Q: Do you have to have CoolSculpting done more than once?
A: The number of CoolSculpting treatments required varies depending on the individual patient. CoolSculpting reduces fat by around 20% after a single treatment, and while some patients feel that this is enough, others want more treatments done for further results. The goal is to treat to completion for maximal results, and often a second treatment is needed. I recommend visiting a board-certified dermatologist for a consultation to see if you are a candidate for CoolSculpting, and to see how many treatments you would need to achieve your desired goals.
Q: Is numbness after CoolSculpting normal?
A: Yes, numbness is a fairly common side effect following CoolSculpting treatments. It should resolve on its own over the course of a few weeks, although in some cases it may last for a month or two.
Q: Is there much downtime after Ultherapy?
A: What’s great about Ultherapy, is that there is usually no down time. After an Ultherapy treatment, you can resume your normal routines. Keep in mind that you may experience some swelling or bruising, so it’s important to be gentle to your skin if you do experience those symptoms.
Q: I have been using fillers (Restylane & Radiesse) in the cheek & nasal labial area for a few years. I also have dental implants. How does Ultherepy affect these?
A: Rest assured that Ultherapy will not have an effect on your dental implants. In regards to your fillers, Ultherapy usually does not target areas of the face where fillers are typically injected, and it will not affect any previous filler. With that being said, I recommend ideally having fillers injected AFTER your Ultherapy treatment.
Q: I had Ulthera on my lower face 3 days ago and still have considerable swelling and bruising. Is this normal?
A: Swelling and bruising after Ultherapy is a common side effect. Though most patients will see this subside after a few days, it can last for up to several weeks. Topical apple cider vinegar, Arnica gel and/or oral Arnica Montana can also be used to help expedite the healing process of a bruise. If you have not seen any improvement after two weeks, call your dermatologist to schedule a follow up appointment.
Q: I've lost 30 pounds, and need to lose another 20. I was considering doing Ultherapy now, but wondering if I should wait until I'm done losing all the weight?
A: With a procedure like Ultherapy, it's best for the patient to be at a stable and consistent weight. Additional weight loss may cause additional laxity to your skin, therefore it is best to have the treatment once you are at your goal weight.
Q: Can Ultherapy be used on your body
A: Currently, Ultherapy is only FDA approved to be used on the face, neck, and most recently the chest. However, the treatment does have a specific clinical indication for lifting the skin on the neck, chin and brow.
Q: Is it reasonable that patients go yearly, or more often for Ultherapy?
A: The longevity of Ultherapy varies from patient to patient, but in most cases it lasts for about a year. However, the skin continues to age over time so future touch up treatments can help keep pace with the aging process.
Q: My 1st Ulthera attempt was painful and I had to stop. Also, I had tenderness along the jaw line 2 days afterward. My 2nd attempt was scheduled with pain medication. Is my experience typical? Please advise.
A: While comfort thresholds vary from patient to patient, most patients now report that the procedure is quite tolerable. If and when any discomfort does occur, it happens while the ultrasound energy is being delivered. Though Ultherapy can be uncomfortable for some patients, a recent software upgrade called “Ultherapy Amplify” now affords a more bearable procedure. I like to tell my patients it might hurt, but it works.
Q: I'm seriously considering getting CoolSculpting done on my love handles and stomach. I've read up on it, but can someone explain to me why it only damages the fat cells and nothing else? And also, does it ever come out "lumpy?" I'm worried about long-term side effects. Also, are the results more dramatic or thinner people or those with more weight to remove?
A: CoolSculpting was developed by scientists at Harvard University. This unique, FDA-cleared and patented procedure uses a targeted cooling process that selectively targets and kills the fat cells underneath the skin, literally freezing them to the point of elimination. Only fat cells are frozen, leaving your healthy skin cells intact. The crystalized fat cells gradually die off and then are naturally eliminated from your body. Using a process called Cryolipolysis, it targets ONLY fat cells, which is why the surrounding tissue is not damaged. In the weeks and months following the treatment, the remaining fat cells condense thus reducing the fat layer. CoolSculpting is completely non-surgical, so typically you can return to normal activities immediately. Some patients experience redness, minor bruising, tingling, numbness and /or discomfort in the treated area which can last several weeks, but these are transient and will resolve. Patients typically return to their normal routine after the session is over. Generally, the treatment works best on individuals who have a bit of 'stubborn' fat that is resistant to diet or exercise and is not suited for individuals with a lot of weight to lose.
Q: Which is better for skin tightening - Ulthera or Thermage?
