practices than plastic surgeons. If you do a lot of fillers, doesn’t that mean you have sufficient skill and experience? What is the big fuss over only seeking a board certified plastic surgeon for fillers?
Answer: It is a common misconception that fillers are quick, simple “lunchtime” treatments. The fact is that serious complications, such as permanent blindness, can and do occur and are actually on the rise.
How Can I Look Younger Without A Facelift?
Posted: 6:00 a.m. Sunday, July 16, 2017Question: I’m in my 60’s and have wrinkles, sagging and hollowing in my face and neck but don’t want a facelift or any aggressive surgery. Is there some way I can look younger without having surgery?
Answer: Today, many patients are opting for minimal and non-invasive procedures for aging in the face and neck because they don’t want the risks and downtime associated with more aggressive surgery and anesthesia.
When A Facelift Can Make You Look Worse?
Posted: 6:00 a.m. Sunday, July 9, 2017Question: I had a facelift 10 years ago. I was happy with it, but now I see some sagging in my neck and lower face. I hear that second facelifts can sometimes make you look worse or unnatural? Are options available that can help tighten and lift my face and neck, yet still keep me looking natural?
Answer: It is typically better to have a facelift when the elasticity of your face and neck skin is still good. As you age, the collagen and elastin fibers of the skin weaken and break down with the skin losing its “memory” and ability to stay in a certain position.
Bellafill For Which Type Of Wrinkles?
Posted: 6:00 a.m. Sunday, July 2, 2017Question: I find the concept of a 5-year filler like Bellafill to be very interesting as I’m tired of refilling with fillers every year or so. It’s also become very costly to keep returning for regular repeat treatments. I have fine lines over my cheeks and lips as well as deep smiles lines and those awful “puppet lines.” What type of lines can Bellafill be used for?
Answer: Yours is an important question since patients often believe that the many injectable fillers are interchangeable. However, each filler is specifically designed to be injected at a certain depth in the skin and used only for certain purposes.
Minimal Invasive Procedures: Real Vs. Hoax?
Posted: 6:00 a.m. Sunday, June 25, 2017Question: I really don’t want a facelift but some of my friends claim it’s the only way to go for facial aging, if you want a worthwhile result. Are minimal invasive procedures a hoax?
Answer: Minimal invasive procedures have been on the rise for the past two decades. If they did not work, patients would not keep returning for more treatments.
Are Fake Cheeks The New Norm
Posted: 6:00 a.m. Sunday, June 18, 2017Question: I’m in my 60’s and have hollow, sunken-in cheeks that make me look sad. I’d like to have fillers in my cheeks, but it just seems that so many older people have huge cheekbones that overpower the rest of their face. Is there some way to just get a fuller, natural-looking cheekbone where I still look like myself?
Answer: Injectable fillers, on their own, do not create fake, oversized cheeks. Surgeons and less experienced injectors do, however. As the focus has shifted from overfilling the lips and smile lines of the lower face to…
Differences Between Bellafill & Sculptra?
Posted: 6:00 a.m. Sunday, June 11, 2017Question: I’m interested in fillers for my face as I’ve lost volume with the aging process. My research shows that Sculptra and Bellafill are good for facial volumization and that they both work by stimulating collagen. What are the pros and cons of using Sculptra and Bellafill?
Answer: While Bellafill and Sculptra may seem similar on the surface, there are substantial and important differences between these two volumization fillers.
The Stimulatory Facial Mask: Contemporary Facial Rejuvenation
Posted: 6:00 a.m. Sunday, June 4, 2017Question: I hear more and more about filler products and laser devices that stimulate collagen. Do these really work or is this just a hoax?
Answer: We are now in the era of collagen stimulation in the field of facial plastic surgery. The idea of stimulating collagen to rejuvenate the tissues began decades ago and is nothing new.
Aesthetic Treatments For Patients Of Color
Posted: 6:00 a.m. Sunday, May 28, 2017Question: I am 53 years old and have black skin. I notice sagging in my lower face, fat under my neck and deep smile lines. I don’t want a facelift. Are there any good minimal invasive treatments that would help aging concerns without causing keloids or noticeable scars in people with black skin.
Answer: Absolutely! With today’s advanced aesthetic technologies which can target different skin types and colors, there are many procedures that can safely and effectively treat patients…
Laser Neck Lift
Posted: 6:00 a.m. Sunday, May 21, 2017Question: I’m interested in the surgical laser neck lift. How do I know if I’m a candidate?
Answer: The Laser Neck Lift is a great procedure for someone who has mild to moderate skin laxity in the neck without or without neck fat. However, if you have platysmal bands, those vertical bands in the front of the neck that are visible with age, this procedure is not going to fix that problem.
The Treatment Flexibility of Infini RF
Posted: 6:00 a.m. Sunday, May 14, 2017Question: I had ultherapy a few years ago. While my facial sagging improved, my face ended up looking hollow and more aged months after the treatment. I went back to the plastic surgeon who told me Ulthera did not cause the volume loss in my face. However, Ulthera was the only treatment I had. I’ve heard the Infini is better for treating face and neck sagging than Ultherapy. Am I at the same risk of having volume loss with Infini RF as I did with Ultherapy?
Answer: In my experience with performing up to 7 to 8 Infini treatments each week, I have not had a patient complain to me about volume loss post-Infini treatment.
Non-surgical Treatment for Sagging Jowls
Posted: 6:00 a.m. Sunday, May 7, 2017Question: I don’t mind aging, but the sagging jowls are the part of my face that really bother me. I saw another plastic surgeon who wanted to do a full facelift with huge incisions, general anesthesia and too long of a recovery. At my age, I prefer not to have aggressive surgery. Do I have any minimal invasive options?
Answer: Today, you do have options other than a facelift. Patients commonly see me in consultation for similar concerns to yours.
The Natural Result Threshold
Posted: 6:00 a.m. Sunday, April 30, 2017Question: I’m ready for facial rejuvenation, but there are so many unnatural and strange looking people walking around. Some don’t even realize how obvious it is that they had a poorly executed cosmetic procedure. How can you prevent an unnatural result?
Answer: A natural result requires a very fine balance between over-correction and under-correction. This balance between doing too much vs. doing too little is the Natural Result Threshold.
Non-Surgical Treatment of Sagging Jowls
Posted: 6:00 a.m. Sunday, April 16, 2017Question: I’m 53 and have sagging jowls. I really am afraid of having a facelift. With all the new procedures available, are there are any less invasive treatments to lift my sagging jowls without surgery?
Answer: There are several effective non-surgical treatments for sagging in the jowl area to give you a more youthful and defined jawline.
Using Combination Fillers for Optimal results
Posted: 6:00 a.m. Sunday, April 9, 2017Question: I have lots of lip wrinkles which look worse when I speak. I also have deep nasolabial smile lines and creases at my mouth corners. Which fillers should I use to get the longest lasting results?
Answer: With the numerous injectable fillers on the market, it can be confusing and overwhelming how to decide on the best options. First, it’s important to remember that not all wrinkles are the same.
BellaDiamond Summit: Top 1% of Bellafill Injectors
Posted: 1:49 p.m. Friday, March 24, 2017Question: I’ve been hearing more and more about Bellafill and would like a 5 year filler for my deep smile lines and droopy mouth corners. The internet contains mixed information about Bellafill. What are the real facts?
Answer: I just returned from San Diego after attending the BellaDiamond Summit held for the top 1% of Bellafill injectors in the world. With no more than 25 of us, summit experts discussed the extensive research on Bellafill.
Bellafill: Satisfying Results From A 5-Year Filler
Posted: 6:00 a.m. Sunday, March 19, 2017Question: I’m tired of yearly maintenance treatments with Juvederm and Radiesse which go away so quickly, often much sooner than the one year that they are supposed to last. I have deep smile lines and sunken cheeks. Bellafill sounds great, but if I don’t like the results, am I stuck with it for 5 years?
Answer: When doing a 5-year filler like Bellafill, there are specific key factors one should take into consideration. Firstly, since it does last 5 years, you want an expert injector with a “surgeon’s mindset” and who believes in getting it right the first time around.
Enhancing Injectable Filler and Laser Treatments with PRP
Posted: 6:00 a.m. Sunday, March 12, 2017Question: I’ve been getting fillers in my hollow cheeks and temples as well as for the wrinkles in my lower face. While the results have been good, I still have stubborn fine lines along my mouth corners and jowl area. Are there any options to help fix this?
Answer: Additional treatment options do exist for your concerns. PRP, or protein rich plasma, has been around for years. It contains a high concentration of growth factors to help stimulate you body’s own collagen.
Bellafill & Infini Pre-Juvenation
Posted: 6:00 a.m. Sunday, March 5, 2017Question: I’m in my late 40’s with volume loss in my cheeks and under eyes and mild chin and neck sagging. My friends think I’m being vain and should wait longer. I don’t want to wait to look worse before doing anything. When is a good age to start plastic surgery treatments?
Answer: It’s less about chronological age and more of how you feel and your unique pace of aging. Each patient is different. Some 35 year olds experience early neck sagging whereas others still have a tight neck at 70.
Does Bellafill Really Last 5 Years?
Posted: 6:00 a.m. Sunday, Feb. 26, 2017Question: I’m interested in Bellafill but so many claims have been made about other fillers like Voluma and Sculptra lasting 2 years. These fillers seem to only last 2 years if you keep coming back for repeat touch up treatments. How do I know that Bellafill will really last the full 5 years?
Black Market Products In Facial Plastic Surgery
Posted: 3:17 p.m Friday, Feb. 17, 2017Question: I’ve been getting Juvederm for $300 per syringe for my deep smile lines. My doctor retired and I’m having trouble finding someone who can match the same prices. I see some surgeons charge up to $850 per syringe. How can there be such a large variation on prices?
Pre-Juvenation, Combination Therapies & Less Invasive Options
Posted: 6:00 a.m. Sunday, February 5, 2017According to the American Academy of Facial Plastic and Reconstructive Surgery’s (AAFPRS) annual survey, “topping the trends, are combination therapies, with 66% of facial plastic surgeons reporting that combining non-surgical procedures in the same patient is the most popular in their practices”
Even after 22 years in practice as a facial plastic surgeon, I can say that it’s a very exciting time in my specialty…
Infini Vs Laser WhisperLift™
Posted: 6:00 a.m. Sunday, January 29, 2017Question: I have sagging in my jowls and neck. I don’t want a facelift but am open to less invasive surgery. How do I know if I am a better candidate for your Infini non-surgical facelift or your Laser Whisper Lift which, from what I’ve read, is surgery but less-invasive compared to a facelift?
Answer: The best way to determine whether Infini RF or the Laser Whisper Lift is most suitable for you is through a one-on-one consultation with a proper and thorough evaluation….
The Laser WhisperLift™: Benefits Of A State-Of-The-Art Technology
Posted: 6:00 a.m. Sunday, January 22, 2017Question: I love the idea of your Laser WhisperLift™. While I know it’s actual surgery, I prefer this less invasive operation compared to a facelift. What I don’t understand is that if it’s less invasive, why does the Laser WhisperLift cost nearly as much as a facelift?
Answer: With today’s cutting-edge technologies for facial renivenation , “less invasive” does not mean “less costly”. If you choose to have a Laser WhisperLift™, you are paying more for the advanced technology…
Unraveling False Claims About Bellafill
Posted: 6:00 a.m. Sunday, January 15, 2017Question: I like the idea of a 5-year filler like Bellafill for my hollow cheeks and temples. However, I’ve spoken to a few other plastic surgeons who say it only lasts a year or two. Why are there such differences in what doctors say about Bellafill?
Answer: Bellafill is a high quality injectable filler that lasts 5 years. This fact is supported by my experience, as a BellaDiamond injector, in using over 2000 syringes and being in my 5th year of using it.
The 3 Types Of Facial Sagging
Posted: 6:00 a.m. Sunday, January 1, 2017Question: I have sagging jowls. I’ve read that putting Bellafill in my hollow cheeks can lift my droopy jowls? How do I know if I should get a facelift or fillers to help my sagging?
Answer: Facial sagging can be divided into 3 categories. Which category you fall into depends on how you age and can also determine your choice of treatment.
Dr. Google vs. Dr. Mandal
Posted: 6:00 a.m. Sunday, December 25, 2016Question: I want Bellafill but I checked the internet and there is a significant variation in prices at different doctor’s offices. How can I know who to select given the different fee structures?
