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Answer:
Answer: I might use Perlane for those, I think options such as Radiesse and Artefill are risky there as it is so close to the lips that lumps can occur. All the best. JG 7.28.10
Answer: yes, a little moist heat and a little massage along with time will allow it to go away. Best of luck. JG 7.28.10
Answer: the younger they are the more satisfaction there is with Sculptra as when one is older the Sculptra is not able to create as much collagen due to the advanced age and loss of reparative process. We have a process where surgery is canceled that is different from his. I understand the loss of time and the inablility to put another patient in your place but as long as you eventually have the procedure, I think most surgeons will not charge you a fee like that. As to the hands, I really do not ahve a good filler, lots of peopel use Scultpra but I have not been impressed with the results of any filler in the hands. Thanks for the kind words and I wish you the best. JG 7.27.10
Answer: I suggest waiting at least 48 hours and try not to elevate your blood pressure and minimize the head down position as much as you can until it starts to get better. JG 7.26.10
Answer: ice to minimize the bruising and then alternate warm and cold starting in 24 hours. JG 7.26.10
Answer: Artefill can be used but more likely the better option would be injecting your own fat, it might take more than one session but as the dents are probably from fat loss, your own fat in that area would be a better option. All the best and thanks for the kind words. JG 7.26.10
Answer: yes. it is possible to do that.Icing will help a very small amount I am afraid. Best of luck. JG 7.26.10
Answer: yes, OK to do. JG 7.24.10
Answer: the swelling the next day is more due to the amount of fluid that the Scultprsa is dissolved in and not the maount of Sculptra itself, so you might just have had less fluid injected. JG 7.24.10
Answer: The dissolving of fillers varies from patient to patient and I have many patients that have fillers like Restylane injected and it lasts much longer, especially in areas where there is not alot of motion such as the areas you had treated.Not a bad thing. JG 7.24.10
Answer: yes, they will go down but it will take time I am afraid, maybe a few more weeks. Go to hang in there for a bit, thanks for the kind words and all the best. JG 7.22.10
Answer: I would have thought the Juvederm should have dissolved away on its own by now, and if thehyaluronidase did not work, it might be because the fullness you now have is due to scar tissue and not any residual filler. JG 7.22.10
Answer: just wait until the next day is all. JG 7.21.10
Answer: yes, works well for Rosacea, but it needs a series and then continued sessions to control it. JG 7.20.10
Answer: help red spots and helps to shrink pores short term. Fotofacial, Photofacial and IPL are all the same. Different companies make the similar machines and use different names, they are all intense pulsed light, thereby the name IPL. JG 7.20.10
Answer: it is made of lactic acid, similar to lactose, but everyone makes lactic acid during exercise so I doubt it would be a problem. There are sutures that are made of lactic acid and they have no problems in patients with lactose intolerance. JG 7.18.10
Answer: you can try potassium and magnesium, maybe 1000mg of the magnesium per day and potassium 99mg as potassium gluconate per day. JG 7.16.10
Answer: can be done, not as robust of a filler as it is on the face though. JG 7.16.10
Answer: I do recommend them, start at least 48 hours before and avoid all blood thinning products like aspirin, Motrin, Ibuprofen, Alleve for ten days before. I think icing before the injection helps with the discomfort but not with the bruise prevention. All the best. JG 7.16.10
Answer: might work to some degree. JG 7.16.10
Answer: yes, than can be done, there should not be any significant interference, all the best. JG 7.8.10
Answer: Restylane or Perlane could be used there also. JG 7.7.10
Answer: dissolving might help, the allergic raction is very very rare and would include, a surrounding rash, itching, diffuse swellin past the are of injection and if it is sever enough there will be itching and swelling far away form the injection site. JG 7.4.10
Answer: it will lift the outer part of the eye brow in most patients, the amount of lift varies though. The lift between the eyebrows is less but will work too. Best of luck. JG 7.3.10
Answer: an allergic reaction is uncommon to get better and worse like that from day to day, and a cyst would nto go up on down. It is an unusual thing to say the least. Might want to try avoid sleeping on that side of your face to begin with, and I would certainly tak ethe pills prescribed just in case. Without a discrete mass in one single area that does not go up and down I do not think intralesional steroids or hyaluronidase will work. You might want to contact the company that makes Teosyl and they might have something else to offer. All the best. JG 7.2.10
Answer: there will be a scar where the incision is made, it is no different than removing a cyst or other mass below the surface of the skin, he likely does not want to get involved with something that went bad. The scar should be relatively small, no longer than the size of the lump. Best of luck. JG 6.30.10
Answer: if it is going to work you will start to see that within 6 weeks and that is the point a repeat injection could be done, in terms of negative effects like soft tissue atrophy or loss,and dilated skin blood vessels and skin thinning, that can continue for up to 6 months. JG 6.30.10
Answer: they usually do go away on their own in time, yes JG. 6.30.10
Answer: it will nto last as long as the other fillers out there, sorry. JG 6.28.10
Answer: if it was Juvederm, it shoudl all dissolve in about one year on its own in that area, you can always have more dissolved though with the hyaluronidase too. Best of luck. JG 6.28.10
Answer: yes, could be a small cyst, might need to be drained with a needle by the doctor, all the best. JG 6.28.10
Answer: I let patients return to full activity the next day. I have them avoid putting their head down and most importantly not lay face down for 4 hours. Best of luck. JG 6.28.10
Answer: I would need to know what filler was injected in order to help you. JG 6.28.10
Answer: you have lost about 80% of the amount injected and now your body is helping to create some collagen around the longer term material in the Radiesse. It is hard to convert amount of filler injected to an implant,because their location is different, with the filler being more superficial and a smaler amount giving a larger degree of improvement. Best of luck. JG 6.27.10
Answer: will likely not help. JG 6.27.10
Answer: I normally use Sculptra. JG 6.27.10
Answer: maybe 6 weeks but effects can last 6 months. If it is going to work you should see something in 6 weeks. JG 6.27.10
Answer: should not affect your heart. The issues you describe from the previous injections are due to location of the injection, and not the medication per se. The feeling tired occurs from the brows dropping in some cases and the one brow arching more is because as the motor end plates that were affected by the Botox are slowly replaced the replacement rates are not always even side to side. Usually it is a subtle difference but in some people, if the effect from the Botox was more profound, it can be more evident as it wears off. Best of luck. JG 6.25.10
Answer: if the saline does not work they can dissolve on their own in some cases, but if a true granuloma has formed, then they might need to be cut out, yes. Waiting a few days for the saline injections is oK but the sooner they are injected the greater the chance of them dissolving with the saline. JG 6.25.10
Answer: shoul be Ok ot do the laser 3 days after the injection, minimal to no effect on the filler. JG 6.25.10
Answer: I think if it is still there your only option is to try to dissolve it once more, all the best. JG 6.24.10
Answer: I think Sculptra is much better and unfortunately I have not been able to use the Restylane Sub Q personally yet as it is not legal in the US but would use it if I could. I think seeing a different PS, at last for a second opinion, is a worthwhile thing. I think offering only one type of filler limits you on what could be in the patient`s best interest. Not all fillers are good for all patients. All the best. JG 6.22.10
Answer: it varies, we have been using it there for a few years and in general the results are quite good, but it takes a lot of experience and the learning curve is steep. JG 6.22.10
Answer: no, it is just a bruise that is slowly breaking down and being absorbed, should not be permanent. A deeper injection might leave a less visible bruise, but if it is large enough, you will eventually see it too. The depth the filler is injected depends on what you are injecting and for what you are injecting for. I rarely feel that injecting on the bone is needed or yields a good result. It is best to inject in the same layer as the material you are trying to replace. Best of luck. JG 6.22.10
Answer: It is always a good idea to let all the material be gone beofre starting over to have a clean slate to build upon. Having said that, I think the green and purple patches were from bleeding and not the material being injected too superficially.Bleeding is a risk with all fillers, even if injected deeper as the needle still has to go through the skin and can injure a blod vessel and cause it. I fear that injecting Juvederm deepely, where it is not meant to be injected, will last a very short period of time. Best of luck. JG 6.21.10
Answer: doubtful there is any relation to the old Dermalive or interaction to the Teosyl, just due to the removal there is more scar tissue there and scar tissue bleeds more easily than normal non-scarred tissue. Hang in there for a bit, it will get better. JG 6.10.10
Answer: could be an infection but more likely it is some blood from the injection that is deep and your body is trying to break it down. I think the antibiotics and anti-inflammatories are fine, along with alternating warm and cold packs too. Best of luck. JG 6.10.10
Answer: I cannot say without knowing the amount of units that were injected, typically for the glabella where the lines that form an 11 are, it takes at least 20 units, I use 30 units there. The number of needle sticks is immaterial because it depends on what amount is injected. The end results depend on where it is injected and the dose injected.JG 6.10.10
Answer: warm moist heat, can also apply Arnica gel topically, it is too late for the Vitamin K, that helps the bruise from happening, but it already has. I think you have a bruise and not a Tindall effect. Hang in there. JG 6.10.10
Answer: because Pearlane is meant for a deeper injection and the skin in the tear trough is too thin and Perlane might leave lumps. I agree that Botox can lift he brows but the injection site does not vary, I know thati s what you believe and what you have seen but as a plastic surgeon that has seen the actual muslces that are injected thousands of times during surgery and in view that the Botox migrates after injection as it disperses, there is no need to frown. You are free to believe what you want, but it is not needed. If you understand the function of Botox, you woudl understand that injecting the muslces that depress the brow and leave the muscles that elevate the brow unjected, it is common and expected that the area not injected will rise and will also show wrinkles where the unopposed muscle is continuing to work. Where the Dr focuses depends on what is being attemtpted to be acheived. Whether the injection works depends not only on location but on the dose of medicine injected. If the correct place is injectd with too low of a dose, it will not work and I think that is likely what happened in your case. 6.10.10
Answer: you are certainly free to hold your opinion but I respectfully disagree as to the Botox and needing to frown. As it is a chemodernervation agent and not a filler, the location of the wrinkle is absolutely inconsequential, as the muscles are in the same place in all patients and the Botox has to diffuse. For fillers I agree it is nice to see the wrinkle to see where you need to inject. As to the tear trough, the only filler I use is Restylane. As to the nasolabil fold I use Restylane and on rare occasiosn Perlane. I would never use Perlane for the tear trough. All the best. JG 6.9.10
Answer: I do not think it is necessary to flex the muscles to know where to inject the Botox. As to what effect the Botox is having in terms of where it was injected, you got exactly what is expected, the inability to raise the eyebrows as the forehead muscles have been weakened. Having said that, not all patients are good candidates for fillers, they do not give everyone the desired look and you might just not be a good candidate for fillers I am afraid. It seems you have tried multiple fillers and multiple doctors to no avail, might need to accept things as they are and await until things get bad enough to warrant surgery. JG 6.9.10
Answer: Tindall is blue and will not fade whereas the bruise will turn green yellow and fade over time. JG 6.9.10
Answer: I think so, yes, the implant would not have that risk, but it would have other risks. I know you have read about necrosis and the angular artery but it is almost unheard of when comapred to the many injections with no problems. Bad occurances get magnified because people like to hear and write about disasters, normal outcomes do not get reported on as much. JG 6.9.10
Answer: less of a risk, but I think in general, the risks are small, even in inexperienced hands. When you compare the number of injections performed versus the reported adverse events, the numbers are incredibly small. JG 6.8.10
Answer: I am sorry, btu there is no way to tell because it depends over what size area and vertical height it is injected, you are asking for an answer that is impossible to calcualte. JG 6.8.10
Answer: there is no such thing as a safe dose I am afraid, atrophy can happen at any dose, but the risks increases the greater the amount of kenalog injected. If there is going to be Kenalog in it, it should not be done more than every 6 weeks, if it is 5FU alone, it can likely be re-injected every two weeks. JG 6.7.10
Answer: impossible to tell what smaller procedure you would need until the filler has been injected and we see what effect and where it has made a difference. It might just be a smaller type of facelift with less lifting and less skin excised. Injecting fillers when not needed can make you face look distorted and unnatural, more is not always better though. JG 6.6.10
Answer: it is technically possible for it to happen, but the skin stretches quite a bit so it would be hard to get it to happen. I think that is quite a bit to have injected, why not start with 2 cc and then wait a wek or two before getting more. All the best. JG 6.6.10
Answer: you might be able to either avoid the facial surgery entirely or opt for a smaller procedure. All the best. JG 6.6.10
Answer: subQ, no problem with the questions. JG 6.6.10
Answer: nope. JG 6.6.10
Answer: seems that he uses the same picture a number of times and I agree, they are not the greatest. You can consider finding someone else, or at least have him do it in small amounts over a series of treatments. Best of luck. JG 6.5.10
Answer: again, there is no increase risk of necrosis with Voluma than other fillers, and it likely needs ot be injected into the check to correct fat loss allowing the nasolabial fold to be more visible, and not directly into the nasolabial fold so the risk of necrosis shoudl be essentially nonexistent. Best of luck. JG 6.4.10
Answer: depends on what you are having injected, hard to believe a 28 yo has volume loss though unless you lost a large amount of weight. Unnatural appearance from a filler is likely more due to injection technique than the filler. JG 6.4.10
Answer: any filler, if injected into an artery, which is extremely rare in experienced hands, can cause necrosis by blocking the blood supply to the skin. I likely would not use Voluma in that area as it is meant for much deeper injection where fat has been lost, I would use the regular Restylane or Perlane for the nasolabial folds. All hyaluronic acids fillers are not interchangeable, just because they last longer does nto make them able to be used in the same way and in the same layer of skin just because you want it to last longer. JG 6.3.10
Answer: in some areas, it might be warranted, but it does not have the versatility that Restylane has and Botox is not a filler, but a neurotoxin so its effects on wrinkles are secondary and not primary. JG 6.3.10
Answer: in most cases it should be gone on 6 weeks, rare for it to last longer than that unless something is causing it to reaccumulate, like a tearing of the tissues. JG 6.3.10
Answer: the noise if from fluid around it. Solid materal like collagen or PMMA do not make noises. JG 6.3.10
Answer: yes, most commonly it is a hyaluronic acid product. Thank you for the very kind words, and I am glad I have helped. JG 6.3.10