A: One thing to keep in mind is that Ultherapy is the only FDA-approved non-invasive treatment for lifting the skin on the neck, chin and brow. Ultherapy is also the only non-surgical cosmetic procedure that uses focused ultrasound to stimulate the growth of new collagen deep within the skin. I personally prefer Ulthera based on my clinical experience and based on the scientific data. My patients have loved the results achieved with this procedure. At your consultation, a dermatologist can determine which treatment will provide you with the best results
Q: What are the potential risks of Ultherapy? What should one consider before having this treatment?
A: Ultherapy has been cleared by the FDA after demonstrating safety in clinical studies, and over 100,000 treatments have been performed safely worldwide. In addition, ultrasound energy has a proven track record, with use in the field of medicine for more than 50 years. What I tell my patients is: "It hurts, but it works." The heat felt during treatment can be controlled with topical and/or oral anesthesia. As for potential side effects, there may be slight redness for up to an hour or so following the treatment, and a small percentage of patients may have slight swelling, bruising, tingling, tenderness or sensitivity to touch, but these are mild and temporary in nature. My patients have seen tremendous results from Ultherapy to the face, neck, and chest.
Q: Is there anything that can be done to reduce the effect of Botox during the first 7 days or so? I’m unhappy with my results.
A: Unfortunately there is not a lot you can do to reduce the effects of Botox after it’s been injected. In general, I suggest waiting 7-10 days to see the full effect of your Botox. If you are not happy with the results, then I would recommend follow-up with your injector to see if anything can be done to correct your results. Often a touch up can be done if needed. Also, it is important to visit a skilled, board-certified dermatologist who has extensive anatomical knowledge and experience injecting Botox in order to get results that look good, but natural. There are many injectors out there that have done nothing more than take a short course on injecting Botox and they are not properly trained in facial anatomy. I see a lot of bad Botox out there.
Q: Do the effects of Botox wear off sooner in younger patients? How long can someone in their early twenties having it done for the first time expect it to last?
A: Age does not have an effect on the longevity of Botox. The duration of Botox is directly dependent on the dosage (the number of units). If more units are injected, it may last longer, but you should not get more units of Botox just to try to make it last longer. The number of units needed will depend solely on you and the extent of your wrinkles. In most patients, regardless of age, Botox usually lasts for around 3-4 months. However, the more you do Botox, it typically will last longer over time. Also, the results look better and better after repeated treatments because the muscles are not as strong, so therefore the lines are not as deep.
Q: Is it okay to rotate Botox injections? For instance, could I have my forehead injected one month, crow’s feet the next, 11s after that, etc?
A: Yes, it is okay to rotate Botox injections. Although it might mean more trips to your provider's office, there is no harm done in rotating injection sites. Certain areas may last longer than other areas and might not need to be treated every time. I recommend visiting a board-certified dermatologist for an in-person consultation to discuss your options. If your reasoning is financial, Brilliant Distinctions is a great reward program in which you get points for each treatment which in turn generates a coupon. In our office, we take of it all for you.
Q: Can a dentist perform Botox?
A: While technically a dentist or any other licensed practitioner can perform Botox, I would be very wary of visiting any practitioner who does not have extensive training and knowledge of facial anatomy for Botox injections. While it may seem like Botox is just a simple injection that anyone can perform, the truth is that it is both an art and a science that requires skill and finesse. In order to get the best results, your injector needs to know exactly where to place the injections, how many units to give for a natural result and how to avoid potential complications. Eyebrow and eyelid droop, asymmetry, as well as frozen, unnatural expressions can occur as a result of misplaced injections. Instead of going to your dentist, I recommend visiting a board-certified dermatologist who regularly performs Botox injections and can give you a customized treatment plan for your individual concerns. For whatever the ailment or concern, I recommend finding a provider that practices within their area of expertise.
Q: Will Botox make my face shinier? I’m 25 and I don’t have any wrinkles, but I want a smoother, tighter, shinier forehead.
A: While Botox does typically give a smoother forehead by relaxing wrinkles; however, if you do not have wrinkles, Botox may not be the best choice for you. Instead of looking into wrinkle reduction treatments, it sounds as though a good skin care regimen or a resurfacing treatment such as microneedling, laser rejuvenation, or chemical peel may be what you need. I suggest visiting a board-certified dermatologist for a consultation in which you can discuss your specific concerns and come up with a custom treatment plan.
Q: How soon after having Botox can you fly?
A: You can fly directly after having Botox. There is no downtime required after Botox injections, and you can resume all of your everyday activities, including travel, immediately after treatment.
Q: Will Botox help me get more defined cheeks? I want higher and more defined cheekbones without surgery.