Answer: First, while the internet can be helpful, it can also be very misleading. There are important differences between “Dr. Google” and, for instance, Dr. Mandal.
Misconceptions About Minimal And Non-invasive Procedures
Posted: 6:00 a.m. Sunday, December 18, 2016Question: I had a mini-facelift by another plastic surgeon who sold me on it by saying it was minimally invasive compared to a regular facelift. I have huge scars in front and behind my ears and don’t look much better. The minimal invasive and non-invasive procedures sound good, but do they actually work on anyone?
Answer: First, a mini-facelift is NOT minimal or non-invasive. Mini-facelifts are invasive surgery involving incisions, sutures and cutting of tissues.
Conservative Approach To A 5-Year Filler
Posted: 6:00 a.m. Sunday, December 11, 2016Question: I love the idea of having Bellafill for my hollowing face because it lasts 5 years. I’ve had temporary fillers like Juvederm but sometimes I have not been happy with the results. What happens if I don’t like the results of Bellafill?
Answer: As a 5-year filler, Bellafill should be performed by a board certified Facial Plastic Surgeon who does a high volume of Bellafill treatments and is thoroughly familiar with Bellafill-specific injection techniques and the aging facial anatomy.
Mini-facelifts: Who is a Candidate?
Posted: 6:00 a.m. Sunday, December 4, 2016Question: I’m bothered by my sagging jowls and neck. I’m open to a mini-facelift, but would never consider a facelift. With so many types of mini-facelifts, how do I know what I’m candidate for?
Answer: While the idea of a mini-lift sounds good, many patients desiring mini-facelifts wait too long and end up with traditional facelifts. Mini-facelifts are very effective in the right patient, but timing is everything with facial rejuvenation.
Is An Allergy Test Needed for Bellafill?
Posted: 6:00 a.m. Sunday, November 27, 2016Question: I am in my 60’s and allergic to several antibiotics as well as mold and dust. I am interested in Bellafill for my sunken cheeks and hollow temples. I know Bellafill contains collagen. I had collagen injections 15 years ago with no problem. I’d like to get the treatment before mid-December. Do I really need to have a Bellafill allergy test and wait the full 30 days to see if I have a reaction?
Answer: While there is a skin test to assess for allergic reactions to Bellafill, after having performed over 2,000 syringes of Bellafill, I have not yet seen an allergic reaction to Bellafill. Such reactions are very rare.
Facelift Vs. Laser Whisper™ Lift Vs. Infini RF
Posted: 6:00 a.m. Sunday, November 20, 2016Question: I have sagging neck and jowls. I prefer the least invasive procedure, even if it has to be surgery, to get some worthwhile improvement and look more youthful. What is the difference between a facelift, the laser Whisper™ Lift and the Infini non-surgical facelift?
Answer: While all three procedures can lift and tighten sagging in the jowls and neck, there are important differences between the three. A facelift typically involves…
The Underestimated Value Of The Temple
Posted: 6:00 a.m. Sunday, November 13, 2016Question: I’m 52, very thin and my face is quite hollow. I’m told I need filler in my sunken cheeks and temples. I can see where filling my cheeks would help, but my bangs cover my temples. Is there really a major benefit to spending the extra money for my temples?
Answer: The significant benefits of restoring lost volume in the temple are commonly misunderstood and highly undervalued.
Bellafill Causes Less Puffiness Than Temporary Fillers
Posted: 6:00 a.m. Sunday, November 6, 2016Question: I have dark circles under my eyes and deep creases in my upper cheeks. I went to a medspa doctor, who was not even a plastic surgeon, but who injected Restylane under my eyes and Juvederm in the grooves of my upper cheeks. The fillers made my eyes and cheeks look puffy for an entire year, without making me look any better. Now that the fillers have gone away, I’m stuck with the same hollows under my eyes and cheek creases. Are there any non-surgical options that won’t make me look so puffy?
Answer: Not all injectable fillers are the same. There are some significant differences in the properties of each of the different fillers. A skilled and knowledgeable plastic surgeon understands their different uses and benefits.
The Laser Whisper™ Lift
Posted: 6:00 a.m. Sunday, October 30, 2016Question: I want to tighten my sagging neck. I don’t want a facelift and even some of the minifacelifts seem to have bigger incisions. Are there any less invasive lifting procedures for a sagging neck that actually work?
Answer: The Laser Whisper Lift is a modified version of the Whisper Lift which I originally invented in 2007. Using the laser allows me to lift the sagging neck tissues through mini incisions.
Could Facelifts Be Obsolete In 10 Years?
Posted: 6:00 a.m. Sunday, October 24, 2016Question: I’m in my 60’s and am terrified of having major surgery like a facelift. I am open to less invasive surgery. Most plastic surgeons I’ve seen recommend a facelift. You specialize in less invasive facial rejuvenation, and I was wondering if there are any other options?
Answer: Firstly, it’s important to understand that facelifts only address specific types of aging, mainly sagging in the neck and lower face. There are many aspects of aging that a facelift will not improve…
Understanding The Limitations Of Facelift Surgery
Posted: 6:00 a.m. Sunday, October 16, 2016Question: I’ve had a few plastic surgery consultations and been told that if I don’t want surgery, I need many thousands of dollars worth of fillers, lasers and Botox. Having all these non-surgical procedures will end up costing me the same or probably more than a surgical facelift. Should I just go for it and have a facelift?
Answer: Comparing the results of minimal invasive treatments like fillers and lasers to a facelift, which is surgery and more extensive, is like comparing apples to oranges.
SculpSure Non-Invasive Fat Removal: Avoiding Complications
Posted: 6:00 a.m. Sunday, October 9, 2016Question: I had liposuction of my stomach fat 5 years ago and it left me with some uneven areas. Then a year ago, I had CoolSculpt which made the bumps worse. Does Sculpsure cause uneven fat removal?
Answer: Unlike surgical liposuction and CoolSculpt, SculpSure consists of flat applicator pads that are technologically designed to “feather” the areas of fat at the treatment borders. This configuration enables a result which is much less prone…
Avoiding An Unnatural Look From Injectable Fillers?
Posted: 6:00 a.m. Sunday, October 2, 2016Question: I want fillers for my deep smile lines and cheek hollows, but I went to a med spa a few years ago and looked like a monkey after Juvederm injections. It took a full year for my face to look normal again. I’d rather look aged than unnatural. How can I avoid the unnatural look from fillers?
Answer: First and foremost, credentials should not be overlooked. It’s important to seek a board certified Facial Plastic Surgeon. However, these days, being a board certified plastic surgeon isn’t enough.
Is Voluma A Worthwhile Investment?
Posted: 6:00 a.m. Sunday, September 25, 2016Question: I had 2 syringes of Voluma in my hollow cheeks. It went away after 4 months. I was told by the doctor that it would last 2 years. How can a doctor get away with not disclosing the full truth about this filler?
Answer: The FDA study on Voluma shows this filler can last “up to 2 years”. What many doctors don’t tell you is that Voluma can last two years if you keep doing touch up syringes every 4 to 6 months.
Less Invasive Eyelid Lift
Posted: 6:00 a.m. Sunday, September 18, 2016Question: I am a 55 year old man with heavy eyelids and fat bags. My male friends think it’s too feminine to have cosmetic surgery, but my eyelids really bother me. How common is it for men to have their eyelids done?
Answer: According to a recent international survey, eyelid surgery ranks as the third most commonly performed cosmetic surgical procedure in the world, making up 13.1% of all cosmetic procedures.
The Tricky Area of the Lower Lid Hollow
Posted: 6:00 a.m. Sunday, September 11, 2016Question: A doctor injected the dark hollows under my eyes with Restylane. My eyelid hollows were less deep, but looked lumpy and uneven. After a year, the filler finally went away. How can I be sure that this won’t happen again?
Answer: The under eye hollows are a tricky area and should only be treated by an experienced injector who regularly fills this area. Anyone can take a 2 week course to learn injection technique.
SculpSure Tx: When Special Skills Are Needed
Posted: 6:00 a.m. Sunday, September 4, 2016Question: I went to a medspa one year ago. The doctor performed SmartLipo on my stomach and outer thigh fat. Even though I now have less fat in those areas, my stomach is lumpy and I have indentations on the sides of my thighs and buttocks. I found out later that the doctor who performed my treatment was not a board certified plastic surgeon. Can SculpSure help smooth out the unevenness of my abdomen and thighs?
Answer: I am seeing an increasing number of patients requesting SculpSure treatments as a corrective approach for lumpy or uneven results that occurred with surgical liposuction, SmartLipo and CoolSculpt.
Bellafill: A ‘Non-Generic’ Specialty Filler
Posted: 6:00 a.m. Sunday, August 28, 2016Question: The idea of Bellafill, the 5 year filler, sounds good. My concern is that none of my plastic surgery friends have heard of it and none of the plastic surgeons in town do it. Are there so many problems with Bellafill that other doctors don’t want to use it?
Answer: Bellafill has an extremely low rate of complications, not only in my hands, but also based on the FDA studies. What’s unique about Bellafill is that it’s been extensively studied in more patients than any injectable filler on the U.S. market.
SculpSure: Why Choose A Plastic Surgeon?
Posted: 6:00 a.m. Sunday, August 21, 2016Question: I’m interested in SculpSure for fat removal on my stomach. I’ve called around and it seems cheaper to go to an office where a technician performs the treatment. If a technician can do the treatments, why pay more to see a plastic surgeon?
Answer: SculpSure, a non-invasive and permanent fat reduction treatment, is superior to CoolSculpt. In fact, SculpSure has become a gold standard in non-invasive fat removal. As simple as each 25 minute treatment may sound, several important factors can increase your chances of a good result.
Bellafill®: The “No Non-Sense” Filler
Posted: 6:00 a.m. Sunday, August 14, 2016Question: I’m looking at my injectable filler options for my hollow cheeks and dark eyelid circles. Why are you such an advocate of Bellafill with so many other fillers on the market?
Answer: There are several important reasons why I, but more importantly, my patients prefer Bellafill, and are willing to pay double for Bellafill compared to temporary fillers.
What’s The Best Treatment For My Double Chin?
Posted: 6:00 a.m. Sunday, August 7, 2016Question: I have sagging skin in my neck but also have a fat waddle under my chin. With so many options for neck fat including liposuction, CoolMini and Kybella, how do I go about choosing what’s right for me?
Answer: First, it’s most important that you find a board certified Facial Plastic Surgeon who specializes in the face and neck. While there are many non-plastic surgeons performing these procedures, have you ever asked why they are not board certified in plastic surgery?
Is Infini RF Better Than Ultherapy?
Posted: 6:00 a.m. Sunday, July 31, 2016Question: I have sagging in my lower face and neck. I don’t want surgery. I’ve read how Ulthera and Infini can give me a non-surgical facelift. Which procedure will give me the best lift?
Answer:While it’s true that both Ulthera and Infini RF stimulate your body’s own collagen to tighten and lift sagging skin, there are important differences between the two.
How To Select The Right Injector For Your Bellafill Treatment
Posted: 6:00 a.m. Sunday, July 24, 2016Question: I want Bellafill but since it lasts 5 years, I’m looking for doctor who is very skilled with Bellafill treatments. With everyone advertising how great they are, how does one find the right Bellafill injector?
Answer:Unlike Bellafill, Botox and temporary fillers are readily offered by a wide range of doctors of many different specialties, including dentists. Bellafill is a specialty filler for facial volumization and 3-dimensional facial contouring.
Is Bellafill Truly Superior to Temporary Fillers?
Posted: 6:00 a.m. Sunday, July 17, 2016Question: I’m tired of getting repeat filler injections every 6 to 12 months, with the costly upkeep. How does Bellafill compare to temporary fillers?
Answer:Bellafill is a gold standard filler when it comes to facial volumization. Below are key differences between Bellafill and the temporary fillers of Restylane, Juvederm, Perlane, Volume, Sculptra and Radiesse.
Is SculpSure Really Better Than CoolSculpt?
Posted: 6:00 a.m. Sunday, July 10, 2016Question: I’m debating between SculpSure and CoolSculpt for my love handles and tummy fat. Which is better?
Answer: SculpSure is quickly becoming a gold standard for non-invasive, permanent fat reduction and was FDA approved in 2015. Below are key differences between the two devices.