Answer: I would use Sculptra for cheek augmetnation, and I inject deeply with that, at the deep surface of the skin. The Tyndall effect is when it is really superficial, and there is usually enough tissue on the cheek to avoid that. As to the under the eyes, I use Restylane there and I inject under the muscle. Could use Voluma for the cheeks in the UK.All the best. JG 6.2.10
Answer: I think the result of fillers in the brow can lift the brow and therefore make the eyelid look like it has less excess skin, especially in patients that have the skin in excess due to fat atrophy from aging in the periorbital area. I have heard of it, seen it, and performed it. JG 6.1.10
Answer: it can be normal in a small number of patients, bruising is always a risk, especially in that area as there are lots of small blood vessels and not alot of thick tissue to hide the bruise with. I think it might take a few more weeks, massage and warm packs will likely still help, although it is mostly a matter of time. All the best. JG 6.1.10
Answer: I would use Voluma. JG 6.1.10
Answer: In most cases I have seen the material dries up and is very hard to inject after it is stored. I am unsure as to the stability after mixing it with local anesthetic and I do not think that has been tested by the company. The Botox shoudl be injected within 4 hours and the bottle should not be shared between patients for fear of transmiting hepatitis, the bottle specifically says single patient use and using the bottle among multiple patients is illegal. If injected with Botox that is older than 4 hours of being mixed is something that might just show less effective length of time, so it just will not last as long. JG 5.26.10
Answer: 6-8 weeks. Thank for the kind words too. JG 5.26.10
Answer: no fillers that will do that in a scar and as to how long the Radiesse will last will depend entirely on how deep they injected it, my guess is nto too long. Subcision will help some on its own, yes, but only mild. It is done under local anesthesia and should not hurt.The ice pick scars can be cut out and stitched closed. JG 5.25.10
Answer: I am sorry, I must have misread what you wrote as I thought you said he injected into the deepr dermis, if I was incorrect, I apologize. A deep dermal injection, where the dermis essentially meets the subcutaneous fat is OK, anythimg more superifical than that I would not do, no matter how much experience. Actually collagen is produced in the deep dermis, by the time the skin cells get to the more superficial dermis they have lost their ability to create collagen as they are too far from the basal layer.If that is what he said, then I disagree with his statement. If injected into the subcutaneous tissue it can indeed create collagen, but as the subcutnaeous tissue is quite giving, the new collagen that can be formed does not have much localized shape that can replace lost bulk. I typically inject right at the border between the dermis and subQ, many times penetrating into the deep dermis, but it is practically impossible to inject into the deep dermis and only the deep dermis with a filler using that amount of fluid, the dermis will not stretch enough to take it all in. Injecting Sculptra into the muscle is also inefficient. Hope that clears it up some. JG 5.24.10
Answer: I think subcision needs to be done and then I might suggest Radiesse. I think long term fillers can have long term complications though, so although desirable, not always a good idea. JG 5.24.10
Answer: I do not use silicone as it is illegal here in Nevada and in many other states to use for cosmetic reasons, as to having an IPL after silicone injections, as long as they are deep, the IPL should not cause a problem, but if the silicone is too superficial it could cause a burn. JG 5.24.10
Answer: saline will last a few hours and I feel that since fat needs to be injected with larger needles, that the control and fine detail is gone with that technique. I think the fillers that dissolve need frequent injections but they are what I would suggest you stick with. JG 5.24.10
Answer: I think fat is more unpredictable than fillers, my preference is Sculptra as it creates collagen and therefore works to re-establish more tissue where the other fillers just hide the loss. JG 5.24.10
Answer: A deep dermal or immediately below the dermis is acceptable. Properly diluted and injected with the proper technique should lead to good results and low risk of lumps. I think you are likely OK to proceed and I wish you the best. JG 5.24.10
Answer: I would wait at least 2-4 weeks after the hyaluronidase to let any swelling go down and be better able to evaluate where the new product needs to be injected.I think Voluma is fine, I wish we could use it here in the US. It is injected deep so lumps should be a low risk in experienced injectors. Between Voluma and Ultra, for facial fat loss I suggest Voluma, no question about it. JG 5.24.10
Answer: if the difference was not there right from the begining it is likely some blood collection that most likely will go away with time, massage and moist heat, I think you should see your injector so they can examine you and see what is happening. JG 5.23.10
Answer: If I can help, I will certainly try, but without seeing you first I cannot say what I can do and I most likely cannnot do it during the first consultation either. JG 5.23.10
Answer: very unusual, if the filler had been injected above the fold to cause that, it should have dissolved by now. I guess you could try the dissolving, little risk, not sure how much it will do as the filler really should be gone by now, if it was real Juvederm. JG 5.23.10
Answer: could be from a too superficial injection, yes, or some slight bruising. Neither one of those fillers are meant to be injected below muscle though, they will not last long time periods if that is done. For cheek augmentation is is placed deeply, right on top of the muscle and I use Sculptra and not Restylane or Perlane for facial fat loss of the cheek. For the rim of bone below the eye I use Restylane and I inject a little below and a little above the muscle of the eyelid. All the best. JG 5.21.10
Answer: at your age,if injected like the Restylane you are using now, it might get lumpy as it needs to be injected much deeper than regular Restylane. JG 5.20.10
Answer: hard for me to say but the amount of lift one gets with fillers like Sculptra will likely not be to the same degree as you see when pulling on your skin in an upward direction. It sounds like what you need is surgery, if you are willing. JG 5.19.10
Answer: Kenalog can casue atrophy with one shot, I think the saline just disperses the material over a larger area and does not cause it to dissolve, and running has no effect at all. Massaging will help the collagen carrier gel to possibly dissolve or disperse faster. The carrier gel is usually gone in 6-8 weeks so maybe just giving it some more time will allow it to look better. JG 5.19.10
Answer: I do not think the hyaluronidase will cause any internal damage to your pre existing nasal structures or tissues. I would likely use it if needed to dissolve a filler if I thought that was the problem. JG 5.19.10
Answer: If 2 cc`s cannot correct the problem, then you are not a candidate for fillers and need surgery I am afraid. Not all folds can be corrected with fillers. JG 5.19.10
Answer: might take 3-7 days until it feels better, a little less before it looks better. JG 5.18.10
Answer: the dents can still happen, I cannot say 100% whether you could eventually get the desired results. JG 5.18.10
Answer: I see no way how Kenalog will dissolve the Artefill, personally. I agree with you that the negative potential side effects far and above outweigh any positive from the injection. I only inject Kenalog into a scar, and then it is mixed with 5FU too, never Kenalog alone. JG 5.17.10
Answer: I have not seen dents occur from hyaluronidase injections. JG 5.17.10
Answer: I have had occassion to cut it out, yes. JG 5.17.10
Answer: I have not heard that myself but will look into it. JG 5.13.10
Answer: do not think massage will make it worse, no. I think after the first couple of months that massage will not do much to flatten the granules I am afraid. JG 5.13.10
Answer: if you have access to all of those I would suggest Restylane Sub Q and it will be an immediate fill, second choice would be Sculptra but it takes a few months to build up, I personally would not use Radiesse for filling in fat loss in the cheeks. Best of luck. JG 5.13.10
Answer: the laser will likely help with the elements left over from the bruising but will not do anything for the lumps. If they are still there they will likely need to be injected with hyaluronidase to remove them. JG 5.13.10
Answer: the scar would be over the lump, should be relatively small, should not leave an indentation. The small granules are not able to be felt until they congeal into a larger lump that is easier to remove. Might suggest Dr Stacy Folk in Denver. Best of luck. JG 5.11.10
Answer: it is not the filler, it is how much they inject and where they place it. JG 5.10.10
Answer: we do not have Voluma here in the US but that would be a good option. I am likewise surprised at how small of an amount they injected, no way that small amount would have helped. I think the Voluma is worth a try first, yes. Best of luck and you are in good hands with Mulholland.All the best. JG 5.10.10
Answer: if it does not flatten on its own, it might need to be cut out, there are no injections that will dissolve the granules. JG 5.9.10
Answer: the collagn,n the granules will be there for a long period of time I am afraid. There is no injection that will dissolve it I am afraid, if it does not flatten on its own it might need to be surgically cut out. JG 5.9.10
Answer: the younger one is and the less fat atrophy they have the less Sculptra one will need so it can be possible. As long as they have experience with the filler around the eye it is OK, I do it all the time. JG 5.9.10
Answer: well the filler that carries the long standing granules will dissipate over 6-8 weeks and massage will help that too. Hang in there. JG 5.9.10
Answer: not much difference. JG 5.7.10
Answer: My choice for fat loss in teh face is Sculptra, that is much longer lasting than the hyaluronic acid fillers I feel. Best of luck and thanks for the kind words. JG 5.7.10
Answer: I personally feel Juvederm is very short lasting as a cheek filler and to believe or suggest, as the doctor did, that the filler will draw the fluid out of the malar bag is ridiculous, absurd and an out an out lie in order to get you to spend money on something that will not work. I strongly suggest you go to a new more ethical place. Best of luck. JG 5.7.10
Answer: a little of both. Hang in there. JG 5.7.10
Answer: it is infrequent, peopel that have Sculptra and have no problems do not post I am afraid. The Sculptra does not migrate very easily, so as long as it is not injected in that area, it shoudl be fine. JG 5.6.10
Answer: sorry, but theer is no way to get it to dissolve only the lump. JG 5.6.10
Answer: likely the most reliable thing will be to wait a full year after the injury, allowing the scar to contract and then have it electively surgically cut out and reclosed with appropriate plastic surgery techniques in multiple layers, bringing the surrounding tissue in to fill in the depression. All else will be less effective. All the best. JG 5.5.10
Answer: well, I have not seen the autopsy report either, the pulmonary embolism can happen due to the position the patient was in, just from her only blood not flowing. This is especially a higher risk in paients on oral contraceptives and those that smoke. Injections into a vein can be missed at times and any filler, PMMA, silicone, or any other filler, if injected in a large enough amount into a vein can migrate to the lungs and have the same exact effect as a pulmonary embolism. Fat injection have also been found to potentially cause embolisms that can result in the same problem. JG 5.5.10
Answer: I have to say that is wishful thinking. I do not think the Fraxel will give you much improvement to speak of once the swelling has gone. The Fraxel also will not softten the scar tissue, that will happen with time even without the laser. JG 5.5.10
Answer: I have never seen it last more than one year personally, you could consider having hyaluronidase injections to dissolve it. JG 5.5.10
Answer: the blood will, with time, dissolve, it cannot get trapped. JG 5.4.10
Answer: it will spread a little, yes. The fluid itself can cause swellling when injected. JG 5.4.10
Answer: I just think that it takes an enormous amount of material to be injected to get a long lasting effect, it is intended for more superficial use and when injected deeper it is not as efffective. Radiesse for nasolabial folds is OK but not for volume loss. Best of luck. JG 5.4.10
Answer: there are silicone implants that fit into that area, called the peripiriform area that might help, it is an implant that goes underneath the base of the nose to both sides but it can be trimmed, that will be your best bet. Otherwise using hydroxyappatite mixed with your own blood can help, it is a material used by oral/maxillofacial surgeons. Best of luck.JG 4.24.10
Answer: Artefil will get a little collagen production but most of its effect is by the PMMA it has, that is why it is not approved nor shoudd be used for tissue loss.Best of luck. JG 4.24.10
Answer: or a silicone implant made for that,need to see a surgeon to se what can be done for it besides fillers. As to the other fillers, likely Artefill would be best. All the best to you. JG 4.23.10
Answer: 3-6 for the Restylane and in that area Sculpra does not work as well as it does in the cheek as it needs to be injected into tissue with good blood supply for it to create the new collagen. JG 4.23.10
Answer: probabaly not too effective and if it were would take a few vials on each side, and also when filling in tissue loss, it takes very large amounts of filler, not the usual one or one and a half syringe like when injecting into the folds or lip lines, it takes lots of volume.In severe cases it can takes 3-6 syringes to fill in each cheek on someone with a significant amount of wasting or tissue loss. JG 4.23.10
Answer: if that is the case it might continue until all the Restylane that is in direct contact or communication with the puncture site has all come out. It is a very rare occurrance. Best of luck. JG 4.23.10
Answer: Artefil counts on your body encasing the permanent PMMA particles in collagen and the Sculptra works by getting the collagne to form around the dissolvabel L-poly-lactic acid material, there is no way to compare which one creates more. JG 4.22.10
Answer: I think the ability to shape them is exaggerated, they are not as maleable as they promote and there are no safe fillers that have that same ability either. JG 4.21.10
Answer: fillers will not displace facial fat to any visible degree. Fillers are not that mobile after being injected where you can displace them to any appreciable degree I am afraid, more likely swelling was caused making it look like that. Sounds more like you are losing facial fat, could be genetics, stress, weight loss, aerobic impact activities, lots of variables. JG 4.21.10
Answer: I think that will be fine, as to the ice, we suggest 3-4 times per day after the injections for 5 minutes each time for a couple of days. The ice before is just immediately before for a few minutes while waiting for the injection. Best of luck. JG 4.21.10
Answer: well avoiding OTC blood thinning products like aspirin and Motrin, along with the use of Arnica for 2 days before and a few days after, ice before and after might also help, but there is nothing that will avoid it 100%. JG 4.21.10
Answer: I always have a nurse in the room with me, I am never alone in an examing room with a patient.Being alone saves the doctor money though. JG 4.21.10
Answer: I cannot say that it an absolute, and if it were in fact true, it would not be so in all darker skinned individuals as the issue with thicker scar tissue is due to many factors along with race. I personally feel the potential for lumps is higher with Artefill. JG 4.21.10
Answer: I know of many doctors that store it for up to one year using sterile technique. JG 4.21.10
Answer: as long as it is stored in a sterile fashion, it can be used for the same patient, many doctors do that. JG 4.20.10
Answer: the issues are lumps and not lasting from the Radiesse, and not lasting with the Sculptra. I think it is not the motion as much as there is not enougth tissue there to incite a reaction to create newer collagen and cause the filling in to occur. For the first few weeks, and especially right after, they look great, but it is how they look at 3 months and after that counts and that is when the disappointment is seen. I think Sculptra is the better choice between the two. Best of luck. Julio Garcia MD 4.19.10
Answer: I think when you start injecting large volumes of any product like Artefill or Precise, the risks of lumps goes up. When injected in smalll amoutns over a large area the risks are much less. I would not use Artefill for fat loss myself. Julio Garcia MD 4.19.10
Answer: yes to both and unimpressed with both to be honest. I do not use it there anymore. JG 4.18.10
Answer: 2-3 months at most. JG 4.17.10