A: Rather than Botox, facial fillers can help you to achieve more defined cheekbones. Fillers such as Voluma or Restylane Lyft can be used to add volume and sculpt the cheeks, while Botox is a neuromodulator that works by relaxing muscles that cause wrinkles. I recommend visiting a board-certified dermatologist for an in-person consultation to find the best way to enhance the appearance of your cheeks.
Q: I’m 27 and am concerned about the lines between my eyebrows. Is Botox the best prevention method? How sustainable and safe is it?
A: Botox is generally considered the best way to treat and prevent lines between the brows. It has bee used in medicine for over 25 year and is considered a very safe treatment when done correctly. By relaxing muscles, Botox works not only to soften any lines that you have, but also to help prevent the lines from getting deeper. Make sure you visit a board-certified dermatologist for the best results.
Q: Will lips bruise after Juvederm injections?
A: There is always a possibility of bruising after injectable treatments, especially in the lips, which are a very sensitive area. If you visit a board-certified dermatologist with experience and skill in lip augmentation, your chances of bruising will be decreased, although there is still a possibility that you may bruise. If you do bruise, you can take arnica to try and help resolve bruising quicker. I also recommend to apply liquid facial concealer to the spot bruises and wear a darker colored lipstick until healed.
Q: Is it safe to get a suntan after Juvederm?
A: No,there is no such thing as a “safe tan”!While it is fine to get a spray tan or to use sunless tanning products after having Juvederm injections, I would not recommend getting a tan from a tanning bed or from the sun. Too much exposure to UV light, whether from a tanning bed or from the sun, contributes to premature aging of the skin as well as to an increased risk of getting skin cancer. One of the best ways to keep skin young and healthy is to avoid excessive sun exposure and make sure to wear broad-spectrum sunscreen every day.
Q: Will smoking affect Juvederm in the lips? I smoke a pack a day and am having Juvederm done tomorrow. Is there more of a risk of bruising or bleeding because of smoking?
A: Yes! While your smoking habit should not have any effect on your Juvederm injections overall, it can impair wound healing. I would strongly recommend thinking about trying to quit. Smoking contributes to premature aging and wrinkles, in addition to simply being unhealthy for your body. Furthermore, smokers tend to purse their lips contributing to even more wrinkles.
Q: What is the recovery time from Sculptra?
A: Sculptra has essentially no downtime. You can apply makeup after the treatment and go back to your normal routine. As with any needle injection technique, there is a possibility that you may bruise, which can be covered with makeup. If you do bruise, you can take oral arnica and apply topical arnica cream/gel to help any bruising to heal quicker. Avoiding blood thinning medications such as aspirin products, non-steroidals and/or fish oils before your treatment for 10 days prior to injections (only if approved by your physician) and visiting a board-certified, experienced injector will help lower the risk of bruising overall.
Q: Can I get Sculptra for undereye hollows?
A: I would not recommend using Sculptra to treat undereye hollows. Sculptra has a high risk of nodule formation or undesirable results in that area, and it can’t be reversed easily like HA fillers can. For undereye circles, I would instead recommend a HA filler such as Restylane. Do not let anyone inject Juvederm under the eye area as it will look blue and puffy. The product attracts too much water (hydrophilic) for the thin skin under the eye area.
Q: How many vials of Juvederm are typically used for the upper and lower rims of the lips, to achieve a nice natural look, but with noticeable difference?
A: Because each patient has a different amount of volume loss and desires different results, there isn’t a standard amount of Juvederm that is used for injecting the lips. In my experience, no more than 1 full syringe is enough to give the lips a plump, yet natural appearance.
Q: I recently had Juvederm for cheek enhancement, done in an effort to correct the undereye hollowness and nasolabial folds. Unfortunately, the filler injected in the area under the eye and beside the nose has caused me to not be able to smile properly. I can only smile half as wide and an asymmetrical smile at that (causing a rather tactless nephew to comment that I look like I just had a stroke). I need the filler removed, but can’t seem to find any information. Any advice on how to get rid of it?
A: If the person who initially injected the Juvederm wasn’t a board certified dermatologist, you’ll want to make an appointment with one immediately! Fillers made from hyaluronic acid such as Juvederm can be injected with an enzyme called hyaluronidase which can dissolve the filler. However, this should be done be a professional who is very knowledgeable when it comes to fillers and in particular, how to treat any adverse effects from them.
Q: Can Juvederm be injected in the area surrounding the eyes: crow’s feet lines?
A: The best treatment for dynamic wrinkles (those that occur from movement) such as the crows feet would typically be Botox or Dysport. Juvederm works better when injected into static deeper folds and wrinkles (wrinkles at rest).