BellaDiamond Injectors: Who Are We?
Posted: 6:00 a.m. Sunday, July 3, 2016Question: I’ve read that you are a BellaDiamond injector. I’m interested in Bellafill, the 5-year filler, for my hollow cheeks and deep smile lines. Is a doctor’s BellaDiamond status an important consideration in having Bellafill treatments?
Answer: Several important factors should be taken in to account when having Bellafill treatments. For one, filling of facial lines and grooves is a 2-dimensional process that can be achieved through a relatively simple skill set compared to 3-dimensional facial volumization.
Rejuvenation of Lip Wrinkles
Posted: 6:00 a.m. Sunday, June 26, 2016Question: I hate the deep lines around my upper and lower lips. I like the idea of using Bellafill, the 5 year filler. What are my options?
Answer: Treatment for deep lip wrinkles often requires a combination of 2 or 3 procedures, depending on your age, genetics, smoking history and sun exposure. Many patients with deep lip lines have the faulty impression that these wrinkles are a quick fix.
Does Your Décolletage & Hands Match Your Face?
Posted: 6:00 a.m. Sunday, June 19, 2016Question: I have had several facial rejuvenation procedures and am often told that I look at least 10 years younger. One day, I was quite embarrassed when someone said my hands and décolletage look 70 while my face looks 55. Are there any effective, non-surgical options for treating aging hands and décolletage?
Answer: With the popularity of non-surgical facial rejuvenation, many more people are undergoing facial cosmetic procedures. As a result, there is a greater focus on the hands and décolletage…
Infini RF With Bellafill Vs. HA Filler
Posted: 6:00 a.m. Sunday, June 12, 2016Question: I had Juvederm and Bellafill in my cheeks and smile lines a few weeks ago. I’m interested in Infini RF for my sagging face, but heard lasers can make fillers in your face disappear. Is it safe to have Infini over the same area of the face that has already been treated with fillers?
Answer: “Laser” treatments, particularly those that work by generating heat in the tissues, can dissolve injectable fillers. Two factors influence the dissolution of injectable fillers.
SculpSure: Beware About Pricing
Posted: 6:00 a.m. Sunday, June 5, 2016Question: I had a SculpSure consult with another plastic surgeon for my right and left flanks. Their technician performs the treatment and saw me. He priced out 4 pads total, 2 on each flank. When I came to see you Dr. Mandal, your fee was twice as high. Since SculpSure can be performed by a technician due to the lower skill level involved, how can I justify paying you double?
Answer: While I’m unable to include your name in my response due to the patient privacy laws, I can say, for a fact, that I advised 4 pads on each of your flanks totaling 8 pads for adequate treatment of both flanks…
Bellafill: You Get What You Pay For!
Posted: 6:00 a.m. Sunday, May 29, 2016Question: I’m tired of getting Juvederm and Voluma in my hollow face. It works but lasts only months and costs thousands of dollars. How will Bellafill benefit me more?
Answer: I bought an inexpensive $49 pair of Jessica Simpson shoes to wear casually. I went to a discount store and was happy to get such a great deal. After wearing them once, the rubber sole lining separated from the entire bottom of both shoes in a few hours…
Long term benefit of Bellafill
Posted: 6:00 a.m. Sunday, May 22, 2016Question: I’ve been getting Radiesse for my deep smile lines and creases at the corners of my mouth. I love the results but it doesn’t even last one full year. Half of it’s gone 7 months later. I like the idea of Bellafill, the 5 year filler but is the extra expense worth it?
Answer: When it comes to dollars, think in terms of what the added value of the dollars you spend is. A cheaper, temporary filler doesn’t really mean that you are getting a deal. Most temporary fillers last 1/5 as long as Bellafill.
The 3 Levels of Facial Volumization
Posted: 6:00 a.m. Sunday, May 15, 2016Question: At 62, my hollow face ages me more than my sagging jowls and neck. I look skeletal! A plastic surgeon advised a facelift but I don’t see how tightening my skin will fill in my hollows. Is there a better option?
Answer: You are amongst the wiser who recognize that a facelift won’t correct hollowing. Many people don’t realize that with age, we actually lose fat and bone in our face….
Treatment For Turkey Neck & Jowls
Posted: 6:00 a.m. Sunday, May 8, 2016Question: I have sagging skin of my neck and jawline and fat under my chin. My high school reunion is in 3 months. I want to look refreshed and good for my age but without surgery. What are my best options?
Answer: Twenty years ago, a surgical facelift would have been your main option. Nowadays, many don’t want to go under the knife.
Numerous non-surgical treatments exist, but only a handful are effective…
Bellafill, Infini RF and Kybella Combination Treatments For Non-Surgical Facial rejuvenation
Posted: 6:00 a.m. Sunday, May 1, 2016Question: I am in my late 60’s with facial sagging, wrinkles and hollowing as well as some belly fat. I’d like to rejuvenate my face and trim up my waistline before my grand daughter’s wedding in a few months. I don’t have the time or desire for surgery. Are there effective options to freshen me up for the wedding photos?
Answer: I offer several non-surgical options for facial rejuvenation and body contouring. Unlike the body, facial aging happens in many more structures, often requiring more than one minimal-invasive procedure for correction.
Kybella: It’s Effective Use
Posted: 6:00 a.m. Sunday, April 24, 2016Question: I am 64 years old and have extra fat under my chin which I want to get rid of without the risk of surgery. Will Kybella work for me?
Answer: Kybella is an FDA approved injection for submental neck fat or fat under the chin. While Kybella can effectively dissolve submental fat in 2-4 injection treatments, it is important to seek a qualified plastic surgeon who thoroughly understands the anatomy of face and neck aging.
SculpSure Treatments: Doctor Vs. Technician
Posted: 6:00 a.m. Sunday, April 17, 2016Question: I’m interested in SculpSure for the extra fat on my stomach and thighs. I’ve noticed many offices offering SculpSure have a technician performing the treatments rather than an actual doctor. Is there a difference?
Answer: While it may be cheaper to have a technician perform your SculpSure treatment, important benefits exist with a skilled physician.
While an increasing number of less invasive procedures are performed by technicians, the fact that SculpSure is non-invasive does not mean that you’ll get the same results by a doctor or a technician.
Injectable Fillers Part II: Myth Vs. Fact
Posted: 6:00 a.m. Sunday, April 10, 2016Question: I want to get fillers for my deep facial grooves and hollows but heard that fillers can move or make your face puffy and that long lasting fillers cause visible lumps over time. What would you recommend?
Answer: Part II is continued from my 3/27/16 article on injectable fillers.
Patients with poor filler results are commonly victims of poor injection technique, inferior aesthetic skill and/or lack of understanding of the complex facial anatomy.
Injectable Fillers: Myth Vs. Fact
Posted: 6:00 a.m. Sunday, March 27, 2016Question: I want to get fillers for my deep facial grooves and hollows but heard that fillers can move or make your face puffy and that long lasting fillers cause visible lumps over time. What would you recommend?
Answer: There are numerous misconceptions about fillers. Almost always, patients with poor results are victims of inferior injection technique, substandard injector skill or poor understanding of the intricate facial anatomy.
SculpSure Fat Reduction Benefits
Posted: 6:00 a.m. Sunday, March 20, 2016Question: I developed fat pockets last year mainly in my flanks and back. My daughter’s wedding is in 4 months. If I get the SculpSure now, can I expect to see any results in time for the wedding?
Answer: SculpSure, which is a laser that can non-invasively and selectively reduce fat, does not give immediate results. While the fat is permanently damaged during the 25 minute treatment, final results are typically seen months later.
Lower Eyelid Hollows & Dark Circles
Posted: 5:00 p.m. Friday, March 11, 2016Question: I have dark circles under my eyes. They are very deep. I had Restylane once and then later Juvederm but they looked good initially but 6 months later half of the filler was gone even though it was supposed to last one year. Are there longer lasting options?
Answer: Firstly, it’s important to understand the difference between dark circles under the eyes and hollowing under the eyes. Dark circles are…
What makes Bellafill so special?
Posted: 6:00 a.m. Sunday, March 6, 2016Question: There are so many fillers on the market? What makes Bellafill so special?
Answer: Compared to other injectable fillers on the market, Bellafill is unique in several important ways:
Bellafill lasts at least 5 years according to FDA studies on Bellafill…
Best Timing For Facelift Surgery
Posted: 5:35 p.m. Friday, Feb. 26, 2016Question: I am 54 years old with some sagging in my lower face and neck. Should I wait longer in order to see a bigger difference from surgery?
Answer: When it comes to a facelift, if you want a worthwhile result, timing is everything!
With age, our face and neck skin no longer resists the forces of gravity.…
The Value Of BellaDiamond
Posted: 4:50 p.m. Friday, Feb. 19, 2016Question: I see that you are a BellaDiamond member. When I Google BellaDiamond, it is associated with Bellafill, the 5-year filler which I’m very interested in. What exactly does BellaDiamond mean and how important is it to get Bellafill treatments from a BellaDiamond physician?
Answer: BellaDiamond represents the top 1 percent of Bellafill injectors in the United States. BellaDiamond physicians perform the highest volume of Bellafill treatments in the country so they have the most experience with Bellafill compared to other injectors performing Bellafill in lower volumes…
A 5-Year Filler Vs. Temporary Fillers
Posted: 6:00 a.m. Sunday, February 14, 2016Question: I like the idea of a 5-year filler like Bellafill. However, a plastic surgeon once injected Juvederm in my cheeks and made them too puffy. It took one year to go away. If I don’t like the results from Bellafill, won’t I be stuck with that look for five years?
Answer: As a 5-year filler, Bellafill is typically not done all at once. As necessary, I break up the Bellafill treatments into more than one session.
The first Bellafill treatment is typically conservative with only…
How effective is CoolMini?
Posted: 8:49 a.m. Monday, Feb. 8, 2016Question: I have a double chin but don’t want surgery. I heard the CoolMini, made by CoolSculpt, gets rid of double chin? How effective is CoolMini?
Answer: A double chin can be caused by excess neck fat, sagging neck skin, vertical muscle neck bands or any combination of the above…
What Makes Bellafill Better Than Other Fillers?
Posted: 7:56 a.m. Saturday, Jan. 30, 2016Question: I’ve had fillers in my cheeks and smile lines but have to go in every year for repeat treatments. Bellafill is costly. What makes it better than the other fillers?
Answer: When it comes to cost, considering the overall value of a procedure rather than just the dollars being spent is key….
How To Look 9 Years Younger In 90 Minutes Or Less
Posted: 8:48 p.m. Saturday, January 23, 2016Question: As a 56-year-old female CEO of a very busy investment firm, my hectic travel schedule is year-round. I can’t afford time off or downtime. Do you offer minimally invasive procedures that effectively rejuvenate my appearance?
Answer: Improving your appearance no longer means surgery or downtime. 2015 marked a significant transition in technologically advanced minimal and non-invasive treatments. This trend is expected to…
SculpSure Vs. Other Fat Removal Technologies
Posted: 6:15 p.m. Friday, January 15, 2016Question: I am interested in fat removal of my stomach, thighs and flanks. There are several other devices like CoolSculpt, Vanquish and Verju that permanently remove fat and are non-invasive, just like SculpSure. How is the SculpSure that you offer better than the other devices that have been on the market longer?
Answer: What’s important to remember is that while there are many non-invasive fat removal devices on the market, only a few can remove fat permanently. Of these few…
SculpSure: The New Standard in Permanent, Non-Invasive Fat Reduction
Posted: 4:37 p.m. Saturday, January 9, 2016Question: I am 59 years old and work out daily. I am slender but have fat pockets over my upper stomach and little love handles as well. CoolSculpt did not do the job in most areas and left loose skin in areas where it worked slightly. It also left me with uneven abdominal fat. Would I be a good candidate for the SculpSure?
Answer: I am 59 years old and work out daily. I am slender but have fat pockets over my upper stomach and little love handles as well. CoolSculpt did not do the job in most areas and…
Look 9 Years Younger In 90 Minutes: Top 3 Cosmetic Procedures For 2016
Posted: 12:12 p.m. Thursday, December 31, 2015Question: My 60th birthday is just around the corner. I don’t want to look too young for my age, but do want to look youthful without having surgery. What are the latest minimal invasive options?