Answer: it can work well, around the lips it might last 2-4 monts and about the same in the marionette lines, but it varies from patient to patient. Prices are prety much the same. All the best. JG 4.17.10
Answer: I would not use it myself on a patient. JG 4.16.10
Answer: no science I am afraid, more likely is when one problem is fixed your eyes gravitate to a new area. JG 4.16.10
Answer: I think the evidence for increased bleeding is small, but taking a few days off before and after might help and certainly will have no adverse health effects for a short period of time. JG 4.15.10
Answer: Restyalne and Juvederm have a natural hyaluronic acid component where Radiesse has a collagen gel in which are floated small pieces of essentially artificial bone. They should not be used interchangeably, it is not just a matter of using what lasts longer, they should be used in different areas and for differnt problems. Lifting weights has no affect on the fillers but running can do to repeat impact, but people that are aggressive athletes tend to lose facial fat more quickly and their tissues fall more quickly so fillers are needed more often. The downtime is essentially the same for all, a few days of swelling and maybe some bruising. I suggest seeing a plastic surgeon or a dermatologist for your fillers rather than a less experienced injector that will sell you something without taking other issues into account. I wish you the best. JG 4.12.10
Answer: I prefer to see patients go to a plastic surgeon or dermatologist. All the best. JG 4.12.10
Answer: I would still use the Restylane SubQ, I think the advances in fat injections are over estimated by those claiming they get them. JG 4.11.10
Answer: I am sorry but there is nothing you can do except waiting to allow it to wear off. Some improvements should start in a few weeks so it will not look like that for too many months. Ice and keeping your head elevated might help with the swelling in the meantime. As to being recommended by Allergan, all that means is that they purchase the products from them and have atteneded training seminars. The presence on the Allergan website does nto necessarilly mean that she is any better than others. I wish you the best. JG 4.10.10
Answer: I usually use them in combination, it is more irritating, yes, but more efective also. JG 4.9.10
Answer: yes, it will work, if it was only in the epidermis,which does not happen in PHI, all you would need is a single microdermabrasion and it would be gone. The thin skin will respond to the bleaching creams as well as other areas, but that skin can become more irritated from the cream too. JG 4.9.10
Answer: no devices that help, and back when we sold our DMAE cream, we had DMAE and lipoic acid in it, it works if the concentrationa are high enough. JG 4.8.10
Answer: Voluma and SubQ are meant for deeper injections not for lines. Although I guess it is possible to have fat loss in a young patient causing the nasolabial fold to be visible, but in younger patients it is usually due ot a skin issue and not a fat loss issue. Look at a newborn babay, they have no fat loss and they have nasolabial folds Using a longer lasting product if the others did not help will not make it work. You likely need to have a different injection technique used for the fold. For a nasolabial fold to be seen secondary to fat loss, then the area that needs injecting is the cheek and not the fold so it cna lift what has fallen. All the best. JG 4.3.10
Answer: I prefer the Restylane family of products. JG 4.3.10
Answer: if it is brown PIH the Lustra should help, worth a try. Best of luck. JG 4.2.10
Answer: the amount of fill appearance is not from the type of filler, it is the amount of filler injected. JG 4.2.10
Answer: I never use Botox around the mouth and as the to the cheeks, it would have taken a large amount of Botox to have that effect, so not quite sure what has caused that except lots of swelling. You can have some Botox injected into the lateral brow forehead region though and that will drop the lateral elevation of the eyebrow that is giving you the Vulcan appearance. All the best. JG 4.1.10
Answer: it is the method used to diminish those lines and a droopy eyelid is possible but rare. JG 3.31.10
Answer: usually 7-10 days.JG 3.30.10
Answer: I would not inject Sculptra around the eye. Not all scenarios can be remedied with fillers and some issues can never be made better no matter what is done I am afraid. I am not a fan of the Titan and without seeing you in person I am afraid I cannot say what it would take to make it look better. JG 3.30.10
Answer: Botox is not a filler, it is a muscle weakening agent. Botox or Dysport both weaken muslces so if you use a filler, like Restylane or Perlane, the lines should be better with no frozen appearance. JG 3.29.10
Answer: it is caused by the cheek tissue falling from the aging process and I typically use Restylane or Perlane for that. The fillers should help, yes. JG 3.29.10
Answer: I will be honest with you, I see no way that a chemoparalyitc agent Like Dysport ot Botox could cause that. Muscle weakness, no matter how profound, would not allow the eye to fall deeper into the socket as you describe, there is something else going on and I think it is a mere coincidence that it has occured after the Dysport. I think your doctor needs to look for some other cause. I wish you the best. JG 3.29.10
Answer: I use Restylane for that area. JG 3.29.10
Answer: the red spot will go and the Botox might take 10 days to kick in. The swelling from the Juvederm is also not uncommonly uneven and does balance out as the post injection swelling gets better, go to hang in there. JG 3.28.10
Answer: I have patient permission to show pictures in my office to individual people but not to post on the internet, not many people agree to that when faces are involved. Sorry. Also, unlike many other surgeries, the results from Sculptra are much more variable in degree from patient to patient along with the amounts injected, time internal, etc. It is hard to show a picture and have it be representative of what another individual could achieve with the exact same procedure. JG 3.26.10
Answer: the initial fluid is usually absorbed in 4-7 days in most instances. At that point it is very typical for the appearance to be just like before the injections. The begining of the new collagen formation starts right after the injections but usually does not become visually perceptible for 6 weeks and continues from there for 4-6 months. It is not inflammation but new collagen that forms. The aging process is never stopped so any new collagen that is created will dissolve with time, the speed of that depends on your own personal genetics and speed of aging. Going back to the pre-injection appearance can take 1-2 years, the older one is the quicker the collagen loss occurs and the less dramatic the foramtion of the new collagen is. Hope that helps. JG 3.26.10
Answer: I have not found that to make any difference. JG 3.25.10
Answer: might take a few more weeks, most of the swelling is from the dental work and not the filler though. Give it some time. JG 3.22.10
Answer: I think lighter (pun also inteneded) lasers like a YAG might help but it would be a series of them done every 4-6 weeks, anything stronger has the potential of making it worse. Fillers are safe though. All the best. JG 3.22.10
Answer: it is for fine lines and texture, it does not irritate the skin or sensistize it to the sun like Retin-A does. JG 3.22.10
Answer: no known effect. JG 3.22.10
Answer: well, I think the doctor was overpromising what the fillers could do is the issue. I use Restylane for the periorbital area and Sculptra to plump the cheeks.Best of luck. JG 3.22.10
Answer: I use Sculptra for replensihing the loss of fat in the face and I use Artefill only for its approved use in the nasolabial fold area, and that is really rare, as I use mostly Restylane in that area. I do not find Sculptra and Artefill are interchangeable, they are to be used in different areas for different things. I am so glad the cream is helping and I wish you the best. JG 3.22.10
Answer: I am sorry but in most cases the material cannot be squeezed out, if it does not dissolves on its own it might need to be cut out. JG 3.22.10
Answer: I always suggest using something like Restylane as it is easier to remove if you do not like it. JG 3.20.10
Answer: save your money. JG 3.15.10
Answer: yes, it is and we are using it. JG 3.15.10
Answer: I suggest you see the doctor that injected it. Any hyaluronic acid filler injected to close to the surface can cause it. JG 3.15.10
Answer: most likely some of the Perlane that was injected into the area. Perlane is not indicated for lip injections, it is meant to be used for deeper injections on the face. Might need to have it cut out or a needle hole made and the material attemtpted to be squeezed out. Best of luck. JG 3.14.10
Answer: if it is bothering you I think going in earlier is a good idea. JG 3.14.10
Answer: I have heard of it being used,never seen anyone`s results with it, if it gets into your eye the same problems can arise. JG 3.12.10
Answer: I have not heard of any problems with it. JG 3.12.10
Answer: I use Restylane for the milder ones and for deep ones I use Perlane, I have not found there to be much difference between Radiesse, Restylane or Juvederm in terms of how long they last. In that area it might be 2-6 months, the more you move, and the older one is the less time it lasts. JG 3.10.10
Answer: no, OK to use both. JG 3.10.10
Answer: well, typically you cannot equate one syringe of one product with one syringe of another, so to get the effect of filling one gets with vial Sculptra will usually take more than one or two syringes of Perlane.JG 3.8.10
Answer: OK to do, just that as the one filler dissolves the cheek will not look as full. JG 3.7.10
Answer: should not happen again and should not have happened the last time either. JG 3.7.10
Answer: nothing topcial sorry, I think a filler is worth a try though. JG 3.7.10
Answer: it has to be injected directly into the mass of the filler, so if they are close but no exactly into it, it will not be as effective. JG 3.7.10
Answer: might fade on its own but it is OK to use the hyrdoquinone at this point, and don`t forget the sunblock. JG 3.6.10
Answer: you are good to go, no problems like that should occur, all the best. JG 3.6.10
Answer: best of luck. JG 3.5.10
Answer: the tone of your muscles is not high, what you have is some loss of tissue below the skin and that makes the muscle more visible and when the muscle flexes, it folds the skin and creates localized damage in the valley of the fold, so it is seen at rest. I don`t think induced muslce atrophy, as hard as it is to acheive, is worth it. JG 3.5.10
Answer: if there are no lines at rest when the muscles are not moving I would not use a filler, otherwise if you fill in the area that is depressed upon animation, it might look lumpy when you stop animating. JG 3.5.10
Answer: I have seen it stay swollen for up to two weeks in some patients. Ice and a little massage should help. All the best. JG 3.4.10
Answer: the same swelling and bruising can occur, yes. JG 3.3.10
Answer: if it was true Evolence it should have dissolved long ago. JG 3.1.10
Answer: the formula utilizes multiple sizes of highly reflective micronized particles of titanium dioxide, zinc oxide, and iron oxide. JG 3.1.10
Answer: we no longer inject collagen, it is no longer commonly available as the newer materials are better. The wavy effect is technique dependent, not material injected. JG 2.28.10
Answer: not sure what type of anestheisa they used, but I do not think it is permanent,might take a while though for it to resolve. Hang in there for a bit more. Some doctors mix the Sculptra with some local anesthesia and it can cause that effect, even in cases where the local anesthetic shoudl have worn off long ago.Hang in ther for a bit JG 2.28.10
Answer: it is the bacteria in the nose that caused the problem, not the filler, it can be used again if you desire. All the best. JG 2.28.10
Answer: they might, it is relatively easy to dissolve them or make a small puncture wound and squeeze the material out in many cases. It is not common to use fillers to the upper lids as the skin is very thin and lumps show easily. I do not think there is any risk of blindness from what you are describing. Dissolving the filler is less difficu.t than injecting the first time> Best of luck. JG 2.28.10
Answer: I do not see how a filler would cause a complication. I have never seen that occur, assuminhg one is using normal legal fillers. With the legal fillers the worst that could happen is you might see a small lump or collection of the filler and it will just dissolve on its own in a faster or shorter time span. JG 2.27.10
Answer: it will do what it is going to do in 24 hours or so. No need to massage it, might need more than one session in some cases, all the best. JG 2.26.10
Answer: I think it is a scam. I have seen no evidence in any peer reviewed medical journal that proves that those mlecules can be absorbed through the skin. Think of it this way, carrier or not, if hyaluronic acid can pass through into the skin, it could then pass out of the skin too, thereby losing your own hyaluronic acid. There are lots of people that are trying to capitalize on the hyaluronic acid filler craze by applying it to the surface to avoid injection, the non-sterile HA is cheap and can be put into a cream easily, but that does not mean that the hyaluronic aicd is ansorbed. JG 2.25.10
Answer: they might have hit a deep vein and the bruise has not come to the surface yet, I certainly would just ice and massage it for now and would not consider any dissolving for at least 10 days after the injection. The hyaluronidase does not caue swelling but since it is put in with a nededle, it can also cause a bruise like the initial injection. The dents are rare. Give it some more time though. JG 2.25.10
Answer: IPL, should not make it worse. JG 2.25.10
Answer: in some people and in some areas yes, but not for ab all people. I think it lasts abou 10-15% longer than Restylane, but you need to understand that when used properly, they are not to be used interchangably. By that I mean that Restylane is used for more superficial injections and Perlane should not be used like that. If Perlane is injected superficially it can cause more lumps. Perlane is meant for deeper injections only. In short, if you get Restylane injected into superficial areas as intended and you want to have it last longer, using Perlane is not the answer. JG 2.25.10
Answer: I see no problem mixing it but I am not sure why that was done, I see no advantage to mixing them unless he needed to inject some very superficially and used Restylane there. JG 2.25.10
Answer: harder than applying face cream, but not too much harder, maybe 3-4 times per day. JG 2.24.10
Answer: it will help some, but the distance moved is not great, it will flatten it more than move it laterally, which in your case is OK, all the best. JG 2.24.10
Answer: I cannot see how a topical hyaluronic acid will penetrate the skin and I am not a fan of the Thermage products, sorry. All the best. JG 2.24.10
Answer: safe to use there. JG 2.23.10
Answer: fillers and lasers can help that, along with Retin-a type creams. JG 2.21.10
Answer: recent studies show that there is no effect to fillers from lasers such as the VBeam. You can receive a VBeam prior to the injection, swelling can be present though as you say. It is my preference to do them a few days apart, not ideal for a person`s schedule, but it can lead to better overall results. If you want to limit the trips I suggest the filler to be done first and then immediately follow it with the VBeam. JG 2.20.10
Answer: sounds like a nasty bruise but warm moist heat and Arnica will help. It is stil early enough the lump can be massaged and smoothed out. Likely no further injection needs to be done. JG 2.20.10
Answer: likely no effect. JG 2.20.10
Answer: it would be Restylane and it would be injected where the fat loss occurred, yes. JG 2.19.10
Answer: save your money. JG 2.18.10
Answer: moving the muscles before the injection does not affect how it works, it just sounds like they might have used a larger amount or injected it in different locations. Using the muscles does not influence the regeneration of the motor end plates where the Botox adhered to, it is just a matter of time. Hang in there. JG 2.28.10
Answer: the body breaks it down, the same way that it breaks down the normally occuring hyaluronic acid we have between our cells. It is degraded and excreted. JG 2.18.10
Answer: no, sorry, I have not. JG 2.18.10
Answer: that is correct, the aging process is pushed back but nto stopped, so once it is done building, it will break down like all collagen in the body. The maximum fill from the Sculptra would be at 4-6 months, and as time goes on, it will be lost, the speed at which that occurs and the length of time it takes to return to the previous state is dependent on genetics and age. The older one is, the faster they lose it after it is formed, and also the less robust the amount of collagen formed. It is very common to reinject patients at 12 months in order to maintain what they have achieved, correct. JG 2.18.10
Answer: I do not think the two are related. JG 2.18.10