Q: I am booked to get Juvederm filler in my lips. My doctor says she will use a topical freezing, then use Juvederm with lidocaine in it. She says that I will see the results of the filler instantly so can adjust as needed. Will my lips look red and swollen after the procedure? If so, for how long? Can I go to work that day or will people wonder what happened to me?
A: As with any injection of a hyaluronic acid based filler such as Juvederm, swelling is a potential side effect. Although it is usually minimal, the degree of the swelling varies with each patient. Your lips may be a bit red and swollen after the procedure, but that should subside within 3-5 days. You should be able to go back to work immediately, but may need to apply concealer to the lips & lipstick over it to conceal any bruises.
Q: I want to get Juvederm injections for the laugh lines around my mouth. Is Juvederm safe? What should I know about the safety of Juvederm?
A: Juvederm is very safe! Not only is it FDA approved, but it is made from hyaluronic acid, which is naturally occurring in the body. Do keep in mind that it’s imperative that you see a board certified dermatologist when you are ready to get the injections.
Q: What’s the secret to minimizing bruises from wrinkle injections like Juvederm or Restylane? Should I apply ice to the area of injection?
A: Keep in mind that every patient reacts differently to receiving filler injections. With that being said, there are some things you can do to try and minimize bruising. 10 days before your appointment, avoid blood thinners such as Advil, Motrin, Asprin, fish oils, some prescription drugs and some herbal supplements. It’s very important that you see a board certified dermatologist who is very skilled at injecting fillers to review your medication list prior to receiving any injections. I recommend apple cider vinegar to the area early in the stages of bruising to get them to heal quicker.Topical Arnica gel and/oral Arnica can also be used to minimize bruising.
Q: How long does it take to see results from Juvederm? I just got some in my nasolabial folds and lips, and I can’t wait to see how it really is going to look.
A: With a filler like Juvederm, you will see immediate results after your treatment. However, most patients may experience some slight swelling which can hide the actual results. This should subside within two weeks, allowing your best results to be appreciated.
Q: My expression and laugh lines bother me. Can Juvederm injections fill these in and still leave me looking natural, not like work was done?
A: Absolutely! But it’s first important that you find a board certified dermatologist who is experienced with cosmetic fillers. Juvederm will give you beautiful, instantaneous results and it produces a natural enhancement that is gentle, safe and effective.
Q: Does Latisse work better than Revitalash? I still have a lot of Revitalash left, and I’m not sure if it’s worth it for me to switch to Latisse.
A: Both products give great results. The main difference is that Latisse is a prescription product and is FDA approved. Revitalash is an over-the-counter cosmeceutical and is therefore not FDA approved.
Q: Can Latisse cause any side effects I should be aware of? If so, what are they and how long do Latisse side effects last?
A: The most common side effects of Latisse are an allergic or irritant reaction that can cause redness, swelling, dryness, and/or itchiness around the eyes. It is important not to get the product in your eyes. As long as you follow the application guidelines, these risks are typically low.
Q: I’m considering getting Radiesse under my eyes to help with the bags. I’ve been reading a lot of reviews that don’t suggest it under the eyes. I’m 27 so my skin should not be too thin. What is your opinion?
A: First, your best move is to make an appointment with a board certified dermatologist. With that being said, Radiesse should not be used to fill the “tear trough” bag hollow under eyes as it can sometimes be visible through the skin. Fillers such as Restylane are best suited for under the eyes instead. Keep in mind, this is a very delicate area and should only be injected by an expert.
Q: How many days of recovery time can I expect with Restylane? Can I have it done in the morning and go to work without anyone really noticing?
A: After receiving Restylane, there is minimal to no downtime. You should be able to apply makeup for coverage and go back to work immediately. While you may have some temporary redness or swelling around the injection site, it should go away within a few hours of your treatment. As with any injection-type treatment, there is the possibility of bruising which can take a while to heal. Bruising can be treated with Arnica (both topical and oral), apple cider vinegar and even laser to speed up the healing time. In my office, it is not uncommon for a patient to return to work immediately after his or her appointment.
Q: I am planning on having Restylane done on the lines that lead from the nose to the jawline. Has anyone had any bad side effects from Restylane or from the anesthetic? What should I expect?
A: Generally, Restylane side effects are very minimal. Some patients may experience slight swelling, redness, bruising or tenderness around the injection site, but these symptoms clear up on their own within a few days. Final results can be appreciated immediately after, but the results tend to look even better about 7 -10 days following the injection.
Q: How long does Restylane last?