Answer: Advances in technology are happening fast with several recently, FDA-approved cosmetic procedures now available. The good news is that none of these minimally invasive treatments involve…
SculpSure Vs. CoolSculpt?
Posted: 7:58 p.m. Saturday, December 26, 2015Question: I recently read about a fat removal laser called SculpSure that is FDA approved for fat removal on the body. How is SculpSure different from CoolSculpt?
Answer: So many of my facial rejuvenation patients ask me to remove a little fat over their stomachs, hips or thighs. Even when they eat right and exercise, they just can’t seem to trim down these…
Do Thread Lifts Really Work?
Posted: 6:39 p.m. Saturday, December 19, 2015Question: I have loose skin around my jawline and neck, but the idea of having a facelift scares me. I’ve read about the Thread Lift, but does it actually work?
Answer: I do not perform Thread Lifts. When it sounds too good to be true, it usually is. Ten years ago, Thread Lifts were a great marketing gimmick but quickly…
Does Kybella For Fat Removal Actually Work?
Posted: 8:26 p.m. Friday, December 11, 2015Question: I heard about a new mesotherapy technique with Kybella injections to remove neck fat without surgery. Does Kybella really work?
Answer: Kybella is a non-surgical injectable which dissolves fat which your body gradually flushes away. It is injected into the fatty tissues of the neck under the chin to reduce fat and/or a “double-chin”. While Kybella is FDA approved, this not mean that treatment will necessarily give you a younger looking neck.
Part II: Tips On Finding An Expert Facial Plastic Surgeon
Posted: 8:49 a.m. Saturday, December 5, 2015While finding an expert plastic surgeon is key to a good result, it can be a daunting task. While board certification and training are very important, they are just the minimum requirements. Below are continued tips from last week to keep you on track…
Tips On Finding An Expert Facial Plastic Surgeon
Posted: 9:36 p.m. Saturday, Nov. 28, 2015Finding an expert plastic surgeon is crucial to a good result. It can be a daunting task when so many doctors claim to “specialize”, are not trained or certified in plastic surgery or carry “fake” board certifications not recognized by any legitimate authority….
Drooling And Droopy Mouth Corners
Posted: 8:19 a.m. Saturday, November 21, 2015Question: I have saliva coming out the sides of my mouth. I want a filler treatment to lift my droopy mouth corners to help the saliva problem. What filler do you advise?
Answer: Saliva leakage from the mouth corners can happen with age as the mouth corners lose support. There can also be several other causes of…
Heavy Eyelids and Botox
Posted: 8:21 a.m. Saturday, November 14, 2015Question: I had forehead wrinkles and slightly heavy upper eyelids. I got Botox from a plastic surgeon for the wrinkles, but two weeks later, my eyelids looked even heavier. When I returned to the surgeon, he said I needed upper eyelid surgery to improve the heaviness. What should I do?
Answer: A complication of Botox is actually a heavier upper eyelid when too much Botox is injected. When done in proper doses, Botox can actually improve mild heaviness…
Eye Bags, Dark Circles and Wrinkles
Posted: 2:12 p.m. Friday, November 6, 2015Question: I just turned 45 and have bags under my eyes, dark circles and laugh lines around my eyes. What is the best treatment?
Answer: Dark circles, eye bags and wrinkles can all be improved effectively, however, a multi-modality treatment approach is needed. Dark circles are more often due to…
Temporary vs. Long-term fillers: Pros & Cons
Posted: 12:46 p.m. Friday, October 30, 2015Question: I need filler in my hollow temples and cheeks. Why go with Bellafill which seems much more costly than other fillers?
Answer: Voluma, Radiesse, Sculptra and Juvederm are temporary fillers compared to long-term fillers such as Bellafill. Your first priority is to choose a filler that…
Treatment of Witch’s Chin
Posted: 8:50 a.m. Wednesday, October 28, 2015Question: I am in my 60’s and notice that over the years, my chin is becoming more and more pointy. I look like I have a witch’s chin instead of the soft, smooth chin which I used to have. Can this be corrected and restored to the youthful chin of my younger days?
Answer: A “witch’s chin” is a common complaint in patients seeing me for facial rejuvenation. Often however, patients complain about their jowls and droopy mouth corners and don’t notice how…
Bellafill vs. Voluma
Posted: 5:03 p.m. Friday, October 16, 2015Question: I want to get my temples and cheeks filled as the hollowness makes me look gaunt and older than I really am. How do I decide if I should have Bellafill or Voluma?
Answer: Both Bellafill and Voluma are safe, injectable fillers that can be used for facial volumization in the cheeks as well as temples. In deciding which filler is most suitable…
Why is so much Voluma needed
Posted: 2:00 p.m. Sunday, October 11, 2015Question: Your article last month said that at least 8 syringes of Voluma are needed for a 2 year result based on the research studies. I had 5 syringes of Voluma six weeks ago for my hollow cheeks and they look just fine. Won’t I look puffy if I get more syringes?
Answer: Research does, in fact, show that when a total of 8.9 syringes were injected, two thirds, not 100 percent, of patients treated were still satisfied with their results at 2 years. This same study showed that…
Avoiding unnatural facial filler results
Posted: 4:27 p.m. Friday, October 2, 2015Question: I plan to have facial fillers for my hollowing face. In choosing a doctor, what kind of clues should I look for to be sure my face will look natural?
Answer: First, it’s important to select a plastic surgeon who is not only board certified but also specializes in the face i.e. a Facial Plastic Surgeon. Despite so many non-specialists in today’s facial filler market…
Most common filler problems
Posted: 1:33 p.m. Friday, September 25, 2015Question: I’m thinking to get injectable fillers for my hollow face. What are the most commonly seen filler problems?
Answer: While injectable fillers do have risks, nodules and serious complications from most FDA-approved fillers are very rare. Of course, you should always get a filler with…
Are Fat Injections Really Better Than Fillers?
Posted: 12:00 p.m. Friday, September 18, 2015Question: I read that fat injections are the best solution for facial hollows. If that is true, why aren’t fat injections more popular than facial fillers?
Answer: Don’t believe everything you hear. With so many doctors, not board certified in plastic surgery, entering the cosmetic industry…
Does Voluma Really Last 2 Years?
Posted: 10:30 a.m. Friday, September 11, 2015Question: I had 2 syringes of Voluma in my hollow cheeks and it started to go away in 3 to 4 months. Are the claims that Voluma lasts two years false?
Answer: Claims of Voluma lasting 2 to 3 years is not quite accurate. The studies on Voluma, show that about 2/3 of the initial amount injected lasted 2 years but much less remained beyond the 2 years. Also, Voluma only…
More Ultherapy Concerns
Posted: 12:00 p.m. Sunday, September 6, 2015Question: Just finished your article in today’s Post. Boy, did you hit me with both fists…Almost two years ago….I went to a very well-known MD…..The tech did Ultherapy….I used to get compliments on my skin and people guessed me at least 10 years younger. I have lost the fat and filled areas of my face….this is my ugly story?
Answer: More and more issues similar to yours are surfacing after Ulthera treatments. I don’t think the Ulthera company was…
Beware of Facial Fat Loss From Ulthera
Posted: 6:00 a.m. Friday, August 28, 2015Question: I just read your honest article on Ultherapy and fat loss. My face was mauled by Ultherapy. I lost my beauty and all of the fat on my face. Worst of all, my eyes became smaller and the lids are super tight. I don’t recognize myself anymore. I wish this company would be honest about their side effects and not take such an aggressive approach. If you know how to reverse the damage, especially the small eyes, please let me know?
Answer: Ulthera was developed with the concept of “the deeper the better”. We now know that…
Why Nasolabial Fold Treatment Can Make You Look Worse
Posted: 2:30 p.m. Sunday, August 23, 2015Question: I have deep smile lines extending from the nostrils to both my mouth corners. Ten years ago, Juvederm filler treatments worked well to soften them. Now my lines are deeper and need more filler, yet Juvederm injections are actually making me look worse and unnatural? Is there a better filler for my nasolabial folds?
Answer: Deepening smile lines or nasolabial folds can have different causes. Identifying the cause of nasolabial fold aging is key to…
Warning On Fake Board Certifications
Posted: 6:21 p.m. Friday, August 14, 2015Question: I had CO2 laser which caused scarring. My cosmetic surgeon belongs to the American Board of Cosmetic Surgery but I’ve learned it’s not a real board and he is not even a plastic surgeon. How can you know if a plastic surgeon is certified by the right board?
Answer: Finding a qualified plastic surgeon can be overwhelming. Many physicians perform cosmetic procedures with no formal plastic surgery training and no…
Loss of excess baby fat versus desirable adult facial fat
Posted: 4:39 p.m. Friday, August 7, 2015Question: I used to have alot of baby fat that made my cheeks look puffy when I was younger. In my thirties, my cheekbones looked higher and more defined as I lost the baby fat. But now in my 60’s, those same cheeks look hollow. Why is my face looking aged and hollow from losing my baby fat?
Answer: Loss of facial fat has different effects on your facial appearance, depending on the areas where the loss occurs and what your chronological age is. While loss of excess baby fat can make you appear…
Upper Outer Cheek Key to Natural Facial Volumization
Posted: 3:55 p.m. Friday, July 31, 2015Question: I had Sculptra by a dermatologist who filled the hollows under my cheeks bones. Now I look puffy and my upper cheek and lower eyelid look like they are missing volume. Why has filling my lower cheek hollows caused a puffy look?
Answer: Filling of the wrong cheek subunit is one of the most common mistakes that I find in patients seeing me for corrective facial procedures after being treated elsewhere…
Sagging jowls: Gravity vs. volume loss
Posted: 11:46 a.m. Saturday, July 25, 2015Question: I have sagging jowls. One doctor advised a facelift or Ultherapy if I didn’t want surgery. Another said filling the cheeks would lift my jowls. Which option will give the best results?
Answer: Sagging of the jowls or tissue along the jawline can be due to collagen loss, allowing the downward pull of gravity to take over. A commonly overlooked cause is…
Eyelid tone & Blepharoplasty
Posted: 2:50 p.m. Friday, July 17, 2015Question: I have heavy lower eyelid bags that make me look old and tired. One plastic surgeon advised an eyelid lift. Another suggested lid tightening surgery at the same time. Why did I get contradictory advice?
Answer: It sounds like the second surgeon evaluated your eyelids in more detail. Decisions about lower eyelid surgery for excess fat, loose skin or both must take…
Fat loss from Ultherapy
Posted: 12:43 p.m. Friday, July 10, 2015Question: I’m interested in Ultherapy for my sagging face but heard it causes fat loss. If this is true, how can I prevent it?
Answer: There are reports of fat loss in the face and neck after Ultherapy. Fat loss from Ultherapy can actually make the face appear more hollow and aged and in the neck…
Dangers of Silicone Fillers
Posted: 6:00 a.m. Friday, July 3, 2015Question: I had silicone injections in my lips 12 years ago. I was happy with the results but as I’ve aged I would like my lips to be even fuller. Why do you not perform silicone filler injections?
Answer: Silicone injections can be very dangerous. It is well known that facial deformities, loss of body parts and even death after silicone injections have occurred. Additionally, these complications…
Infini To Maintain A Facelift
Posted: 3:33 p.m. Friday, June 26, 2015Question: I had a facelift a few years ago and now have some sagging. Although it’s too soon for another facelift, the loose skin really bothers me. Is there some way to tighten my jawline and under chin areas?
Answer: The Infini Radiofrequency “laser” can be very effective alone and/or when combined with surgery. Infini stimulates your body’s own collagen resulting in newer, younger…
Preventing ‘Duck’ and ‘Sausage’ Lips
Posted: 11:53 a.m. Friday, June 19, 2015Question: I had my lip borders filled with Restylane by a doctor but they look “ducky.” A second doctor advised filling the lips themselves. How will additional filler look more natural when less made me look “ducky?”
Answer: Sadly, with the high number of people that I see with unnatural, overfilled lips, “duck” and “sausage” lips seem to have become socially acceptable. Many patients and doctors, alike, are so focused on…
Bellafil Superior To Fat For Facial Volume?
Posted: 1:55 p.m. Friday, June 12, 2015Question: I’m interested in fat injections for my hollow cheeks and eye circles. I’ve heard of Bellafil but isn’t fat better since it’s your own natural tissue?