Answer: the doctor can change the dilution, it is more a matter of the active ingredient used into the particular area than the amount it is diluted with. JG 2.17.10
Answer: in small doses, it is likely OK, but it has never been studied. Safest to wait. JG 2.16.10
Answer: they must have used a filler like Radiesse as Botox would not have the effect of lifting the tip, in most cases, over time, the filler will go away, but it takes a long time. JG 2.16.10
Answer: all from the muscle flattening out. JG 2.16.10
Answer: the muscle over the area which added some bulk over the bone has relaxed and now it is less thick. It will wear off in time and the muscle will bunch up again, or you can use a short term filler into the area if desired. JG 2.16.10
Answer: you can have some injected into the frontalis muscle by the doctor and that should drop it down. JG 2.16.10
Answer: it will spread to the surrounding areas to a small degree, but since the body replenishes hyaluronic acid and since the amount of hyaluronic acid is less in normal tissue compared to a filler injection, the effect is minimal to none on normal tissue. The dilution method is well documented in the medical literature and your doctor can easily find it. Best of luck. JG 2.16.10
Answer: Bell`s Palsy is caused usually by a virus, and stressful things can cause it but it is highly unusual for it to be caused by injections such as you had, I wil say that it is almost unheard of getting a facial paralysis from a Botox injection unless large amount or fake Botox is used. In most cases Bell`s Palsy improves over time, but in rare cases it can leave a permanent weakness to some degree. Using an electrical muscle stimulator can help avoid muscle atrophy until the palsy wears off over time. Best of luck to you. JG 2.15.10
Answer: well diluting more weakens it but actually allows it to spread more becasue there is more fluid to spread out. There is no value in a skin test with Vitrase, best of luck. JG 2.13.10
Answer: it is more likely that there are small areas that are dissolving and other areas where there is more filler that are responding slower. You can certainly try more of the hyaluronidase or see if they can pierce the skin and squeeze some out. All the best. JG 2.14.10
Answer: the collagen will build up for 4-6 months, the older you are the less collagen forms. I think in your case the additional filling this far out is likely from them swelling that started in the temples migrating downward. All the best. JG 2.12.10
Answer: yes it is true about the Botox and the lips, fillers are good options for many but not all patients though, hard for me to tell without seeing you in person. Sorry. JG 2.11.10
Answer: no, the new Sculptra injections will only increase collagen where it is injected. It might be some of the swelling moving down with gravity is all. JG 2.11.10
Answer: I think as long as they knwo how to use the hyaluronidase, they are equal. Not sure why they used Juvederm Ultra in that location, it is meant for deeper injections and not suitable for that location. JG 2.10.10
Answer: well, I have done it and I am not really impressed with the results to be honest, it is mild. There are not alot of options though. I hope I have helped on your visits. JG 2.9.10
Answer: I see absolutely no reason to inject through the mouth, all it does is increase the risk of infection as you cannot wipe the surface with alcohol before piercing it with the needle. It is no way near normal. For filling of the cheeks, Restylane Sub Q is good but we cannot use it in the US. JG 2.9.10
Answer: no,they will go away in time it is just the skin is thin and the bruises are more easily see. Hang in there.JG 2.8.10
Answer: never seen weakness occur, maybe it is just a small nerve irriation, should all go away on its own. Hang in there. JG 2.8.10
Answer: I have seen it squezezed out, not easy to do though, as to the Wydase, it does spread but I have nto seen it cause a problem becasue of that.JG 2.6.10
Answer: might be another 3-7 days, warm moist heat, arnica and bromelain from the health food store. Hang in there. JG 2.6.10
Answer: well, in very small doses for people that wrinkle their chin pad, it can work, but if it is too much, the lower lip can become weak and then your lower teeth can show, and that`s a sign of aging. Since it will only affect the dimpling seen when you contract that muscle, you need to decide if it is worth it.I think I have doen it 5-6 times in my Botox career. Most of the time it is fine, but if you get unlucky, you look weird for a few months. All the best. JG 2.4.10
Answer: I concur. JG 2.2.10
Answer: Well, there is no way to really tell, it all depends on where and how it is injected. I would suggest starting with one syringe and then adding more only if needed and if no problems have arisen previously, sorry, wish I could give you a flat answer but it does not exist. JG 2.2.10
Answer: sorry, yes, if it is just due to the fluid from the injection and the swelling for any shot, it should go away in about 7 days. A little ice and head elevation and avoiding salt might help some too. All the best. JG 2.1.10
Answer: I am doing great, thanks. As to the filler on top of an implant, yes, it is OK to do that. I think most off the shelf fillers like Restylane always continue to work, it is more of how much is needed to hide what age has done is the issue. As long as you like what you are getting and the price is not a barrier, I think you can proceed. all the best. JG 2.1.10
Answer: you are very welcome. JG 2.1.10
Answer: there is always a small amount of your own hyaluronic acid that is dissolved but your body replenishes it fairly quickly. Might just need some more in the the areas that were not treated with the dissolving agent is all. Best of luck. JG 2.1.10
Answer: yes, and it can also cause weakness of the eyelid muscle so you will see too much of the white portion, can lead to temporary dry eye, can lead to the fat pockets behind the musvle looking puffier too. JG 2.1.10
Answer: well, it usually does not work out that way as the concentration more so correlates to how long it will last and not as much as to the volume it will replace. Not a silly question at all. JG 2.1.10
Answer: I am sorry but no, I do not. JG 1.31.10
Answer: it might be just a little lake of the Restylane SubQ that is in one area and it is soft so it can feel like that. Nothing to worry about, your doctor coudl try to remove a little by using a needle to suck a little out. JG 1.31.10
Answer: well, you can certainly try it, please give us feed back on how long it corrected for after the shot. JG 1.29.10
Answer: I am sorry but we use regular Restylane, not the thinner Vital Light due to its very quick disappearance. JG 1.29.10
Answer: well I use Restylane for the orbital rim but not for the eyelid itself as it can get lumpy. A filler will do something different that a skin excision though. In some cases, if the problem is puffyness only of the lower lid, then the fillers can buy you some time before surgery is done. JG 1.29.10
Answer: I think you will disappointed once the swelling goes down, sorry. JG 1.29.10
Answer: it might, yes. I would seek a YAG laser. JG 1.28.10
Answer: it should have no long term effects. JG 1.28.10
Answer: it should not affect it but that might dissolve sooner than the new filler and then you might need a touch up down the road. I think injection too superficially can leave the blue color so it needs to be done deeper, at times under the muscle. JG 1.27.10
Answer: I do not think the Retin-A will do much as the skin is thicker and less likely to respond compared to facial skin. As to fillers in the hands, it will last only a fraction of the time they do in the face due to the constant motion, sorry. JG 1.25.10
Answer: I would say so, yes. All the best to you too. JG 1.25.10
Answer: unfortunatley, yes, the lumps from polyacramid will not go away on their with time, they will need surgery. They do not come and go, they stay. Some of the material might have seeped out through the small hole the docotr made and released some of the swelling and pressure. What came out is the material surrounding the filler, the carrier which the granules are floated in so it can be injected, and your body`s white blood cells trying to protect you agianst the material which is foreign to your body. I do not think it has anything to do with yoru teeth. In early phases before the granuloma is too well formed the small punctures and pushing material out might help, but eventually that will no longer work and they will need to be cut out. All the best and sorry you are having all the problems. JG 1.23.10
Answer: I have inejcted Sculptra in those very areas without anything negative happening, blogs are wonderful, but remember, happy patients rarely are on websites posting good things so we get a slanted view of complications and their rate of occurrance, although some do. In most cases, if a granuloma were going to form, it usually does it in the first few months. If it did happen with Sculptra, they do react in a more positive way compared to polyacramid as that permanent material will never go away whereas the polylactic acid in Sculptra does dissolve in time.I think you are out of the woods. I appreciate your post and your visiting and thank you for the kind words. JG 1.22.10
Answer: in time the small clumps congeal into larger ones making them easier to grab and remove surgically, at times there is a small amount of tissue that is removed at the same time that is wrapped around the nodule.What you are having is not an infection, it is the activity of the circular muscles around the lips pushing the nodules together into larger clumps. The MRI will only tell you that there are lumps but not tell you what they are, what they are is the polyacramide granules that he injected and they are surrounded or encased in scar tissue, they are called granulomas. I seriously doubt they would be able to remove it from the nasal cavity, it usually takes an incision directly over the lump, trying to go from the inside might avoid an external scar but will damage more muscle on the way to remove it if they are superficial. I have removed them on many people I am sorry to say, but one thing you need to know is that there is likely polyacramide in areas of your lips that has not congealed yet and even if I remove all that you have in place at present, there could be more lumps that develop over time I am afraid. Wish I had better news for you. JG 1.22.10
Answer: not sure where you live but that product should not be injected into the area around the mouth or lips and is illegal in the US. I am afraid that you will likely need surgery to remove all of the material, or at least most of it. I am sorry for your troubles. JG 1.22.10
Answer: no evidence that it will affect them in any negative way. I suggest the fillers first usually as the slight swelling that can occur with any laser can make the evaluation of the filler placement slightly more difficult. JG 1.21.10
Answer: I prefer Sculptra. JG 1.20.10
Answer: it all depends on how big it is and how deep. In your case it can take a couple of weeks at times. JG 1.19.10
Answer: if you can get that, use it, I wish we had it here in the US. JG 1.16.10
Answer: Radiesse to both questions. JG 1.15.10
Answer: that happens only if so much is injected into one spot that the nasal angular artery is closed off by the pressure, it should never be injected in a bulk fashion like that, like a bolus, it is meant to be injected in a thin layer over a wide surface in multple layers and crosshatched. JG 1.14.10
Answer: the look is no different, but Sculptra is the only one of the ones you mention that builds up anything. As to the hyaluronic acid fillers appearing translucent, that occurs only if you inject them too superficially and then you get a Tydall effect. The deeper you inject the less chance of tranlusence and the more opaque. JG 1.13.10
Answer: alternating warm and cold for the next 48 hours, 2-3 times per day will help, all the best. JG 1.13.10
Answer: I do not think there can be any structural changes that could occur that would influence the ability to hold a filler, although your injector is experienced, a deeper injection can always occur and is the much more likely culprit for it not lasting. It is meant to be injected into the deep layer of the skin, not below and the skin is a very thin piece of tissue, especially as we age, so going a little too deep is actually easy to do, even in experienced hands. I think, if you wanted to, you could go ahead with more injections at any time. JG 1.13.10
Answer: if diluted properly and injected in the correct fashion, negative outcomes should be quite small, there are areas, like the temples where the tissues are very thin and side effects are higher. I also think, that being slow and methodical helps, trying to inject too much at one sitting, for example, more than one or two vials, increases the problems. More vials is OK if injected over larger areas, but since it works as a biological filler and the body has to respond to it, it has to be done slowly. I think, at times, a physician might inject more than needed in order to give the patient a faster response, but that does not always work out in a positive way. I like Sculptra and am pleased with what it does. JG 1.13.10
Answer: most likley it is because not enough of the permanent part of filler is put in, might just need more to compensate for the carrier that dissolves. All the best. JG 1.13.10
Answer: it is already being sold again in the U,irritable should not make you more susceptible to lumps though. There are no true allergic reactions to Artefill so injecting it in one place to see is probably not worth it. JG 1.13.10
Answer: some but not much. JG 1.12.10
Answer: I think it is because they want an immediate response mostly. JG 1.12.10
Answer: yes, it could be filled in. JG 1.12.10
Answer: I guess it could be, yes. JG 1.11.10
Answer: hyaluronic acid. JG 1.9.10
Answer: Artefill for the nasolabial fold is OK but will not be a good choice for filling in the area where the fat was lost on the lower medial cheek. Best of luck. JG 1.9.10
Answer: yes, it is into that area more superficial to the canine fossa where the Sculptra would be inejcted into, in order the blend the upper cheek fat into the depressed area,when I said not into the fold, I meant it needs to be injected above the crease itself, into the area where the tissue has dissolved, Sculptra cannot be used directly into a fold like Restylane would be. Sculptra can be injected into the upper cheek, or into the submalar area too. I still think Sculptra would be my choice for what ails you. JG 1.8.10
Answer: you are not having Sculptra into the nasolabil fold, you would be getting injections above it to lift the deflated part up, but it can be and has been FDA approved for nasolabial folds. I do agree that fat is not the most reliable filler, it is more expensive, has more down time too. For what you need I think Perlane and Radiesse are poor choices and are not meant for tissue loss. JG 1.8.10
Answer: you are very welcome. JG 1.7.10
Answer: that is correct, the reports are sketchy as to if it was the filler or a blood clot that went to her lungs and caused her death. If a filler was injected into a vein, and in a large quantity, it could happen, but the amount typcially injected into lips for example, would not be large enough to casue death. As to knowing if it is in a blood vessel, the doctor can withdraw on the plunger and see if blood comes into the syringe, if it does, then you are in a blood vessel and should stop. I think the case of the death likely would result in a malpractice issue, if it had been in this country. A blood clot could have been the problem due to the positioning of the patient, the amount of time she was in that position, and especially if she was on oral contraceptives as they increase the blood clot risk. JG 1.7.10
Answer: correct, the amount of fill reduced due to the lidocaine being aborbed.It is not a common practice at all. I am not a fan of Sciton or Thermage, sorry. All the best. JG 1.7.10
Answer: I understood what you meant.JG 1.7.10
Answer: those types of injections will augment bone size and since it is so far away from the fold,and since the fold is not due to a bone issues, I do not think it will correct things any better than before, the fold comes from the pull of the muscles and loss of fat above the muscles, that is why malar fullness needs to be addressed. I will say that most calcium hydroxy injections are done by oral surgeons or plastic surgeons that do cranfacial surgery. All the best. JG 1.7.10
Answer: it is up to the surgeon in some sense, but there are many variables that are out of the surgeon`s hands too, like if the fat cells were damaged when harvested, whether the injected fat is injected in small enough parcels to develop new blood supply, whether small enough aliquots of the fat were inejcted to allow it to survive, what plane the fat is injected into, what size cannula is used to harvest and inject the fat. JG 1.6.10
Answer: I prefer Sculptra for that. JG 1.5.10
Answer: might suggest fat injections to build the area up, or Sculptra. Best of luck. JG 1.4.10