A: Depending on where Restylane is injected, it can last between 6 to 12 months. In areas with a lot of movement, such as the lips, it can fade quicker and has an average duration of 6 months. In areas of the face with less muscle movement, such as under the eyes, it can last longer. Studies show a duration even up to 5 years in the glabella (frown area). As with all fillers, the longevity is strongly dependent upon the skill level of the person injecting the product, which is why it is integral to visit a board certified dermatologist.
Q: I like the volume I’ve gained with three sessions of Sculptra but now I’m really scared about the long-term side effects. How long has Sculptra been around and what can be expected? Is it a smart choice? I’ve heard such a mixed review.
A: Sculptra Aesthetic has been FDA approved and on the market for the past 8 years. When injected by a skilled dermatologist, it can give fabulous, natural looking results. It is probably the “safest” of all of the injectables because it is stimulating your own body’s production of collagen. There is nothing artificial or foreign injected. The most common potential side effects can be related to the injection procedure itself and include: redness, bruising, swelling, infection and/or mild discomfort during the injection. A very rare potential delayed side effect that has been reported is the appearance of small bumps under the skin. These Sculptra nodules are small bumps that may or may not be visible and tend to happen several months after treatment. They may go away on their own or need to be treated. They were more common in the past with more concentrated solutions, but are now uncommon with the dilutions that are currently used.
Q: Can you please compare Radiesse and Sculptra?
A: Radiesse and Sculptra are both used to correct volume loss on the face. Sculptra is delayed gratification as it works slowly over time and involves a series of injections to stimulate your own body’s production of collagen whereas Radiesse is a filler that gives immediate results. Sculptra consists of an all natural sugar molecule, poly-L-lactic acid, which helps to stimulate your own collagen production.The effects of Sculptra will increase gradually over time and the duration is typically about two years where as Radiesse, made of hydroxyapatite, is a temporary filler and works immediately. With Radiesse, touchups may be needed at three months and it typically lasts for one year or less. I personally like to use Sculptra because of its longevity in the patient and the natural results that can be achieved.
Q: How is Dysport different from Botox? Is it cheaper? Is it better?
A: Overall Botox and Dysport are very similar. Both are a type of botulinum type used to relax the muscles that cause frown lines and other overactive muscles on the face, like forehead lines and crows feet and the lower face. Dysport is a smaller-sized molecule so its unit of measurement is different than Botox. However, both have been in used in medicine for years and have a high safety profile. Both Dysport and Botox must be injected every 3-6 months to maintain the results.
Q: I’m considering getting Dysport but I want to know what the typical recovery is like. Is a couple of hours enough? Or will there be bruising or swelling that will require a longer downtime?
A: There is no downtime and no “recovery time” is needed after Dysport injections. Usually, there is minimal redness that subsides within 5-10 minutes after the injections. As with any needle injection procedure, there is a slight risk of bruising.
Q: I’ve been researching how long Juvederm lasts, but what people say in Juvederm reviews and what the FDA says don’t really match up. Can someone tell me, how long does Juvederm last? Does where you have the Juvederm injections in your face make a difference in how long it lasts?
A: That’s a great question and one that I get often. The longevity does vary, depending on the injection site. For example, Juvederm typically lasts up to 6 months in the lips/around the mouth and 9-12 months in other areas . However, it is important to remember that the timeframe can vary for each individual.
Q: What is Juvederm Ultra used for? How is this different from other types of Juvederm, like Ultra Plus – do they treat different things?
A: In essence, Juvederm Ultra and Juvederm Plus are both in the same family of all natural hyaluronic acid fillers and are used to treat wrinkles of the face. Juvederm Ultra is a smaller particle size and is used to treat mild to moderate lines and wrinkles whereas Juvederm Plus is a larger particle size and is used to treat deeper folds and wrinkles. At your consultation, a dermatologist can determine which will be best for your unique treatment plan.
Q: I’m thinking of having Juvederm for deep wrinkles between brows. Are there any side effects?
A: When injected correctly, filler between the brow can have fabulous results. However, if injected incorrectly, it can have potentially serious adverse effects. The most important thing to understand when it comes to having your face injected is to go to an experienced physician injector that not only understands how to treat the face, but also can treat the possible side effects. While the most common side effects are mild — redness, swelling and/or bruising at the injection site. In addition, a very small percentage of patients may develop a hypersensitivity reaction resulting in prolonged red, tender or swollen areas. The most serious possible effect is skin necrosis (sloughing) and even very rarely, blindness.For deep wrinkles between the brow, one may also want to consider a combination treatment of a filler and a neuromodulator such as Botox for a synergistic effect to both fill and relax the area for a natural, youthful appearance.