Answer: A fat graft is simply not better because it’s your body’s own tissue. An ideal long-term injectable filler should also not resorb, or go away, quickly. While fat is “permanent”, at least half of…
False Fears About Permanent Fillers
Posted: 2:33 p.m. Friday, June 5, 2015Question: I prefer a long lasting or permanent filler for my hollow cheeks due to the costly maintenance of having temporary fillers every 1 to 2 years. My concern is that while temporary fillers eventually go away, what if I don’t like the results of a long lasting filler?
Answer: There’s no question that long-term or “permanent” injectable fillers require greater technical skill and knowledge of facial anatomy…
Infini Vs. Facials, Peels, Micro-Dermabrasion
Posted: 4:23 p.m. Monday, June 1, 2015Question: I am 56 with fine lines and rough skin all over my face. Dermatologists and medical spas offer so many choices – facials, chemical peels, dermabrasion procedures and lasers. Which skin treatment will give me worthwhile results?
Answer: Over age 40, facial lines and sun-damage become more visible. Less aggressive skin procedures may not be enough. Although lower in cost, such treatments are often…
Creating Natural Looking Nasolabial Smile Lines
Posted: 1:27 p.m. Friday, May 22, 2015Question: I have deep lines from my nostril to mouth corners. A doctor who is not a plastic surgeon injected Juvéderm. Now my face has an overfilled “monkey” look. How did things go so wrong?
Answer: To treat nasolabial smile lines (NLF), a skilled injector recognizes differences in nasolabial fold (NLF) aging. Deep NLF grooves can be due to volume loss deep to the skin…
Errors in Filling Lower Eyelid Hollows
Posted: 3:35 p.m. Friday, May 15, 2015Question: My under eyes hollows were filled and now my eyes look puffy. The doctor was not a plastic surgeon but said the filler would dissolve with time. How can I prevent this in the future?
Answer: Correction of under eye hollows can be tricky. Knowledge of surgical anatomy, lower eyelid/cheek anatomy and anatomy of aging is key…
Facelift vs. Minimal Invasive
Posted: 3:35 p.m. Friday, May 8, 2015Question: I am 72 and prefer to avoid surgery. For my lip and chin wrinkles, deep smile lines, droopy mouth corners with sagging, hollow cheeks, a plastic surgeon advised Botox, fillers and laser. With so many different treatments, would I be better off just getting a facelift?
Answer: While it would be nice to treat all your wrinkles, sagging and hollowing with a one procedure, I don’t know of a single procedure that corrects all of those problems. Twenty years ago, facelifts, which mainly…
Facial Plastic Surgeons Vs. Med Spa Doctors
Posted: 3:28 p.m. Friday, May 1, 2015Question: What is the difference between a plastic surgeon and a doctor at a medical spa. If they are both MD’s and I’d like a non-surgical cosmetic treatment, why not go to a medical spa?
Answer: There are important differences between plastic surgeons and medical spa doctors who are not plastic surgeons. The cosmetic industry is filled with misleading advertising…
Facelift Scams: False Promises
Posted: 2:00 p.m. Friday, April 24, 2015Question: A medspa ad for “Instant Facelift” without surgery showed a 72-year-old woman with sagging and wrinkles transformed into looking 40 years old. How can an “instant facelift” take 30 years off your face?
Answer: Not all physicians follow the code of ethics and professionalism when it comes to cosmetic procedures. Beware of prices that are too low …
Treatment for three types of facial sagging
Posted: 10:53 a.m. Friday, April 17, 2015Question: I have heavy jowls. One plastic surgeon advised a facelift whereas another surgeon recommended filler to lift the jowls. How do I know whether to choose surgery or filler?
Answer: Facial sagging can have several different causes. It is important to seek a specialist who can identify the correct cause before proceeding to treatment …
Infini® Is In, Ulthera® Is Out!
Posted: 3:41 p.m. Friday, April 10, 2015 Question: I know Ultherapy® is a popular non-surgical treatment for a sagging neck and face, but I’ve heard it does not work. You’ve written many articles on Infini. Why don’t I hear much about Infini?
Answer: Infini has distinctive benefits, making it more likely to give a superior result compared to Ultherapy. Not only does Infini treat wrinkles, fine lines, large pores, poor skin texture and scars, but it also tightens and lifts sagging skin …
Three Part InjectionTechnique To Lift Droopy Mouth Corners
Posted: 6:59 p.m. Friday, April 3, 2015 Question: I have droopy mouth corners but do not want surgery. I’ve had Restylane® and Juvederm® but they don’t work very well. Is there a better filler?
Answer: Finding a qualified Facial Plastic Surgeon who is familiar with the complexities of facial anatomy in order to identify the true cause of your mouth corner aging is the first step. The appearance of droopy mouth corners (MC) …
Truth About Injectable Fillers
Posted: 2:09 p.m. Friday, March 27, 2015 Question: I read a med spa doctor’s article last Sunday on the benefits of Voluma lasting 3 years and that it can be dissolved if the results are unsatisfactory. Doesn’t Voluma last only 2 years?
Answer: Firstly, do not believe everything you read or hear! There is a great deal of misinformation put out by some physicians and pharmaceutical companies who are more focused on selling their product rather than providing quality results.
Botox Injections at Salons
Posted: 12:27 p.m. Friday, March 20, 2015 Question: I get Botox® every 3-4 months and it gets costly. Many salons and spas offer Botox for cheaper. Why go to a plastic surgeon’s office?
Answer: If Botox is administered at a salon by a plastic surgeon, it’s curious why a well-respected plastic surgeon would travel to a salon rather than do medical treatments like Botox in an office.
Is Fat The Best Permanent Filler?
Posted: 2:57 p.m. Friday, March 13, 2015 Question: Fat graft injections were recommended for my hollow face. I’m told fat grafts are permanent and come from your body’s own tissue? Since fat is natural, why use another commercial filler?
Answer: Fat grafting for facial volume loss is more complex than one might think. A typical good result is when only half of the fat remains and the other 50?percent resorbs within 6 months…
Facelift for cheek sagging
Posted: 3:01 p.m. Friday, March 6, 2015 Question: Infini was recommended to lift and tighten my cheeks. Since I’m having a facelift to lift sagging jowls, won’t surgery also help sagging cheeks?
Answer: Sagging of the cheeks is usually not the same type of aging process as sagging of the jowls. Thus, treatment may not necessarily be the same for sagging of the cheeks and jowls. …
Benefits Of ‘Added Value’ Cosmetic Procedures
Posted: 2:51 p.m. Friday, Feb. 27, 2015 Question: You recommended Bellafill™ for my hollow cheeks and Infini™ for my sagging, wrinkled skin. These procedures are expensive. Why have a more costly procedure when cheaper fillers and lasers are available that many people use?
Answer: This is a common question with no simple answer. First, consider choosing a plastic surgeon who performs a high volume of facial cosmetic procedures …
Do Facelifts Really Last Longer?
Posted: 10:10 a.m. Friday, Feb. 20, 2015 Question: Two plastic surgeons told me that the longest lasting result is with a facelift compared to fillers and laser. However, I know several people whose facelift only lasted a year or two. Should I have surgery or take the minimal invasive route?
Answer: Procedure costs are naturally an important consideration for most of us. When looking at costs, you want to be sure …
Infini™ For Limited Facial Areas
Posted: 4:29 p.m. Friday, Feb. 13, 2015 Question: I am 60 years old and have deep lines and sagging mainly over my jowl area. Can the Infini laser be used over this area of the face without my having treatment on the rest of my face and neck?
Answer: While Infini can be performed on smaller facial areas with some improvement, most patients over the age of 50 years typically have a full face …
Infini™ More Effective Than C02 Laser?
Posted: 6:00 a.m. Sunday, Feb. 8, 2015 Question: A plastic surgeon recommended CO2 laser for my facial wrinkles. Another advised that Infini works better. What is the difference?
Answer: Infini has significant benefits over C02 laser resurfacing. C02 Laser resurfaces the skin whereas Infini not only treats wrinkles …
Effective Treatment for Large Facial Pores
Posted: 2:44 a.m. Friday, Jan. 30, 2015 Question: I’m in my 50’s and have tried so many peels, lasers and skin products but the pores on my face are still large and noticeable. Is there any effective treatment that exists?
Answer: A most effective treatment for large pores on the face is Infini, a powerful radiofrequency treatment that stimulates collagen. As we age, we …
Simultaneous Granulomas to Sculptra® and Bellafil®
Posted: 11:50 a.m. Monday, Jan. 26, 2015 Question: I had Sculptra a year ago to my temples and Bellafil to my smile lines 6?months ago. I was pleased with the results but developed lumps in both areas a few months ago. Fortunately, the lumps were successfully treated and I look pretty good. Why did this happen at the same time to two different fillers?
Answer: Your lump pattern and time frame of occurrence is very uncommon …
Total Eyelid Rejuvenation
Posted: 9:19 a.m. Monday, Jan. 12, 2015 Question: A surgeon recommended that I have eyelid lift surgery while another cosmetic doctor said botox and fillers would do the job. It’s very confusing. How do I know which route to take?
Answer: Eyelid rejuvenation has several important aspects, depending on the causes. It is important to seek a cosmetic specialist with extensive experience in both surgical as well as non-surgical …
Meaning of Bellafill FDA approval
Posted: 9:19 a.m. Monday, Jan. 12, 2015 Question: A plastic surgeon advised Bellafill® for my under eye hollows. Is Bellafill® safe for my dark circles even if it’s only FDA approved for the nasolabial smile lines?
Answer: Bellafill®, like most injectable fillers, is FDA approved for use in specific facial areas only. However, treatment of other facial areas with Bellafill, even if not FDA approved, is …
Is Bellafill® a new filler?
Posted: 2:16 p.m. Monday, Jan. 5, 2015 Question: I’ve been hearing about a new filler called Bellafill that is supposed to last 5 years or longer. I have had Bellafill® and love it. How is Bellafill different from Artefill?
Answer: Bellafill and Bellafill® are actually the same product. Suneva medical, the company that manufactures Artefill, has changed the product’s name to Bellafill. …
Timeline for replenishing a “permanent” facial filler
Posted: 6:00 a.m. Sunday, Dec. 28, 2014 Question: I have Bellafill® in my temples, forehead and cheeks. It took 15 syringes but the results look great and very natural. Even though the Bellafill® costs much more, it was well worth the price since I’m not returning every year for refilling. Although Bellafill® lasts a long time, when would I require more filler since I’ll continue to age?
Answer: Bellafill® was FDA approved over five years ago for the cosmetic treatment of certain facial wrinkles, even though the active ingredient of Bellafill® has been used in medicine prior to its cosmetic formulation. …
The Bellafill® “Dip”
Posted: 9:54 p.m. Thursday, Dec. 18, 2014 Question: I had Bellafill® placed into my hollow temples two months ago. At first, the results looked good and I was really pleased. Six weeks after my treatment, my hollows began to show again. My surgeon told me that Bellafill® would last at least five?years or longer. Why did the Bellafill® go away so quickly?
Answer: No need to fret so soon. It is not uncommon to see a “dip” in facial volume many weeks to months after an Bellafill® treatment. …
Collagen stimulation with Bellafill® vs. Infini
Posted: 4:08 p.m. Tuesday, Dec. 16, 2014 Question: I have Bellafill in my cheek hollows. I know it works by stimulating your own body’s collagen. I also heard Infini® improves wrinkles and tightens loose skin by stimulating collagen. If both stimulate collagen, can the Bellafill® in my cheeks also smooth out the lines and wrinkles in my face instead of doing Infini?
Answer: Not really. The field of Facial Plastic Surgery has evolved in terms of collagen stimulating products and devices which are much more effective than those in the past. …
Loss of ‘baby’ versus ‘mature’ fat in the face
Posted: 1:51 p.m. Monday, Dec. 8, 2014 Question: I never liked the baby fat in my face during my 20’s. I looked best in my 30’s and 40’s as it went away and my cheekbones looked higher and sexy. Now in my 60’s, I look more hollow and gaunt. I’m wishing I had the baby fat back. Is there is way to restore the youth to my face? I don’t want to look much younger but just good for my age.