Answer: it just got re-released and for narrow indications like nasolabial folds or depressed scars I think it is good, not much godd though for locations where Restyalne or Juvederm are used though. JG 1.3.10
Answer: as long as you wait a couple of days it should be fine. JG 1.3.10
Answer: I use Restylane in the tear trough all the time, best of luck. JG 1.3.10
Answer: I think oral arnica, 4 pellets 4 times per day is what we use. It can also be used as a gel topically, can also use bromelain to help reduce the bruising. JG 1.2.10
Answer: I would NEVER inject Botox into the lids as if it works to weaken the muscle, the whites of your eyes will show and your appearance will change and your eyes mugh feel dry. JG 1.2.10
Answer: they usually do not grow but if the short period of time has transpired as you say, they can possibly be broken down with some saline injections. The temples are areas where they happen a little more often than others as the tissues there are very thin. There are no personal issues that make one person more prone to granules, no. Best of luck and thanks for the kind words. JG 1.2.10
Answer: although frequenlty used in the cheeks, I wil say that nether product is appoved or recommended for use there as it is well known they do not last long as they were not developed and desigend for that use. As to it moving, it is highly unlikely the product has moved that much, but the swelling the filler causes can move. Movement of the product is not affected by skin laxity. As to lumps, any filler, including the ones you have used carry risks of lumps. I think trying to fill in empty cheeks with hyaluronic fillers that we at present have in the US is a poor choice and waste of money, sorry. JG 1.2.10
Answer: it will, but it will take at least 2 vials in most patients, and in some more than that. JG 12.30.09
Answer: granulomas take at least 6 weeks to form and are hard, essentially scar tissue, not soft and squishy, yours sounds more like a collection of fluid or blood. I think at this point I would continue the massage and maybe apply some warm mpoist heat to draw more blood supply to the area to assist in its absorbing. I personally would not be concerned at this point and would just keep up with what we have discussed. All the best to you too and Happy New Year. JG 12.28.09
Answer: No, I do not mean it does not work but I feel that the patient must be chosen carefully becasue Sculptra is not a typical filler, it will fill in the area below the skin and in some cases can make the mouth area look fuller, even too full when using it around the nasolabial fold and especially the marionette lines. I do use it, in selected cases, for the nasolabial folds but not for the marionette lines. Best of luck. JG 12.28.09
Answer: the doctor can inject hyaluronidase to get the filler to dissolve, but it will not last much time in that area anyway. JG 12.28.09
Answer: likely not, it will have to dissolve for it to get better.Sorry. Merry Christmas and a Properous New Year. JG 12.24.09
Answer: I usually use Restylane in that area to liftteeh skin and allow the light to reflect better and reduce the dark circles. Merry Christmas and a Prosperous New Year. JG 12.22.09
Answer: It has been approved for injections in the face, the injection into the hands is what is considered an off-label use and it can lead to lumps, so to avoid that it needs to be injected in a very dilute concentration and over a large dispersion area to reduce but not eliminate the risk. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.21.09
Answer: I like Sculptra but it takes a few months for it to build up so some patients get impatient. Sculptra is usually injected deeply so lumps should be a rare problem. The pattern from the laser will fade in time, got to hang in there. Thank you for the kind words too. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.21.09
Answer: I use Sculptra for the cheek filling and I prefer an open forehead lift in order to have multiple points of fixation to give a longer lasting effect. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.21.09
Answer: they will work less well as it is more difficult to get new blood flow into the tissues inplanted rather than injected. Merry Christmas, Happy Channukah and a Properous New Year. JG 12.20.09
Answer: well, the stronger the laser the greater the collagen formation, but it will still be less compared to when you were younger, the older you are the less the ability of your skin to create new collagen, no matter what technique is used. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.19.09
Answer: I would imagine it might help the brows too, I have not had anyone try it though. The manufacturer of Revitalash does not include dry eye in its list. Merry Christmas, Happy Channukah and Prosperous New Year. JG 12.18.09
Answer: most likely you will have to repeat it. I do not perform fat injections to that goove of the eye area due to the unreliable results. Sorry. Merry Christmas, Happy Channukah and a Prosperous New Year. JG 12.18.09
Answer: well, fillers are commonly done after a facelift, I think they might think your degree of improvement may not be as dramtic and they might not want to undertake it for you. The area in front of your ear is the preauricular not buccal area. Fillers over the chin will likely not impact the lips at all. I think the degree of new collagen you will get with the APL is likely not worth your money. All the best, thanks for the kind words too. JG 12.17.09
Answer: no experience with Restylane Vital here in the US, but I like Restylane. As to mesotherapy, I do not believe in it. JG 12.12.09
Answer: next day. JG 12.12.09
Answer: pretty safe in experienced hands, not as easy to use as hyaluronic acids. Nothing,even the HA`s are totally risk free. JG 12.12.09
Answer: maybe 6-24 months. JG 12.12.09
Answer: we use it at times when injected around the lips, otherwise we do not use it. JG 12.10.09
Answer: some doctors will store in under sterile conditions for a bit and others will destroy it. JG 12.10.09
Answer: it might, yes, but I have no laser that will reliably dissolve the filler any faster than waiting, sorry. JG 12.9.09
Answer: I would wait a full two weeks before entertaining that concern. JG 12.9.09
Answer: well, I have to say that in the time I have injected hyaluronidase, I have never seen it cause a depression. Now, if the filler was injected and the hyaluronidase was not injected into the filler but into the surrounding area, that would appear like a depression as the filler has not been dissolved. As to building the area up I might suggest injecting Sculptra which works slowly to build up your own collagen and is used for fat loss in the face. JG 12.9.09
Answer: Nodules where only hyaluronic acid fillers were used should go away in time, but Radiesse lumops can be much more difficult and in rare cases need to be cut out. During a facelift the nodules might be seen but if they are truly in the skin and not below it that might not. I seriously doubt you have had enough fillers placed that your face would deflate when they dissolve. Pictures of you when you were younger are always helpful and as to the fat of the upper lid, it is removed during the surgery,the eyes will look differently after the surgery but usually look better. JG 12.9.09
Answer: It can be swollen and bruised for a number of days, I would suggest some warm moist heat and some massage to get it to go down some. Final results are suually seen after a couple of weeks or so. JG 12.7.09
Answer: yes, normal and it might take another 3-5 days to go away. JG 12.6.09
Answer: it is essentially the same, not sold in the US, just Europe and there are no teas or vitamins that will plump your face, sorry. JG 12.6.09
Answer: the massage will help both lumps that are felt and then also the small amounts of the injected material, no injection is ever 100% smooth as it depends on the pressure applied to the plunger. Swelling, that you might not perceive either, will also be helped by massage just like it would anywehre else on the body. JG 12/6/09
Answer: I would massage it and not consider the hyaluronidase for at least 10-14 days after the injection. I think it should go down some within that amount of time. Massaging it now is not too late to be effective. Perlane will take longer to dissolve but the massage is just as effective in smoothing small lumps out. It might take a bit more hyaluronidase to dissolve it though. Best of luck. JG 12.5.09
Answer: sounds prety cheap. One more thing about Botox. It has come out that the education that injectors were given since the beginning of Botox release was incorrect. The bottle is to be used for a single patient. That means that a bottle should not be shared between multiple patients. The company that makes Botox has known about this but has never issued an alert to doctors or patients. The risk is that of the bottle becoming contaminated and passing a communicable disease like HIV or hepatitis from one patient to another. There are no known reports of disease transmission in the use of Botox, but it has not been looked at yet in order to determine that issue. For that reason I strongly urge you to demand that a new bottle be used when you are treated and then observe the injector destroy the remainder of the bottle. If that is not done I urge you to contact the local board of health for the violation. Ask to look at the box it comes in and you will see the single patient, single use wording. JG 12.5.09
Answer: it wil take almsot a week for the swelling to go down. JG 12.4.09
Answer: OK to do for the first few days. JG 12.4.09
Answer: all normal and the red bumps are where the needle went in, yes. Hang in there and it will get better. JG 12.3.09
Answer: as it dissolves it tends to get softer and smaller. I agree that sticking with the firm areas in using the Vitrase is wise. Best of luck. JG 12.3.09
Answer: impossible to say but fat injections require larger needles and yield more swelling too. JG 12.2.09
Answer: well, it might last forever, there is no guarantee and it does not all survive in most cases and frequently needs to be repeated a few times. JG 12.2.09
Answer: I have seen no difference between Restylane and Juvederm when treated with Vitrase, but it is common to have to do it more than once if large volumes were injected. The Vitrase is essentially gone in less than 24 hours, as well as its effects, so it can be reinjected in a couple of days. Best of luck. JG 12.2.09
Answer: correct, more likely an intravenous injection of the filler that went to her lungs. JG 12.1.09
Answer: very unlikley, with the number of injections already done, it would have happened already, the deal with the buttocks injections was the material and the size of needle used with potential injection into a vein, highly likely on the face. JG 12.1.09
Answer: well I think the Juvederm will work but I think it will likely last only a few weeks. I personally would use Perlane between those two as I would be injecting deeper and then the risk of lumps is low and th ePerlane will likely alst longer than the Juvederm. Best of luck. JG 12.1.09
Answer: skin elasticity or its lack will not affect the length of time a filler will last, but it might take more filler to correct a problem. I do not think skin tightening via laser resurfacing will make the filler last any longer, sorry. JG 12.1.09
Answer: I do it all the time so just seek an experienced doctor do the injections. The amount needed can vary, from 0.4 to 1.0 cc. JG 11.30.09
Answer: usually weeks, the older one is the longer it takes. JG 11.30.09
Answer: should be enough, small chance of bruising but in ten days should be gone. JG 11.
Answer: yes, Restylane can be used short term. JG 11.
Answer: the natural hyaluronidase in your tissues typically recovers from the injection in a relatively short period of time. JG 11.29.09
Answer: in all the years of using hyaluronidase I have never seen nor heard of it happening permanently. JG 11.29.09
Answer: my preference is still Restylane. Looking to see you and seeing what needs to be done. JG 11.27.09
Answer: well, you can sometimes get complete paralysis of the muslce, but in some patients, no mater how much you inject, you still have motion. It is common for some patients to require alot more Botox or Dysport to weaken a muscle. As to the statemnet about Dysport, the units are differnt but the cost is the same, so she is incorrect there. As to the Latisse, it is a loss leader for her as if you like it, you will need continued use of the product, just like all other eye lash enhancers. One more thing about Botox. It has come out that the education that injectors were given since the beginning of Botox release was incorrect. The bottle is to be used for a single patient. That means that a bottle should not be shared between multiple patients. The company that makes Botox has known about this but has never issued an alert to doctors or patients. The risk is that of the bottle becoming contaminated and passing a communicable disease like HIV or hepatitis from one patient to another. There are no known reports of disease transmission in the use of Botox, but it has not been looked at yet in order to determine that issue. For that reason I strongly urge you to demand that a new bottle be used when you are treated and then observe the injector destroy the remainder of the bottle. If that is not done I urge you to contact the local board of health for the violation. Ask to look at the box it comes in and you will see the single patient, single use wording. The bottles of Botox come only in 50 and 100 unit vials, so although they might use less, they need to throw the rest away or they are using it incorrectly on another patient in order to save money. JG 11.26.0
Answer: well, anytime a needle is used, there is a very small risk of scar tissue, with the hyaluronic acid filler, since they dissolve totally, there is little chance of scar tissue, but the others like Radiesse can casue long term scar tissue is a very small number of cases. If you get a hematoma, or a blood clot, that can also cause a small amount of scar tissue too. Overall I think it is essentially an insignificant thing, although if you are going to have a problem, thin tissues liek the lip are the most prone. The scar tissue will feel hard to the touch and when the injector inserts the needle, they can frequently feel it as the needle goes through the scar tissue area. Happy Thanksgiving to you too. JG 11.26.09
Answer: might need a little more filler in a more superficial plane to correct the problem, but not all creases can be eliminated completely, best of luck. JG 11.25.09
Answer: the degree of migration is minimal. Ultra will typically last longer but it stil responds to the hyaluronidase. I think trying more Vitrase is certainly an option, best of luck. JG 11.23.09
Answer: The longer lasting Restylane has not been approved yet and I do not have any open spots for Restylane this week but please call the office as my nurse injector might have. Sorry. JG 11.23.09
Answer: I figured. JG 11.22.09
Answer: sounds like a low dose of the Vitrase. If it was real Juvederm, it will go away in a couple of months though. JG 11.22.09
Answer: maybe 2-4 months, not much more as it is not meant to be injected into that area as it is meant for more superficial filling. JG 11.22.09
Answer: all it does is make it hurt less, it does not impact the filler, but if you are having pain and make the injector stop due to the pain, you might not get as much filler as you need. JG 11.22.09
Answer: sounds about right and you might need a filler too, yes. JG 11.22.09
Answer: common for a few days after that injection due to swelling and stretching, it should settle down in a week or two, but it depends greatly how much was injected and exactly where it was placed. I do not think I would consider the hyaluronidase yet, just ice it and give it some time, it should get better. Best of luck. JG 11.21.09
Answer: if there is still residual filler, it will work, yes. In that area it takes 2-6 months for it to dissolve, it varies from patient to patient. The inconsistency is not the filler, it is the injector, different planes or locations of placement lead to those issues, but they are temporary. I think Retin-A or Renova will likely help the texture and is essentially what the Obagi system is. A granuloma is a hard firm knot that is made mostly of scar tissue, it is rare with hyaluronic acid fillers. Even if you had a granuloma, it would not cause texture differences, that usually comes from the intradermal injection of the filler distorting the skin itself, hang in there. JG 11.19.09
Answer: I think a couple of months should not make a large difference without something else going on. You might want to look at some recent photos before the injections to compare to the present condition as a way to objectively compare things. JG 11.19.09
Answer: no personal use of the product, but I believe it has stopped being sold due to poor sales and no significant difference from all the other fillers already on the market. JG 11.19.09
Answer: the fat is injected deeper. JG 11.20.09
Answer: I have used Sculptra for over 4 years and we mix it 48 hours before its use. I am sorry but I cannot refer you to any docs in GA or TN. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 11.20.09 http://www.surgery.org/public/findasurgeon.php.
Answer: it is OK to use and should not affect the Sculptra in any way. Best of luck. JG 11.19.09
Answer: reasonable to use there, yes, all the ebst and thanks for the kind words. JG 11.18.09
Answer: well, it also might be because Juvederm Ultra is intended for deeper injections, it is not to be used interchangeabley with regular Juvederm, they are different products and are supposed to be used for different isues. Sculptra also is injected deep, so if injected properly it should not show through. JG 11.18.09
Answer: In the years I have used hyaluronidase I have never seen it dissolve normal HA to that degree.In general, I think it is best to have the person who injected the filler to do the hyaluronidase so they know where they put it. I do not think anything permanent will happen to your skin though. You might need to get some more injected into the remaining lump to flatten it out to make it look less obvious though. JG 11.17.09
Answer: I think to answer your questison adequately I would need to see you so I could see your skin and its movement upon animation. Non-invasive things are sometimes an option but not always. Botox and fillers compliment one another, one does not replace the other. JG 11.17.09
Answer: the product is the same but the preparation and injection technique are vastly different, therefore the better and safer results. The material it is made up of is the same as the absorbable sutures we have used for many years, so it is safe. JG 11.16.09
Answer: it might happen, I have not had a case in all the ones I have done, but I have seen and read about it happening. I would personally use Sculptra. JG 11.15.09
Answer: it can, but by definition it will make the lower face and chin area fuller and larger. I would likely use Restylane for that if indicated. JG 11.15.09
Answer: there is no way to 100% avoid it, that is part and parcel of any injection. JG 11.15.09
Answer: any filler, even your own fat can cause a granulomas and a bump,just read through the postings here and you will see ample unsolicited evidence. I would venture to say that that particular surgeon markets fat injections though. I do think permanent fillers, or at least fillers that have small amounts of potentially permanent fillers should be avoided. I would be willing to bet a large amount of money that the particular plastic surgeon you are quoting has used absorable sutures in the past and that is what Sculptra is made from. For that reason, I think the choice of words on his part was,at least, unartful and well though out, at least in my opinion. JG 11.15.09
Answer: I would ice it and see what happens, I would not be too concerned at present. I doubt it will be permanent but I do think you should see the doctor in a week for follow up. JG 11.15.09
Answer: I have used 5FU but I have never used bleomycin for that. I do know that the 5FU, although it is off-label, does work well after a series of injections. It can help soften scar tissue but will likely not dissolve fat. JG 11.13.09
Answer: unpredictable fat survival with injections there. JG 11.12.09
Answer: yes, it is OK to start in your case since you have what Sculptra is intended for, the loss of fat. There should not be any long term problems, best of luck. JG 11.12.09
Answer: well, not totally normal but not unusual, as to what can be done, I think massage will still help some at this point. As to the ability to frown, Botox is not intended to paralyze all of the muscles, it is meant to weaken them so some motion in expected and normal, might want to go back to the doctor who injected you and see what is going on. Best of luck. JG 11.12.09
Answer: I would use Sculptra for that actually. It might take a series of 2-3 vials but it might last up to two years then.I think if the fat was removed already, you really are not left with many other options I am afraid. JG 11.11.09
Answer: the deeper they are injected the less time they last. JG 11.11.09
Answer: yes. JG 11.11.09
Answer: yes, it still will. JG 11.11.09
Answer: I think you will see a large improvement in the swelling in 4-7 days, hang in there. JG 11.11.09
Answer: well, use Botox if you are willing to live with slurring your words and drooling. JG 11.9.09
Answer: at any time, if it still there it will work. Best of luck and thank you for the kind words.JG 11.8.09
Answer: I have not seen any adverse effects from the use of hyaluronidase. JG 11.7.09
Answer: the biggest downside is that it might take multiple attempts to get the injected hyaluronidase to work, and therefore potential of bruising from the shots. Hyaluronidase does break down normal hyaluronic acid but the body is in a constant mode of self-replenishment of HA so although it will dissolve the bulk of the injected HA, it should not, nor have I seen it affect, the normal HA turnover. In that area the Restylane can last 2-4 months in most cases. Best of luck. JG 11.7.09
Answer: couple of days should be OK. JG 10.30.09
Answer: not all folds are able to be corrected with fillers and it sounds like yours might be one of those cases, hard to say what else could be done without seeing you in person, sorry. JG 10.26.09
Answer: It can but I do not think the end result will be any different from what you have gotten so far, sorry. JG 10.26.09
Answer: I certainly do not think it is extreme and has very little downsides, very rare chances of lumps, for thin faces it is less extreme than surgery.Best of luck. JG 10.25.09
Answer: yes, a little massage and time will help, should be better in 10-14 days. JG 10.24.09
Answer: well, the main ingredient that makes it last a long time has had a long history of problems around the world so I doubt that the US FDA will loook to approve it anytime soon. I personally would not even consider using it until at least a 5 year follow up on the material is published showing long term safety after it is approved, that is because the problems reported around the world required surgery to correct. JG 10.24.09
Answer: or see an oral surgeon to have some hydroxyappatite injected on top of the bone for longer term fill. JG 10.24.09
Answer: I personally have not had a patient develop a granuloma. I would not hesitate to have it done by an experienced injector. Best of luck. JG 10.23.09
Answer: in my practice it is about a 50-60% overfill with the injection. Not as bad as the fat though as there are fewer passes with the needle when using Sculptra and that contributes alot to the swelling. I have patients take off 2-4 days if they are concerned about looking swollen or bruised. The deflation takes about 2-6 weeks and then the build up starts. Bruising has not been much but there is some, all depends on how many times the needle is passed into the tissues. I find these injections much less painful than hyaluroinc acid and some doctors do use lidocaine but by the time the lidocaine takes effect the injectiosn are done. Best of luck with the plumping! JG 10.22.09
Answer: you cannot have it done in the US any longer,the company that made it went bankrupt, it is not sold anymore, neither the test nor the Artefil, if you live outside of the country and are having it done I am not sure what thay would charge you. JG 10.22.09
Answer: theew is a hard lump because you likely have a hematoma, it can always happen but in areas where there have been many injections there can be scar tissue which is more likely to allow excessive bleeding. It can happen to anyone. I seriously doubt it is the filler so the hyaluronidase is not effective, I suggest warm packs and maybe having the doctor aspirate the hematoma once it is softer and more liquified. In time it should all go down. JG 10.20.09
Answer: it used to be $50 but since it is off the market, I am not sure you can have it done in the US. JG 10.20.09
Answer: I think you need to see the doctor who did the injections as it is difficult for me to say without seeing you, sorry. JG 10.19.09
Answer: next day is OK. JG 10.18.09
Answer: sorry, never heard of ABC units. JG 10.18.09
Answer: massage can help smooth it out some but not totally, especially in that area. The swelling and bruising are normal I am afraid, especially if alot of massage was done. The initial difference could have been from bleeding too and not just the filler. It might take a couple of weeks to go away. Using hyaluronidase will speed the dissolving of the filler but will not affect th eswelling if it is due to bleeding. Give it some time and hang in there. JG 10.16.09
Answer: I personally would not use it for that. JG 10.16.09
Answer: injected properly the chances are quite small. As to the tear trough I use Restylane, but lumps can happen with all fillers. JG 10.16.09
Answer: in time it should go away, a little massage should help. I am unsure why you would still see the needle hole sthough, not common. JG 10.16.09
Answer: the Artefil has a sugar based carrier that dissolves over 6-8 weeks, all normal, the thought is that your body will grow into the granules that remain and get fulller over time. JG 10.15.09
Answer: I would use Sculptra to fill in cheeks, I find that all else that is legal in the US is not worth it. JG 10.14.09
Answer: I would use Sculptra injections and once they are filled enough, it could last 2 yars at your age. 10.14.09
Answer: I personally would not do it, it is not meant to be used that way as it will not last and the volume injected will be not too impressive of a change after just a few weeks. JG 10.13.09
Answer: No experience with Ulthera but I think the Voluma Lift might give some for a short period of time, I would not use the Ultra Plus for that though. JG 10.13.09
Answer: might dissolve a little of the surrounding area filler. JG 10.9.09
Answer: my patietns like the Revitalash, no allergy problems, no changes in iris color in my patients or in the medical literature, should see some improvement in 4-6 weeks or so. JG 10.9.09
Answer: I have never seen Juvederm or an other true hyaluronic acid filler migrate to any significant effect, I will say that superficial injections can often take much longer to dissipate but properly injected hyaluronidse, if it was real Juvederm, should cause it to dissolve almost immediately, if injected too deep, nothing will happen.Scar tissue can develop from the inejction but is more common from the blood and not the filler. Long term effects of Juvederm and Restylane are that the products are quite safe in experienced hands, the only precaution has been in people with a tendency to form hypertrophic scars, otherwise negatice effects long term of a negative nature are few.JG 10.7.09
Answer: I would not for fear of the lowere lid losing tone and looking paralyzed. JG 10.6.09
Answer: maybe 1-2 years or so. All the best. JG 10.5.09
Answer: some people have thicker skin and you see them less than in others, that is related to age, sun exposure and genetics. JG 10.4.09
Answer: just tincture of time is about all. JG 10.3.09
Answer: neither lasers nor an eyelift will help, you have dynamic lines and there is not much that can help that at present, sorry. JG 10.3.09
Answer: I think it is a waste of time with no documented science behind it to show any clinical improvement. JG 10.3.09
Answer: yes, I agree with her. JG 10.3.09
Answer: you would need to ask the FDA about that, it is quite political. No granuloma formation once does not guarantee for future injections. JG 10.3.09
Answer: it is an option but would likely take a large amount ot create fullness. I think for deeper injections it will last longer than Restylane. http://skincarerx.com/neova.html JG 10.3.09
Answer: if you get your forehead injections to relieve the horizontal wrinkles of the forehead that will never help the eyes and will drop your forehead and make yoru eyes look deeper and have more skin. You should not have the forehead injected with Botox if you want to lift it, if the doctor does not understand that, I suggest going soemwhere else. JG 10.4.09
Answer: should work fairly well, but although the filler might last a long time the effect migth not as the progressive sagging of your cheek skin will make them come back.JG 10.4.09
Answer: would not recommend it. JG 10.3.09
Answer: removing eyelid skin can, in some cases make your eyes look more open, yes. I might need to see some pictures of your face and eyes both in a relaxed position and then with your forehead lifting to help you. You might also want to look at some old photos as lifting your eyebrows migth make them look too high if you always had a lower set brow. JG 10.4.09
Answer: in the US there is nothing else I would suggest, other parts of the world I would suggest Restylane SubQ. JG 10.3.09
Answer: should go down, give it some time. If it gets worse call your doctor. JG 10.3.09
Answer: it can last up to two years in published reports. JG 10.3.09
Answer: essentially ti wil go back to some degree but nto entirely as ther ahs been skin removed and that does nto grow back. The skin that was left sags by stretching over time. That is why it cna be doen more than once, becasue the aging process which includes skin stretch is nto stopped. Teh skin gets thinner with age, but surgery doe snto alter that. JG 10.3.09
Answer: There is no evidence that Radiesse injected into the cheeks does that, it will incite soem reaction around the granules but in most cases it is all gone in less than a year. Radiesse and Sculptra are totally different in their make up and cannot be compared that way, Radiesse`s effect is due to the filler it self and not to any new collagen effect, if it were it would last as long as Sculptra and it does not. JG 10.2.09
Answer: not dangerous or painful I would say and it might last 5-10 years, varies depending on the patient and their skin and their genetics.JG 10.2.09
Answer: not much difference with those versus the Radiesse I am afraid. With all of those products, injecting deepr makes it last less time. JG 10.2.09
Answer: well, it will dissolve on its own in time, but there is no injection that will speed the dissolving like in hyaluronic acid fillers. Personally I do not think Radiesse is a wise option for filling in lost cheek volume, I think Sculptra is a vastly superior product for that area but it takes to build up the filler as your body has to produce its own collagen. JG 10.2.09
Answer: maybe 5-7 days. JG 10.1.09
Answer: it is not intended to be used to fill in cheeks that have become empty, so using it there will not last as long as in more superficial areas where it is intended to be used. I usually use Sculptra for filling in cheek volume.JG 10.1.09
Answer: what you are seeing is that the picture of what one person thinks makes another happy varies. It is best to go in with specific areas of concern and have those addressed, otherwise you are submitting yourself to the doctor`s impression of what they think is the best for you. This an art and their impression is less important than yours. Fillers and a facelift complement one another, they do not replace one another so you might and might not be a cnadidate for a facelift. JG 10.1.09
Answer: I do not think the Juvederm will fill in any more than the Restylane does if the same volume or amount is used, if anything, it would be the other way around, all the best. JG 9.30.09
Answer: I suggest massage and time, in most cases those initial uneven areas will smooth out. JG 9.30.09
Answer: injecting the muscles of the forehead has been known to cause it, it should wear off in a couple of days, Tylenol and ice should help. JG 9.29.09
Answer: impossible for me to say without seeing you in person, sorry. JG 9.29.09
Answer: I think you need to give it a few weeks for the swelling to go down and I think injecting a filler through the mouth is not a good idea as it is almost imposssible to inject the filler in the proper layer and the risk of infection is higher. What you are describing for the most recent injection is all normal though. I would just let it settle in and do nothing for the time being. JG 9.29.09
Answer: I do not use fillers on the eyelids themselves but I commonly use Restylane at the orbital rim. JG 9.29.09