Answer: There is a big difference between losing baby fat when we are very young and losing mature facial fat as we age. …
The downside of HA fillers in the cheeks
Posted: 6:00 a.m. Sunday, Nov. 30, 2014 Question: I’ve had Juvederm and Voluma in my upper cheeks for hollowing. I like the results, but now notice upper cheek swelling that comes and goes. Are the fillers causing my swelling?
Answer: While a surgical brow lift can raise the eyebrows, it is important to understand that a higher eye brow does not always make one look more youthful …
Injectable fillers for dark eye circles
Posted: 2:39 p.m. Friday, Nov. 21, 2014 Question: I had a few consultations for dark eyelid circles and was told that the dark circles are really caused by hollowing under my eyes and fillers can be used for treatment. Every plastic surgeon advises a different filler from Juvederm® to Perlane® to Restylane® to Sculptra®. How can I know which filler is best for me?
Answer: Dark circles under the eyes have varied causes …
Bellafill vs. Sculptra™ nodules
Posted: 11:02 a.m. Monday, Nov. 17, 2014 Question: I was happy with the Sculptra treatment for my cheeks a year ago but recently got bumps. My plastic surgeon said it’s a delayed reaction to Sculptra which has a 19% chance of nodules. He treated the nodules which went away. I want cheek fillers again, but am afraid to get more Sculptra. Is there a better option?
Answer: While Sculptra is a quality filler, it’s true that the average granuloma …
Is a surgical or non-surgical facelift better?
Posted: 8:14 a.m. Monday, Nov. 10, 2014 Question: I’ve seen a few plastic surgeons. I know my options are facelift surgery or a combination of fillers with laser without surgery? How do I know whether to go with a surgical or non-surgical procedure?
Answer: It is important to realize that a surgical facelift does not usually address …
Restore facial volume: Collagen stimulation
Posted: 11:05 a.m. Sunday, Nov. 2, 2014 Question: I’ve read that Infini™ and Ultherapy® both treat sagging skin by stimulating collagen and that Bellafill also works by producing collagen. Wouldn’t Infini also stimulate collagen to restore lost volume in my hollow cheeks so that I wouldn’t need Bellafill?
Answer: While its true that …
Bellafill® timing with Infini
Posted: 9:08 a.m. Monday, Oct. 27, 2014 Question: I have Bellafill in my cheeks and Belotero® in my smile lines. I am happy with my Ultherapy® results from a year ago and want to maintain with Infini™. Are Infini treatments safe when done over the same areas I’ve had Bellafill® and Belotero?
Answer: It is important to …
Non-surgical treatment for sagging cheeks
Posted: 1:58 p.m. Friday, Oct. 17, 2014Question: My cheeks are sagging, making my nasolabial smile lines deeper. I don’t want a facelift and am wondering if lasers like Ulthera® or Infini™ will give me a cheek lift?
Answer: Cheek sagging is different from sagging skin in the neck and jowl areas. Sagging in the cheeks is …
Most effective collagen stimulators
Posted: 1:12 p.m. Friday, Oct. 10, 2014Question: With the many collagen stimulating devices out there like Ultherapy, Infini and Dermapen, how can one know the right option?
Answer: There are many products on the market that stimulate collagen. Some are effective whereas others are not. Of the ones that do work, it comes down to selecting …
Why collagen stimulation ‘laser’ for facial rejuvenation?
Posted: 9:15 a.m. Monday, Oct. 6, 2014Question: How can a laser that only stimulates collagen make a noticeable difference in my aging face?
Answer: Collagen makes up 75 percent of the skin’s protein. It is found in bone, tendon, ligaments and internal organs, giving tissue strength and support. In fact, collagen has a tensile strength greater …
Non-surgical ‘facelifting’: Bellafill-Infini combo therapy
Posted: 2:48 p.m. Friday, Sept. 26, 2014Question: My lower face is sagging but my upper face is hollow in the cheeks and temples. Several other plastic surgeons advised a facelift but how will a facelift get rid of my hollows?
Answer: Facelifts do not address many facial aging concerns that we have today. When I began …
The truth about Voluma
Posted: 2:49 p.m. Friday, Sept. 19, 2014Question: I hear Voluma™ is the latest filler on the market. With all the fillers that you use in your practice, I’m wondering why you do not offer Voluma?
Answer: Voluma is a hyaluronic acid and type of Juvederm® that recently became available on the U.S. market. Its common use …
Less discomfort with Infini™ than Ultherapy®
Posted: 2:01 p.m. Friday, Sept. 12, 2014Question: Last year, I had Ultherapy™ which gave me great results in terms of tightening of my neck. However, the treatment was uncomfortable. Is Infini less painful than Ulthera?
Answer: Most patients find Infini to be much more comfortable than Ultherapy. This difference may be partially due to the fact …
Infini® vs. Ultherapy®
Posted: 10:45 a.m. Friday, Sept. 5, 2014Question: I am 56 years old and quite pleased with my Ultherapy results from a year ago. How does Infini compare to Ulthera for a sagging neck?
Answer: Infini uniquely differs from Ultherapy which, until now, has been considered a gold standard for non-surgical face and neck lifting. Ulthera is …
An advanced ‘laser’ treatment
Posted: 2:07 p.m. Friday, Aug. 29, 2014 Question: I have sun damaged skin with facial wrinkles and brown spots. I also have some sagging of my facial tissues. Is there a treatment for both concerns without surgery or downtime?
Answer: The Infini system is a unique “laser” device that can improve both the skin surface as well …
Correction of filler injections
Posted:10:16 a.m. Friday, Aug. 22, 2014Question: My surgeon injected hyaluronic acid filler for my under-eye hollows to improve the eyelid bags. I’m not sure if I had Restylane™ or Juvederm™ but I’m overfilled. I’ve heard of a product that dissolves fillers, but can’t I just wait until it goes away on its own?
Answer: Hyaluronidase …
Is Bellafill® an implant or filler?
Posted: 8:49 a.m. Monday, Aug. 18, 2014Question: I’ve been researching injectable fillers on the Internet. What I learned is that Bellafill is actually an implant even though my doctor told me it was a filler. Isn’t it dangerous to inject an implant into your face that can harden over time?
Answer: While the Internet contains helpful …
Are natural fillers like Restylane safer?
Posted: 9:43 a.m. Friday, Aug. 8, 2014Question: I’ve been getting Restylane™ and Juvederm™ in my hollow cheeks. I’ve read that Bellafill lasts much longer. However, I prefer natural hyaluronic acid fillers like Juvederm. Isn’t it safer to inject a natural filler into my face?
Answer: There are many misconceptions about “natural” fillers. Some patients believe that …
Higher cost of facial volumization
Posted: 3:57 p.m. Friday, Aug. 1, 2014Question: I want my cheeks filled and know it’s cheaper to have Juvederm™, Radiesse™ or Sculptra™ treatments. My research shows that Bellafill is more appealing since it lasts so many years, but why is Bellafill® is so much more costly than other fillers?
Answer: It is important to understand that …
Are permanent fillers dangerous?
Posted: 11:17 a.m. Friday, July 25, 2014Question: My friend had silicone injections in her cheeks. She looked good at first, but after a few years her cheeks became lumpy and deformed? I want Bellafill, but how does Bellafill® compare to silicone injections?
Answer: Bellafill® is a completely different product from silicone. As a practicing surgeon of …
Ultherapy FDA cleared for new treatment area
Posted: 11:21 a.m. Friday, July 18, 2014Question: I’ve been seeing a plastic surgeon for improvements in my face and neck. While I’m pleased with the results, I notice my chest looks more aged since it does not match the youthfulness in my face and neck. Can anything help?
Answer: These days, women are taking better care …
Cheek volumization: The Submalar Zone
Posted:2:46 p.m. Monday, July 14, 2014Question: My face looks very hollow and old. I have high cheekbones but the hollowing is just below my cheekbones. Can the hollows be improved to make me more youthful without the “puffy” look?
Answer: The area under the actual cheekbone is called the submalar zone. Malar refers to the …
Fillers for sagging jowls
Posted:11:18 a.m. Thursday, July 3, 2014Question: I am 50 years old and have sagging jowls but do not want surgery. Can filler injections in my cheek area lift up the jowls?
Answer: With advanced techniques, injectable fillers in the cheek/mid-facial areas can not only fill hollows but also help lift sagging. Sagging jowls have multiple …
Treatment for deeply set eyelids
Posted:10:16 a.m. Friday, June 27, 2014Question: I’ve noticed that my eyes are aging and look deeply set. I saw a plastic surgeon about having an upper eyelid lift and was told that surgery would not help. Is there any other option, as my eyes make me look very tired?
Answer: It is a common misconception …
Treatment for suken forehead
Posted: 10:36 a.m. Friday, June 20, 2014 Question: I am 64 years old and my forehead looks “sunken in,” and my brow bones are prominent. A plastic surgeon advised a forehead/brow lift to fix forehead wrinkles and droopy brows, neither of which are bothering me. Will surgery help my real concerns?
Answer: Volume loss of the forehead …
Is your face sagging or hollowing?
Posted: 12:02 p.m. Friday, June 13, 2014Question: I’m in my late 50s. My face is sagging and my cheeks are hollow. A plastic surgeon advised that a facelift will correct the sagging and the will fill in hollow areas. Is this true?
Answer: Our face age on multiple levels. We all experience some degree of sagging …
Proper use of Bellafill can yield excellent results
Posted:10:22 a.m. Monday, June 9, 2014Question: I’ve been getting temporary fillers in my face for years. I’m quite happy except for the costly maintenance of repeat treatments when the filler goes away. I’d like a permanent filler like Bellafill® but won’t a permanent filler sag with the rest of my facial tissues over time and …
Bellafill® treatments for dark skin
Posted: 2:12 p.m. Friday, May 30, 2014Question: I am a mix of Italian and Puerto Rican. I am prone to easy scarring, because of my dark skin tone. Is Bellafill® a safe option for me?
Answer: I have used Bellafill® on a diverse range of ethnic patients without an increased risk of scarring, nodules or other …
The Bellafill® option for hollow temples
Posted:Question: I have very hollow temples. My girlfriend had Radiesse™ injected into her face by a plastic surgeon but now has lumps. Since my skin is so thin, which filler is least likely to give me lumps?
Answer: Bellafill is one of the most effective injectable fillers for treatment of …
Predictable volume restoration with Bellafill
Posted: 2:00 p.m. Friday, May 16, 2014
Question: I’ve had Bellafill injections in my hollow cheeks and temples, and like it since it’s more permanent than other fillers. Since it causes growth of your own body’s collagen, can you have uneven collagen growth and asymmetry in the face?
Answer: In addition to its high safety profile and …
Great option for facial ‘tweaking’
Posted: 11:19 a.m. Friday, May 9, 2014Question: I had a facelift six months ago in another state and still have some fullness under my chin. I don’t want more surgery for this small problem, even though it really bothers me. I’ve heard Ultherapy™ might help. Is that a option?
Answer: Ultherapy is the only device on …
Contouring vs. plumping with fillers
Posted: 10:06 a.m. Monday, May 5, 2014Question: I have very hollow cheeks and temples and am told that I need injectable fillers. I see so many plumped and unnatural faces. Even some of the richest movie stars look fake. Is there a filler that will make me look natural and refreshed?
Answer: It is unusual for …
How often to repeat Ultherapy?
Posted: 1:00 p.m. Friday, April 25, 2014Question: I had the Ulthera non-surgical facelift 7 months ago and had very good results with tightening of both my jowls and neck. I want to go on a maintenance regimen before my face starts to sag again. How soon can i repeat an Ulthera treatment?
Answer: The collagen and …
Sagging jowls — surgery or non-invasive treatments?
Posted: 2:26 p.m. Friday, April 18, 2014Question: I’ve noticed my jowls starting to sag. Can the loose tissue be improved without having a facelift?
Answer: The choice of treatment for sagging jowls depends on the cause of jowling as well as the degree of sagging. Sagging of the lower face, particularly the jowls, can be due …
Facial Mapping: Avoid an unnatural look from fillers
Posted: 11:06 a.m. Friday, April 11, 2014Question: I got Sculptra™ in my face last year and the surgeon put it in my lower cheeks. Now my face looks puffy and pear shaped. What can be done to look better?
Answer: I commonly see new patients in my office who have similar concerns. It can happen with …
Sculptra for thin facial skin
Posted: 10:26 a.m. Friday, April 4, 2014Question: The skin on my face has thinned out with age, making me look much older than I actually am. I want to get a facelift but am told that I may look overpulled because my skin is too thin. What treatments are available?