Answer: good option, should last a couple of years depending on how fast you are aging. JG 9.28.09
Answer: good filler for that area. JG 9.28.09
Answer: I cannot say how much it will fill and I feel they last about the same amount of time. JG 9.28.09
Answer: I doubt this far out it is a bruise so it is likely a spot where the Restylane is too superficial nad you can see the filler right below the skin. JG 9.28.09
Answer: impossible to tell as it is quite varied but a general guess is at least one syringe, maybe more.JG 9.28.09
Answer: you can always ask to look at he box before they open it. JG 9.28.09
Answer: I personally have never seen a delayed reaction like that since we started using Restylane over 5-6 years ago. JG 9.25.09
Answer: I figured it was cost.JG 9.25.09
Answer: I have not seen that happen. JG 9.25.09
Answer: I think the amount of Artefil you would require to plump an area is likely large enough that granulomas would be a problem, I would not suggest it for large areas. JG 9.25.09
Answer: I think Sculptra has less granulomas, lasts longer, creates your own collagen that then dissolves rather than masking what has already been lost with no new collagen creation. Properly injected granulomas should be rare. JG 9.25.09
Answer: all the best to you, we have docs here in Nevada that do it also, although it is a felony here. JG 9.25.09
Answer: I have never used Evolence anywhere on the face so I cannot say, sorry. I use Restylane in that area and typically see 8-10 months in most patients. JG 9.25.09
Answer: I personally prefer Restylane. All the best. JG 9.25.09
Answer: I feel Restylane SubQ will last longer with less risks of lumps too. JG 9.24.09
Answer: I think fine lines of eyelids skin is very difficult to fill with any filer due to the degree and amount of motion of that skin, I personally do not peform it for those reasons. I do the filler touch ups in that area at 6 weeks if they need more but if it is uneven I do not hesistate to retreat afer 10-12 days. JG 9.24.09
Answer: do not recommend it, waste of money. JG 9.22.09
Answer: Restylane Vital is not used in the US at present, it shows some promise, although not really sure if the difference is much from the regular Restylane. It is injected for fine lines, correct. The Restylane SubQ is injected deeper for loss of fullness. I do not think orange peel skin will be improved by fillers, that is more of a laser or chemcial peel issue I feel most times. All the best. JG 9.22.09
Answer: well, Radiesse has small microscopic granules, that is why I doubt it would migrate this far out as it will behave like velcro, if it was something else like polyacramide, liquid silicone or a variety of other products, most of which are illegal in the US, it might have moved. You might want to request your chart from the doctor who injected it, but if they were using something they were not supposed to use, it might not be accurate. Wish I had more to offer you. A CAT scan of the face might give some help in determining what the fullness is. JG 9.22.09
Answer: I honestly cannot see how Radiesse, if in fact it really was Radiesse, could have migrated like that because that material is prone to form granulomas, the ability of the residual material left after the initial carrier is absorbed in 6 weeks is almost nil. I fear there is something else going on in your case if it migrated that far afer the injections. JG 9.22.09
Answer: both of those and time. JG 9.21.09
Answer: absolutely no difference, it is just that the old one was approve only for fat atrophy especially for AIDS patients and was used off-label for cosmetic reasons, and now it has been approved also for cosmetic reasons for nasolabial folds. JG 9.21.09
Answer: the granuloma cannot move, it is the motion of the filler that brought it together to form a granuloma, and granulomas can form with all fillers but some have higher rates of granuloma formation, and it depends greatly on where it is injected too. JG 9.21.09
Answer: yes, that can be done. JG 9.21.09
Answer: 7-10 days in most cases. JG 9.21.09
Answer: cheeks is OK, would nto use it in what is called the tear trough area or where the skin is thin around the eye. All the best and glad the prior Sculptra went well. JG 9.19.09
Answer: in the same areas as you would use Botox. JG 9.19.09
Answer: In most cases the dents on the cheeks can also be filled in with Sculptra too. An inperson evaluation is always a good idea to explore options and any limitations. Remember the Sculptra fills in slowly whereas the Restylane SubQ is an immediate fill, so it depends on your desires. JG 9.18.09
Answer: it can take a few days, all depends on how much was injected, I find it lasts about 10% longer than Botox. JG 9.18.09
Answer: well, fillers are options but fillers in some cases will not help if the problem is too far gone, impossible for me to tell without seeing you in person, I think Juvederm Ultra Light will be no better than the Radiesse though. JG 9.18.09
Answer: I prefer Dysport. JG 9.17.09
Answer: atrophy of the mucosal glands and saliva glands mostly. There is no fat in the lips themselves. Thanks for visiting. JG 9.15.09
Answer: hard to say, maybe 6-8 months. JG 9.15.09
Answer: never heard of it being done and do not see how it would be effective, it certainly will dilute the medication and therefore to some degree weaken it but at the same time diffuse it over an even larger area, but in most cases, by the time you appreciate the begining of the dent, the medication is long gone and you are only seeing the longer term effects of the injection. JG 9.14.09
Answer: might suggest using Sculptra in that area, best of luck. JG 9.14.09
Answer: yes and yes. JG 9.13.09
Answer: no way to concentrate it safely. There is on;ly a set amount that can be injected due to the amount of fluid. JG 9.13.09
Answer: essentailly the same thing.Sculptra was never meant to be injeced into the nasolabial fold like hyaluronic acid fillers, so getting a nodule would be expected due to the improper use of the product. JG 9.11.09
Answer: I think every surgeon will have a different fee based upon how involved it will be, I think you need to see a surgeon in person and then see what is the fee and what they suggest. Pictures might not be enough as the problem is 3-dimensional, in person is best, maybe see a plastic surgeon in your vicinity. JG 9.09.09
Answer: I have not as the injections there are usually done much deeper and there are no circular muscles that can make the nodules form by pusing the material into clumps. JG 9.09.09
Answer: bromelain, pineapple juice. JG 9.09.09
Answer: I have not seen or felt a nodule in my patients with Sculptra. I prefer Sculptra over fat at present. JG 9.09.09
Answer: OK to use in your 20`s and it can last 1-2 years or so in most areas injected, might need a small touch up at one year. Lumps are rare if injected at the proper depth. JG 9.09.09
Answer: no way to predict, need to wait the 6 months and see.The discoloration should get better if it fills in too. I would not do the filler until 6 months for fear it will be too much. JG 9.10.09
Answer: I use it to to that frequently. JG 9.10.09
Answer: I usually use either your own fat or Sculptra to fill in the depression, it comes from using the needle that is too short, properly injected deep into the tissue it should not happen. Nothing topical will help. Whatever is going to come back on its own will do so in the first 6 months. Best of luck. JG 9.09.09
Answer: no plans on using the Hydrelle at present. No new fillers on the horizon that will get me to change from what we are using at present. Thanks for visiting. JG 9.09.09
Answer: I think just wait and it will all settle down, no need to jump into trying to get it to dissolve at this point. JG 9.8.09
Answer: have a great day. JG 9.7.09
Answer: sorry, no there is not. JG 9.7.09
Answer: OK to have the facelift done, it wil likely just dissolve a little faster. JG 9.7.09
Answer: it is a new filler that had lidocaine in it, no personal experience with it though, no plans at present to add it to our office. JG 9.7.09
Answer: I use Restylane, nothing new on the horizon here in the US that will change that. Fine line fillers do exist and we use them, Restylane Fine Line, Prevelle are two. JG 9.7.09
Answer: if used it can itself cause sweliing, yes I typically do not use local anesthesia for NL folds. JG 9.7.09
Answer: I think that is an OK place to put the Artefill, it should not cause a droop, that is seen after the injection for a few dasy due to swelling. Best of luck. JG 9.7.09
Answer: before.JG 9.4.09
Answer: Fallene Total Block is what we use. JG 9.3.09
Answer: sunscreen allows some percentage of sunlight through, the higher the number the less it allows through, where a sunblock does not allow any sunlight through. JG 9.3.09
Answer: no sunscreen, needs to be a complete sunblock. JG 9.3.09
Answer: I think waiting 4-6 weeks is enough before having the laser done. I suggest a YAG or VBeam laser JG 9.3.09
Answer: might take 6 weeks or more, a laser will help though. JG 9.3.09
Answer: no news on Restylane Sub Q being released in the US, as to Voluma, it has also not been released in the US yet and I have no idea when it would be released, sorry. JG 9.2.09
Answer: no, there is no time limit on the complications, they can happen years in the future, sorry. JG 9.2.09
Answer: warm packs, and massage and some Arnica Montana from the health food store. JG 8.31.09
Answer: it will, I suggest some light massage, warm moist heat and Arnica Montana from the health food store, also stay out of the sun until it is gone to avoid brown spots from forming. JG 8.31.09
Answer: I think as long as it was not reconstitued it is likely OK to use, but there are many variables that may make it not effective. JG 8.30.09
Answer: the buckling is like when you pinch and fold a straw between your fingers. I do not recommend it. Might be time for surgery. JG 8.26.09
Answer: not all marionette lines are amenable to correction with fillers, no matter which one, might need surgery to improve them, sorry. JG 8.24.09
Answer: fat transfer and Sculptra are not as easily displaced as hyaluronic acid fillers. As to going back for the same, I think waiting for it to totally dissolve and then have him re-evaluate it is the best. JG 8.17.09
Answer: massage is still good to try. JG 8.15.09
Answer: the swelling can take 5-7 days in that are so I would give it some time to settle down, a little masssage is still a good idea. A little ice too. JG 8.15.09
Answer: if injected into the wrong area, yes, it can happen. I was injected too deeply. JG 8.15.09
Answer: because the other fillers when injected into that layer do not give much result and it does not last too long. I find Sculptra to be more effective for that, that is what it was approved for by the FDA.It should work well for the canine fossa. JG 8.15.09
Answer: yes, but the improvement is for the boney area below your nose, not really much for the canine fossa, sorry. JG 8.15.09
Answer: difficult area to use implants in due to the need for a custom shaped implant, I might suggest trying Sculptra in that area as it is a good solution for fat loss issues. JG 8.14.09
Answer: Botox for crows feet affects the muscles at the outer corner of the eye. If the muscles become weakened, in some cases the skin will appear looser and sag or wrinkle more. JG 8.13.09
Answer: I would not do it, I think it is a lot of hype. JG 8.12.09
Answer: well, in that scenario I think stick with the fractionated CO2 and skip the erbium as it does not generate heat so the collagen formation is the weakest, best of luck.JG 8.10.09
Answer: well, what you describe is not uncommon after Botx for crows feet since the lower eyelid muscle is now working while the lateral aspect muscles are not, making the lower lid look more wrinkled upon animation. It might start to look better after 6-8 weeks though. I think you should not do anything more, just let it wear off on its own with time. JG 8.10.09
Answer: no, I am afraid not. The baseline will not shift. JG 8.10.09
Answer: in some people with larges muscles it can last less time. Heat will not affect the wearing off of the effects as it is due to the muscle building new receptors for the acetylcholine and that is not affected by heat. Best of luck with the new injector. JG 8.10.09
Answer: Botox is not truly diluted in order to use it, it is a powder that needs to be reconstituted, dilution implies a weakening of the material and that is not usually the case, having said that, if the material is reconstituted with a larger amount of solution, then it is diluted in comparison to another vial with less fluid. If the dose injected is the same, the effect should be the same, regardless of the amount of fluid injected. I think specials do involve the inappropriate sharing of bottles between unsuspecting patients, yes, along with the possibility of contamination with a communicable disease like hepatitis from the prior patient. JG 8.7.09
Answer: yes, diluted, or actually resuspended. The company says that once it is mixed it should be used within 4 hours but many doctors go against the labeling and share bottles with other patients and will store the left overs for days and weeks in some cases. Each bottle is labeled for single patient use and should not be shared, ever. Legally, it is your right to aks them to mix it in front of you and then they are supposed to discard any remainder, otherwise it is a reportable offense to the state board of health. That is the case nationwide, not just here in Nevada. I would not term it confronting him, I would say it is assuring yourself of the safe practice that should be followed. As to how long it lasts, in my practice I see anywhere from 3-6 months, it lasts less time in males due to their larger muscles of the face. JG 8.7.09
Answer: do not see how remaining Restylane SubQ would affect the fat transfer, except that he might inject less fat than desired as the Restylane Sub Q is stil there and as that dissolves then the fat transer might not have been in enough volume is all I can think of. JG 8.7.09
Answer: seems like a low dose, It is safe to repeat when you see the function of the muscle begin to reurn. It is safe to put more in without it totally wearing off. JG 8.7.09
Answer: surgery is the only way, it is likley the best to lift the skin using a blepharoplasty incision to access the multiple lumps rather than small incisions directly over the individual lump. JG 8.7.09
Answer: I doubt it as if it is fat encapsualted in scar tissue, neither one will dissolve it. Sorry. JG 8.7.09
Answer: that would require a CO2 laser and not a Portrait session. Lasers are intended to smooth fine lines and not lift sagging skin, any effect of lifting the skin will be fairly shortlived and will disapate once the swelling is gone. JG 8.6.09
Answer: it is a step down from the CO2 laser which we offer,less effective, but less downtime. The company that made it has closed, I still have some treatment heads so I am still doing the treamtens until I run out of the heads, I personally feel it is superior to the other minmally ablative technologies promoted on the web. JG 8.4.09
Answer: leave it on the internet and your money in your wallet. JG 8.4.09
Answer: well, lots of variables, could be diluted but they told you it was the same amount, it might have been mixed and then stored for later use or mixed and then the bottle shared betwen patients which is also not supposed to be done, impossible for me to tell. I might suggest going back to the original doctor is all. JG 8.4.09
Answer: I think it is no better than any other filler out there as it is made from nonhuman source. We do not see it in or office as it offers no advantage over the others that have been around for a long period of time. JG 8.3.09
Answer: I would personally use Restylane for that area. Plain Juvederm will work fine for those wrinkles too. JG 8.2.09