Answer: While lasers and prescription skin …
Forehead lift vs. Bellafill
Posted: 2:19 p.m. Friday, March 28, 2014Question: My forehead is aging. My brows are droopy and the thinning skin makes my forehead look bony. How do i know whether to have surgery or do injectable fillers?
Answer: A surgical browlift or forehead lift is a good option for raising the eyebrows. It can soften forehead wrinkles …
Injectable fillers for younger looking hands
Posted: 9:44 a.m. Friday, March 21, 2014 Question: My face looks youthful as I maintain regular treatments with Botox, fillers and lasers. However, the back of my hands give away my age. Can fillers be used to give volume to my aging hands?
Answer: While my practice is mainly restricted to the face and neck region, I …
Myths about long-term fillers
Posted: 9:53 a.m. Monday, March 17, 2014Question: I’m interested in Bellafill as I spend too much money each year to maintain filler injections for my face. Can a long-term filler like Bellafill® deform your face many years after treatment?
Answer: Unlike certain other long-lasting fillers, Bellafill® has been shown to be very safe. One false myth …
Treatment of a droopy outer eyebrow
Posted: 12:33 p.m. Friday, March 7, 2014Question: The outer part of my eyebrow sags and makes me look sad. A plastic surgeon advised a browlift, another said Botox™, and a third recommended injectable fillers. I’m so confused. How can I know what is right for me?
Answer: There are several ways to lift a droopy outer …
Enhance your eyelid surgery result
Posted: 4:57 p.m. Friday, Feb. 28, 2014Question: I had a lower eyelid lift by a plastic surgeon who removed the excess skin and fat bags several months ago. My eyes still look hollow and tired and the eyelid wrinkles are still there. What should I do?
Answer: While an eyelid lift can rejuvenate the upper face, …
Bellafill® for droopy mouth corners
Posted: 9:37 a.m. Friday, Feb. 21, 2014Question: I have creases at the mouth corners which are also droopy. A plastic surgeon injected the lines with Juvederm™, but my mouth still looks droopy. Can Bellafill give better results?
Answer: Treatment of the mouth corners can be tricky. It’s not always a simple matter of filling lines and …
Bellafill for Upper Face Rejuvenation
Posted: 2:05 p.m. Friday, Feb. 14, 2014Question: Some of my friends who look rested and youthful mentioned that they had Bellafill® injections in their forehead and temples. How can the upper face look younger with filler injections?
Answer: Bellafill® has advantages over many temporary fillers in the upper face. It is a very smooth material with …
Bellafill — long-term safety
Posted: 9:27 a.m. Monday, Feb. 10, 2014Question: I’m interested in Bellafill® for hollowing cheeks. My doctor says that it has only been studied for about 5 years. How do I know that it will be safe in my tissues 15 years from now?
Answer: Bellafill® has been shown to be very safe long term. It contains …
Substitute for a Browlift
Posted: 12:30 p.m. Friday, Jan. 26, 2014Question: I have heaviness of my eyelids. A plastic surgeon said that I have excess skin and upper eyelid fat and sagging eyebrows. He advised an upper eyelid lift and a browlift. I’m interested in the eyelid surgery but the brow lift seems too invasive. Is there another option to rejuvenate my brow?
Answer: While a surgical browlift can raise droopy brows, sometimes it can give an unnatural appearance to the face. Botox or Dysport, in combination with an Ultherapy non-surgical browlift can naturally raise the brows with less downtime and risk compared to surgery..
Facial Fillers During and After Weight Loss
Posted: 11:53 a.m. Friday, Jan. 26, 2014Question: I am in the process of losing 30 lbs and have 12 more pounds to go. I’ve heard that you should not have plastic surgery unless you have lost all of the weight? Is this also true for injectable fillers like Restylane or Bellafill?
Answer: While it is true that you should ideally be within 5-7 pounds of a stable weight prior to having facelift surgery, the same principles do not quite apply for facial fillers..
Technical Finesse in treatment of deep eye circles
Posted: 11:53 p.m. Friday, Jan. 17, 2014Question: I have had the hollows under my eyes treated with fillers by several different plastic surgeons over the years. Each time, I either end up looking uneven or too puffy. Are there certain techniques that can give me a natural look?
Answer: Filler injections for the hollows under the eyes require greater technical skill than injection of many other areas of the face. Factors to be considered prior to filler treatment …
Bellafill for the lower eyelid hollow
Posted: 10:47 a.m. Friday, Dec. 13, 2013Question: I have deep hollows under my eyes that make me look tired and aged. My friend had Bellafill under her eyes and is very happy. Why did my surgeon say that Bellafill® cannot be used under the eyes?
Answer: The use of Bellafill® for the hollows under the eyes is considered “off-label” use by the FDA. However, Bellafill® treatment of this area is also a commonly-accepted standard practice for many cosmetic doctors…
Bellafill® For Dark Circles Under The Eyes
Posted: 1:55 p.m. Monday, Dec. 9, 2013Question: I have dark circles under my eyes. I’ve heard that Bellafill® can improve my dark circles and give long lasting results. How do I know if am a candidate for treatment?
Answer: Long term injectable fillers such as Bellafill® are commonly used in my practice to treat certain types of “dark circles” under the eyes. One should be aware that not all dark circles are alike. Dark circles can occur from hollowing under the eyes as a result of…
Timing between Ulthera™ and Bellafill
Posted: 11:05 a.m. Friday, Nov. 29, 2013Question: I had an Bellafill® treatment two days for hollows cheeks. I’m interested in the non-surgical Ultherapy micro-facelift to lift sag in my face and neck. How long should I wait for the Bellafill® to settle before I start the Ulthera treatment?
Answer: When Temporary fillers like Restylane, Juvederm, Radiesse or Sculptra are placed into the same areas as Ulthera, Ultherapy is performed first, followed by filler treatments days to weeks later…
Can Bellafill be removed once injected?
Posted: 11:38 a.m. Monday, Nov. 25, 2013Question: I’m tired of costly maintenance treatments and am interested in Bellafill, which I’m told lasts many years. If I’m unhappy with the results, can Bellafill® be removed from my face?
Answer: Yes, it’s true that Bellafill is long lasting. One can think of its effects as similar to surgery in that additional treatments are mostly needed for future…
Afraid of Having A Permanent Filler?
Posted: Sunday, Nov. 17, 2013Question: I have hollow cheeks and deep smile lines. I like the idea of a long term filler like Bellafill® that lasts many years. How do I get past my concerns over a result that I may not like and that can’t be reversed.
Answer: The long duration of Bellafill® is not a reason to fear a bad outcome. You can take several steps to increase the likelihood of a good result…
Why Have I Not Heard Of Bellafill?
Posted: 11:28 a.m. Friday, Nov. 8, 2013Question: A plastic surgeon recommended Bellafill® as I wanted a filler that is long lasting with fewer maintenance treatments. I am a bit leery since he was the only doctor in the area doing Bellafill? If Bellafill® is such a great product, why don’t you hear about it as much as Botox?
Answer: Bellafill® is a specialty product that is not available on as widespread of a basis as Botox or Restylane which are sold on bill boards and in fashion magazines…
Renting vs. Owning your filler
Posted: 10:41 a.m. Monday, Nov. 4, 2013Question: I want a long lasting filler but the longer acting ones seem much more expensive than Restylane or Radiesse. How can I justify paying the high cost of long term fillers?
Answer: It’s really a question of whether you want to rent or own your filler. While the upfront costs of long term fillers like Bellafill® are higher than …
When a mini-facelift is not enough
Posted: 1:54 p.m. Friday, Oct. 18, 2013Question: I am in my 60’s and recently saw a plastic surgeon for a mini-facelift. He said I needed a regular facelift since I was too far gone to have a “mini.” I really don’t want a standard facelift. How could I have known that I should have had a mini-facelift years earlier?
Answer: Aging in the face and neck is part of a spectrum. The greater the pull of gravity and the poorer your tissue elasticity, the greater the degree of sagging…
Is Bellafill really a permanent filler?
Posted: 10:42 a.m. Friday, Oct. 11, 2013Question: I’m interested in a permanent filler for my hollow cheeks and smile lines, and my surgeon recommends Bellafill. But why did the company tell me that Bellafill is not permanent?
Answer: While the company may say that Bellafill is “semi-permanent” or not permanent, it is commonly thought of as permanent…
Is Ultherapy™ safe for darker skin tones?
Posted: 11:54 a.m. Friday, Oct. 4, 2013Question: I am a mix of Italian and African-American. I’ve heard lasers cause complications when used on dark skin. I’m interested in lifting my sagging neck and jowl area with Ultherapy™ because its noninvasive. Am I at increased risk due to my darker skin tone?
Answer: Unlike laser resurfacing and deeper chemical peels which are less suitable for darker skin tones due to the risk of complications, Ultherapy™ is commonly used on dark skin. Having performed many Ultherapy™ treatments on patients…
Does smoking affect facial cosmetic surgery?
Posted: 10:35 a.m. Friday, Sept. 27, 2013Question: I have been a smoker for 40 years. I am interested in having surgery for my sagging jowls and baggy eyelids. Is it safe for a smoker to have cosmetic surgery?
Answer: While it’s true that cigarette smoking can increase the risk of poor wound healing, a smoking history alone is not an absolute contraindication to having facial cosmetic surgery…
A Permanent Chin “Implant” Without Surgery
Posted: 9:54 a.m. Friday, Sept. 20, 2013Question: My receding chin makes my nose appear bigger on profile. I am on a blood thinner and don’t want surgery. Is there a non-surgical way to improve my profile?
Answer: Surgical chin implants are limited in the degree of augmentation. The reason is that chin implants can not only increase chin projection on profile, but also can make the chin and face look longer on front view. The chin can even appear too wide or masculine, requiring removal of the implant…
When Is it Safe To Have An Eyelid Lift?
Posted: 9:14 a.m. Sunday, Sept. 15, 2013Question: I am 72 years old and was told I should not have eyelid surgery due to my poor eyelid tone? Can you explain the reason as my surgeon never took the time to?
Answer: Blepharoplasty, also known as an eyelid lift is performed to remove excess skin, fat and/or muscle from the upper eyelids lids, lower lids or both…
Benefits of a Whisper Lift™
Posted: 11:00 a.m. Tuesday, Sept. 10, 2013Question: I’m 70 years old and do not want aggressive surgery or general anesthesia. What are the benefits of a Whisper Lift™ compared to other types of lifts?
Answer: The Whisper Lift™ was developed in 2007, as part of the next generation of Quick Recovery Facelifts. Designed for patients willing …
Posted: 4:14 p.m. Friday, Aug. 30, 2013Question: I’m 70 years old and do not want aggressive surgery or general anesthesia. What are the benefits of a Whisper Lift™ compared to other types of lifts?
Answer: The Whisper Lift™ was developed in 2007, as part of the next generation of Quick Recovery Facelifts. Designed for patients willing …
Finally! A permanent filler that’s safe
Posted: 10:12 a.m. Friday, Aug. 23, 2013Question: I am looking for a permanent filler for my deep facial lines and hollow cheeks. Are there any permanent options that are actually safe?
Answer: Some permanent injectable fillers are available, many are associated with complications or unsatisfactory results. Bellafill, however…
Minimize facelift scars
Posted: 9:58 a.m. Friday, Aug. 16, 2013Question: I had a facelift one year ago and I have thick scars in front and behind my ears. Is there anything that can improve their unsightly appearance so that I can wear my hair pulled back?
Answer: Most facelift scars are unnoticeable if the surgical incisions are placed into specific areas that camouflage the scar and the wound is closed without tension. Patients who have darker skin tone or certain diseases can be predisposed to thicker, wider, more visible scars…
Male and female differences in brow and eyelid rejuvenation
9:22 a.m. Monday, Aug. 12, 2013
Question: I am a 54-year-old male who would like to correct my droopy eyelids. I have a male friend who had a brow lift and now looks feminine. What can be done to maintain masculine features after cosmetic surgery?
Answer: When it comes to facial cosmetic surgery, gender differences between men and women are often overlooked. It is important to find a surgeon who recognizes the specific…
Correction of droopy mouth corners
10:37 a.m. Friday, Aug. 2, 2013
Question: The corners of my mouth have begun to turn downward. People say I look sad even though I am a happy person. I do not want surgery. Are there any effective non-surgical options?
Answer: Droopy mouth corners are often treated without surgery in my practice, whereas sagging jowls more likely require surgery…
Dry Eyes After Eyelid Surgery
11:15 a.m. Monday, July 29, 2013
Question: After eyelid lift surgery, my eyes began to water and feel very dry. My plastic surgeon said they would get better, but it has been a year and there has been very little improvement. What can I do?
Answer: It is not uncommon to experience dry eyes within the first few weeks after surgery. Persistent dry eye can occur and, in some cases, can be due to a pre-existing problem or a surgical complication…
The nasolabial smile line: To fill or not to fill
9:23 a.m. Sunday, July 21, 2013
Question: I have deep creases from my nostril to the mouth corner. A plastic surgeon suggested filling them, but I’ve noticed the folds look deeper because my cheeks are falling. Would it be better to lift my cheeks?
Answer: The creases you are referring to are known as the nasolabial folds (NLF). In the past, it was acceptable to eliminate deep NLF by filling them. Due to the increased focus on a natural appearance…
Avoid a ‘Spock Brow’ from Botox injections
10:45 a.m. Friday, July 12, 2013
Question: I had Botox to my forehead twice by a plastic surgeon, and my brows looked like “Mr. Spock” from the Star Trek movie. How do I know it won’t happen again if I change surgeons?
Answer: A surprised or “Spock” look after Botox can be avoided with proper injection technique…
Tips for injectable treatments
1:04 p.m. Friday, July 5, 2013
Question: I’ve seen two plastic surgeons for Botox and fillers. Their fees were much higher than most medical spas. Is there any real benefit to paying more for a plastic surgeon?
Answer: Botox and fillers may seem quick and easy, but serious complications do occur…
Tips on making lips fuller but natural looking
11:41 a.m. Monday, June 24, 2013
Question: My lips are thin and wrinkled. I badly want to get my lips filled but see too many distorted, overplumped lips. How can I get a natural looking lip?
Answer: With age, the lip edges, or vermilion border, flattens. Raising the vermilion edges with a single, precise stream of Restylane in the fine vermilion border space can restore lip definition…
Treatment for facial brown spots
9:42 a.m. Friday, June 14, 2013
Question: I have many brown spots on my face but was told laser treatments don’t always work. What is the best treatment for my concerns?
Answer: Facial brown spots have multiple causes, including hormone changes, genetics, aging, sun damage and even skin cancer. Hormonal changes with pregnancy or birth-control pills often appear as discoloration of the sides of the face, jawline and lip area…
Difference between Ultherapy™ and Laser Resurfacing
11:34 a.m. Friday, June 7, 2013
Question: I have wrinkles and sagging of my face and neck. A plastic surgeon advised C02 laser resurfacing and another suggested Ultherapy™. Which laser gives the best results?
Answer: Ulthera was originally developed to tighten and lift deeper tissues, not only in the deep skin layers but, more importantly, in a muscle layer under the skin called SMAS. The SMAS has traditionally only been addressed by surgeons with facelift surgery…
A natural-looking browlift: Ultherapy™ vs. Surgery
10:38 a.m. Monday, May 20, 2013
Question: I have sagging eyebrows that droop more on the outer part, making me look sad. A surgeon recommended a brow lift, but I know people who look surprised or unnatural after surgery. Is there a less drastic option?
Answer: While a surgical brow lift can raise the eyebrows, it is important to understand that a higher eye brow does not always make one look more…
Temple often overlooked in upper facial rejuvenation
2:39 p.m. Thursday, May 9, 2013
Question: A plastic surgeon suggested fillers for my cheeks and temples. I saw him for sad, tired-looking eyes, but what is the benefit of filling my temples?
Answer: The temple area is commonly overlooked by both patients and surgeons in upper facial rejuvenation. As we age, we lose bone as well fat and develop…
Sculptra to lift the face without surgery
2:14 p.m. Friday, May 3, 2013
Question: I am 62 years old, on a blood thinner and cannot have surgery. Most fillers I know of can fill lines. Is there a way to lift my cheeks and sagging jowls by using fillers?
Answer: With advanced injectable filler techniques that have developed in only the last few years, we are actually able to use fillers to not only to fill…
Less invasive treatment of sagging neck
2:58 p.m. Friday, April 26, 2013
Question: I am 62 years old, and I have a sagging neck with a fat wattle under my chin. I was told I need a necklift but am wondering if liposuction can tighten my neck, as I don’t want extensive surgery.
Answer: As you age, the neck tissues lose elasticity and begin to sag due to the pull of gravity. Excess fat can also accumulate under the chin area…
Facelift vs. Ultherapy™ for sagging facial scars
10:40 a.m. Saturday, April 20, 2013
Question: I am 60 years old but, as a teen, I was in a car accident that left scars on my face that improved with peels and laser resurfacing. With aging, though, my cheek scars seem worse again. Will Ultherapy™ or a facelift help?
Answer: Many facial scars, as well as acne scars, appear worse as the face sags …
A two-layered filler approach for difficult wrinkles
6:00 a.m. Saturday, April 13, 2013
Question: I have deep grooves at my mouth corners that look like “puppet lines.” I have been to several plastic surgeons who have used different fillers, but I only get minimal improvement. Is there any hope without surgery?
Answer: Oftentimes, very deep lines or grooves at the mouth corners are not adequately treated using the …
Belatero® — a new filler for fine lines
6:00 a.m. Saturday, April 6, 2013
Question: I have fine lines in my upper-lip skin and in the crow’s feet around my eyes. My surgeon says the lip lines are too fine to treat with Restylane or Juvederm. Also, Botox does not completely improve my crow’s feet. Are there other options?
Answer: Belatero® is a newer filler that has been successfully used…
Do baggy eyelids improve with weight loss?
2:29 p.m. Saturday, March 30, 2013
Question: I am 60 years old and have lost 75 pounds. I have bulging fat in my lower eyelids that makes me look sickly. I still have 25 pounds more to lose. Should I hold off on eyelid surgery until I’ve lost the rest of my weight?
Answer: Eyelid fat is part of the eye socket and supp …
Sculptra vs. fat injections
10:37 a.m. Saturday, March 23, 2013
Question: One doctor recommended Sculptra for my hollow cheeks whereas another advised fat injections. Which is the best treatment option?
Answer: While there are numerous techniques for filling in hollow areas of the cheeks, I have found Sculptra to be a superior option. Compared to most other injectable fillers and …
How effective are eyebrow hair transplants?
1:37 p.m. Friday, March 15, 2013
Question: I’m 55 years old and have thinning eyebrows. I’ve tried brow tattoo makeup, but it gives me a “painted-on” look. Am I a candidate for an eyebrow transplant?
Answer: Eyebrow transplants are a permanent and natural looking solution for thinning eyebrows. Your brows can not only be made thicker …
Filling lip wrinkles without looking unnatural
1:14 p.m. Friday, March 8, 2013
Question: I’ve received Juvederm injections several times to my lips wrinkles. Each time, the lip lines improve but my upper lip skin looks bumpy. Is there a way to improve lip lines but still look natural?
Answer: Lip wrinkles can, in fact, be treated effectively without appearing bumpy or unnatural. …
Tips for a natural-looking ‘no downtime’ facelift
10:54 a.m. Saturday, March 2, 2013
Question: A plastic surgeon injected the deep grooves at my mouth corners with Juvederm. While the grooves are gone, my lower face and chin look heavy and feel unnatural? How can I prevent this in the future?
Answer: This type of result can be prevented if overall facial balance is …
Ultherapy for cheek wrinkles
9:51 a.m. Saturday, Feb. 23, 2013
Question: I have numerous deep wrinkles over my cheeks and sides of my face. I had laser resurfacing for the wrinkles around my mouth but was left with white scarring. Are there options other than resurfacing?
Answer: In addition to tightening and lifting of facial tissues, Ultherapy™ can be effective …
Longer-lasting filler for facial hollowing
10:05 a.m. Saturday, Feb. 16, 2013
Question: The hollowing in my cheeks makes my face look saggy and wrinkled. My doctor treated me with Juvederm and Radiesse, neither of which lasted more than two to six months. Can you recommend any longer-lasting fillers for cheek hollows?
Answer: My product of choice for facial hollowing, is Sculptra …
Avoid unnatural, over-plumped lips
9:04 a.m. Saturday, Feb. 9, 2013
Question: I had a Juvederm treatment for thin lips but they now look unnatural and over-plumped. When I told my doctor I look like a “duck,” he said the filler would go away in six months. Is there a way to get rid of the Juvederm without waiting so long? …
Answer: Yes. As long as the filler consists of hyaluronic acid …
Facelift surgery — the second time around
11:13 a.m. Saturday, Feb. 2, 2013
Question: I had a facelift 10 years ago and have seen some sagging in my jowls and upper neck in the past five years. Is it safe to have a second facelift? What are my options if I don’t want surgery?
Answer: If your sagging is only noticeable in the …
The truth about facelifts
7:38 a.m. Wednesday, Jan. 30, 2013
Question: I’m wondering if a facelift really works since I’ve heard some of the sagging returns after surgery.
Answer: It is true that the face and neck tissues tend to settle around four to six months after facelift surgery. The degree of settling varies, however. Causes of settling are often …
Facelifts and thick skin
1:46 p.m. Friday, Jan. 18, 2013
Question: My husband has sagging of his face and neck and wants a facelift. I’ve heard it is harder for men to get a good result due to their thicker skin. If this is true, what are his options?
Answer: Men tend to have thicker skin than women. Generally speaking, …
Upper age limit for Ulthera
9:50 a.m. Monday, Jan. 14, 2013
Question: I am in my 70’s and don’t want surgery for my sagging jowls and neck. Is Ulthera effective for someone my age?
Answer: I have successfully used Ulthera in patients ranging in age from 40 years to the late 70’s. Age alone does not determine whether you are a …
Treating post-facelift sagging
3:37 p.m. Thursday, Jan. 3, 2013
Question: I had a facelift four months ago. While I do look better and more youthful, I am not satisfied with the results. I still have some sagging under my chin and in my jowl areas. Can this be improved without having more surgery?
Answer: Ulthera is a non-surgical alternative …
Prolong the results of a facelift
11:37 a.m. Wednesday, Jan. 2, 2013
Question: I had a facelift one year ago and have noticed mild sagging in my neck over the past few months. Is there anything I can do to maintain my results without further surgery?
Answer: Aging, in fact, begins immediately after surgery. Also, no matter how skilled the surgeon, the …
A new treatment for wrinkles
10:20 a.m. Wednesday, Dec. 26, 2012
Question: I’ve heard Ulthera can improve facial wrinkles. Is this true, and what type of results can I expect?
Answer: Studies show that Ulthera can effectively treat face and neck wrinkles. In addition to tightening and lifting sagging tissue, Ulthera is used in my practice for upper and lower lip …
A new solution for lower neck aging
10:55 a.m. Monday, Dec. 24, 2012
Question: I have sagging and wrinkles in my lower neck. I’m told a facelift won’t improve the lower neck sagging and a chemical peel can’t be used in that area. Are there any effective treatments?
Answer: Facelift surgery and deep skin resurfacing has been limited to the upper half of …
Hollows & Dark Circles Under Eyes
Sunday, December 4, 2011
Question: As I’ve aged, I seem to have developed dark circles under my eyes as well as hollowing. Not only does this make me look tired, but my eyes also appear small. Is there an effective way to treat hollows and dark circles under the eyes?
Answer: Those hollows under the eyes are often caused by fats loss and …
Eyebrow Hair Transplast vs. Brow Tattooing
Sunday, November 6, 2011
Question: My eyebrows have always been thin and I’ve been getting permanent makeup treatments for years. Now that I’m older, my brows have lost more hairs and tatto makeup gives them a “painted” look. Is there something available that is more natural looking, longer lasting and less maintenance?
Answer: With advances in hair restoration surgery, eyebrow …
Thinning Hair in Women
Sunday, October 30, 2011
Question: I am a 56 year old woman with a thinning hairline along my forehead, making it difficult to style my hair. This also makes me look older. I am interested in hair transplants but was told they are done primarily in men. I am also concerned about having an unnatural look of hair “plugs”.
Answer: Contrary to popular belief, hair transplants are …