Answer: I think that is fine, one can alwasy disagree, if you believe in it, then I suggest you have it done, personally I would not but caveat emptor. Best of luck. One observation if I might though. If in fact, there are patients that have had a single series of Fraxel treatments and they have not had their wrinkles return for 5 years, why does not the company show those pictures on their website to promote their wonderful technology? I would think that would be a better selling point than showing pictures just a few months afterwards.Just a thought. Let me guess, they have been approached by the company but they do not want their pictures shown to others but they have admitted to the procedure to you, hmmmm. JG 7.30.09
Answer: because the laser will never remove all of the damage, the wrinkle might look visually better for awhiel but there is deeper skin damage that has not been totally eliminated. I think you are expecting something from a laser that nothing, not even something besides a laser will provide. The best thing is prevention, not treatment, once you have a wrinkle, all you can do is improve it, not remove it. I know what you want but you are never going to get it. JG 7.30.09
Answer: because, as I have said to you previously, the prime issue is genetics and they have better genetics than some others. But think about how much better their skin would have been if they had never been in the sun. JG 7.30.09
Answer: because the aging process is not stopped by the laser, it reverses some of the changes but does not stop the aging of the skin. The skin will eventually return to the way it was and there will also be new winkles that did not exist before, both. JG 7.29.09
Answer: age, sun, smoking, genetics, it is all a normal process. JG 7.29.09
Answer: it is genetically controlled but sun and smoking can accelerate it. JG 7.29.09
Answer: nope, there is nothing permanent, sorry, your skin will always be better off if you do it compared to never having it done, but the wrinkles return, the thinner the skin, the sooner they come back. Since nothing is stopping the aging process, they continue to form, all the lasers do is take a few years off but they allow the clock to still tick. JG 7.29.09
Answer: if not properly done that is correct, but in experienced hands with the understanding that results will likely last a few years at most, it is still the gold standard, other lasers might be less risky but will offer even less improvement if any improvement. JG 7.29.09
Answer: totally ablative CO2 laser. JG 7.29.09
Answer: I am not a fan nor beleiver in the claims made for Fraxel. JG 7.29.09
Answer: those are where the needles were placed to inect the filler and usually go away on their own in 7-10 days, should not be a problem. JG 7.28.09
Answer: no, it should not make the skin more saggy, it should juts go back to the way it was. JG 7.27.09
Answer: I do not see the need to have the patients animate like you would with a filler as Botox is injected into the muscles and not the skin. Those muscles do not move in their location so they can be injected without asking you to move your face. The doctor should know what muscles to inject and actually you are not injecting the wrinkles that form upon animation, you should be injecting the muscles that pull the forehead down. JG 7.25.09
Answer: Absolutey as safe as Botox. It does seem to work faster than Botox, yes. I think you should try it. We use it in our office. JG 7.24.09
Answer: you can try fat injections or Sculptra, best of luck and sorry to hear about the problems. JG 7.23.09
Answer: sorry, nope, might help joint pain to help injured or damaged joints heal themselves. JG 7.22.09
Answer: it is true, there have also been cases of the filler inadvertently being injected into an artery causing tissue loss. Very very rare occurances though. I normally use Restylane in that area. In experienced hands I do not think it is risky, best of luck. JG 7.21.09
Answer: there is nothing the patient can due to influence that,maybe minimizing motion, but that is almost impossible to do. JG 7.21.09
Answer: yes.JG 7.21.09
Answer: sorry, but no, nothing non-surgical will work in my opinion. JG 7.20.09
Answer: I think that information should be gathered by the doctor and not you. JG 7.20.09
Answer: yes, you can still have a deep bruise if not seen because if the bruise is so deep that the tissues overlying it cover the appearance, it can still be there. JG 7.20.09
Answer: try it for at least one week. JG 7.20.09
Answer: I normally use Sculptra for that. JG 7.19.09
Answer: the bruising might be deep and cause pain but not be visually appreciated, and thanks for the kind words. JG 7.19.09
Answer: no need tt stop the fish oils. JG 7.18.09
Answer: I have not seen a problem with it affecting the normal tissues. JG 7.18.09
Answer: it is a poor attempt to call a midfacelift by a new name to make it sound new, improved and like it is different form what has been done for years. I seriously doubt it will improve your concerns, sorry. In fact, a properly done midfacelift can make nasolabial folds look deeper if it brings the malar fat pad up and increases the fullness of the upper cheek. JG 7.18.09
Answer: Restylane does not move the way you are thinking, it will not migrate to a different part of your face, I think what you are seeing is mostly swelling and I suggest you just leave it alone for a couple of weeks, the Restylane does not last long in the cheeks anyway. JG 7.18.09
Answer: no, it is just the amount of the product injected is different.JG 7.18.09
Answer: try those U shaped pillows that go around your neck sold for airplane flyers. JG 7.18.09
Answer: no, a good chance of it going down, especially early on. I suggest massaging it 4 times per day for 5-10 minutes each time. All the best. JG 7.17.09
Answer: most patients see results in 3-6 weeks and I have not seen any side effects in the patients that have used it in our office, but the risk of allergy is small. JG 7.14.09
Answer: it can form lumps and granulomas that need surgery to remove them, it can migrate into areas not injected, it can cause scarring that can limit muscle funtion or skin flexibility. JG 7.14.09
Answer: I have not seen a depresssion but I have seen where filler was placed and caused a bump. JG 7.14.09
Answer: personally I do not think it fulfills its promises, I have seen enough disappointed patients treated in other locations that I will not offer it. JG 7.14.09
Answer: I would never allow a patient to have silicone injections anywhere on their body. In Nevada it is a felony to perform silcone injections for cosmetic enhancements. JG 7.13.09
Answer: eventually will resorb in months, first 6 weeks are tough, will look swollen and get firmer, I do not use that technique for those reasons. JG 7.12.09
Answer: hard to say without seeing pictures of what you looked like before the injections. Sorry. JG 7.12.09
Answer: I cannot see how a filler would cause stretched skin and I do not think a midfacelift would help, it might get better with a laser if it is the skin that is loose. JG 7.11.09
Answer: more likley a festoon. JG 7.11.09
Answer: injected properly, that should not happen, especially if you have had it injected with hyaluronidase. I see no benefit in further injections to dissolve it. JG 7.11.09
Answer: it is not caused by hyaluronidase, it is fluid caught between two muscles and in many cases it needs to be cut out and a scar would be left permanently. No real way to avoid it, you are genetically susceptible to getting it. JG 7.11.09
Answer: part of it is bad luck, some of it has to do with the material injected and also the amount to some smaller degree. Products like Radiesse and Sculptra have higher granuloma rates than the hyaluronic fillers like Restylane or Juvederm. JG 7.10.09
Answer: if it is a lump, loclaized in a pinpoint area and is there past a few months it is likley a granuloma.Pulling on the skin is merely pushing it deeper is all. JG 7.10.09
Answer: I do not think a mid-facelift alone will remove any lumps, they will need to be cut out at the time of a mid-facelift if you truly need the mid-facelift. JG 7.10.09
Answer: essentially, yes. Granulomas can form anywhere a filler is injected. JG 7.10.09
Answer: yes, you can try it but they are likely granulomas now and it will not work on the granuloma. JG 7.10.09
Answer: yes, that is the idea but not everyone gets a total paralysis, some people need more if that is what they desire. Botox will not help the wrinkles seen at rest though, just the wrinkles on animation. JG 7.9.09
Answer: never heard of it being used for the prevention of bruising and do not see how it would do that. JG 7.9.09
Answer: It is difficult to inject while in the smiling position, and also understand that fillers are not supposed to correct the line when smiling, they are only meant to correct the line when in the relaxed pose. Might need a diferent injector. JG 7.9.09
Answer: if it is for a hollow then Perlane would be better. JG 7.9.09
Answer: if injected properly, which by that I mean deep underneath the skin, then no. Please understand it is not FDA approved for what you are contemplating, it is a dermal filler, not a filler intended to be used to replace lost volume below the skin. JG 7.9.09
Answer: it is maleable but I think it is not worth doing because of the short time it will last. I do not think overfilling will be an issue. JG 7.8.09
Answer: OK after waiting at least 4 hours, safer to wait for one day. JG 7.8.09
Answer: might want to try some kenalog or 5FU injections to softent the scar tissue some. JG 7.8.09
Answer: it is an acceptable technique, yes. You cna send the picture to drgarcia@lvcosmeticsurgery.com JG 7.8.09
Answer: it is essentailly the same area, it should not be injected into the eyelid skin itself. JG 7.7.09
Answer: I would use the remainder in a differnet area as injecting a lump is not a good idea. JG 7.7.09
Answer: I see no way that it would help the nasolabial folds. In parlayzed patients it alleviates the fold in only young patients, once the facial fat has dissolved to some extent, a normal thing with age, then facial paralysis will create a fold also. The aging process involves loss of facial fat with age, but there is no falling or weakining of the muscles so there is no place for facial exercises to help the visiual effect of aging. JG 7.5.09
Answer: If I coudl use Restylane SubQ I would use that, I feel it will last at least as long if not longer and it is less risky of lumps. Happy Independence Day. JG 7.4.09
Answer: I think it is likley safe to do so. I think Dysport starts working faster and likely lasts longer. No agent like Dysport or Botox will correct lines seen at rest though, migth need a filler in addition to them. JG 7.3.09
Answer: no, becasue all of the tissues are above the access plane and none of that would be able to be seen. No way to correct a festoon endoscopically. JG 7.1.09
Answer: I do not think it will help the lumps if they have been there that long, they will likely need to be cut out. JG 7.1.09
Answer: I think the newer ways we are injecting Sculptra over the past 2 years has essentially removed the risks that were more common in the distant past. I use it frequently with no problems. In most cases the improvements last 1-2 years. Thank you also for the kind words. JG 7.1.09
Answer: for the orbital rim I prefer Restylane, for over the cheek bone or temple I prefer Sculptra. JG 6.30.09
Answer: from my view, no, they cannot because they affect different parts and locations of the face. JG 6.30.09
Answer: there is no effect on lumps from fillers with skin resurfacing, especially ones present for that long. JG 6.29.09
Answer: it will dissolve a small piece of your own hyaluronic acid and usually it reforms it within a few days. JG 6.29.09
Answer: I do not inject Juvederm there but I have had Restylane stay in place for longer than a year in a small percentage of patients. Now when a lump forms, it is very common for it to last long periods of time because the surface is smaller and usually encased in scar tissue making the dissolution of it by your own body`s enzymes slower and more difficult for it to work. JG 6.29.09
Answer: likely just the skin where the Juvederm was injected that has to slowly shrink back to its normal appearance. JG 6.29.09
Answer: bruises are common and as to it being diluted it might have been but also, Botox does not always remove all the wrinkles, especiallly if there are wrinkles at rest. JG 7.1.09
Answer: I suggest 12 months. JG 7.1.09
Answer: it will take about 6 months. JG 7.1.09
Answer: it is essentially the same but it is meant for deeper injections so when going more superficial, it should not be used. JG 6.28.09
Answer: I suggest using Sculptra at this point in time, all the best. JG 6.25.09
Answer: hyaluronic acid cannot be absorbed through the skin so it is not better than what they had before, except they are hoping you do not know that the material cannot be absorbed. JG 6.25.09
Answer: as to fillers, no, as it will not stop any naturally occuring process but using products like Botox or the newer, and I feel better, Dysport, that weaken the muscles so the skin cannot fold as much can. The reason thay can is because some of the wrinkles that form occur from the repeat folding of the skin and resultant skin damage, so if the skin does not fold as much, the development of the wrinkles will be less. Of course, if you just voluntarilly move the muscles less, that will also work, especially when trying to avoid squinting. JG 6.25.09
Answer: All commercially available fillers can be used there, I usually use Restylane or Perlane. JG 6.23.09
Answer: Perlane or Sculptra. JG 6.23.09
Answer: I have not as the effectiveness and length of improvement make it not a good option. JG 6.23.09
Answer: I think that after two years the hyaluronidase will not help, that is for the soon after time. You might have what is called a granuloma there and at the point might need to be cut out, sorry. JG 6.23.09
Answer: the difference can be due to placement and also the amount of Botox injected. I think the effects on the chest would not be worthwhile, sorry. Might suggest light chemical peels or IPL for that area. JG 6.23.09
Answer: the amount of motion or movement is minimal, a millimeter would be alot, although it can flatten some. As to the effect you got, understand that it takes Botox on average 7-10 days to work so the change you saw was not the Botox, might have been the filler, but that you would have seen sooner after the injection. I see no way that the filler or Botox injected at the back of your jaw would have an effect on your chin, sorry. JG 6.21.09
Answer: could be from you sleeping with that side down. I think the Restylane not working is likely injector effect, and using a dfferent filler by the smae injector will likely lead to a repeat disappointment. Sorry, best of luck. JG 6.21.09
Answer: it is s doctor preferrence, I prefer Restylane for my injections. JG 6.21.09
Answer: more so the Restylane than the Juvederm, but they are gels and attract fluid that stays in the product, the swelling that occurs is not solely due to the the gel hydrating but from the inflamation from the injections themselves. The injector needs to be experienced to compensate for the fluid afterwards. The fluid comes from the surrounding tissues and the body replaces it. JG 6.21.09
Answer: the even discoloration is more likely just from the filler and as it dissolves it will get better. In most cases the lumps should be gone by now. JG 7.1.09
Answer: I typically use Restylane for that area. The depth of injection varies form patient to patient depending on their needs.JG 6.10.09
Answer: the ability for Juvederm to attract fluid is only a matter of days so I do not think that is the issue, maybe send me some pictures of your face and I can tell you a little more, send them to drgarcia@lvcosmeticsurgery.com JG 6.10.09
Answer: I do not think it is due to the Juvederm after this amount of time, it is likely due to what was done now, either the injection itself or the procedure that was done after the injection. The ability for Juvederm to absorb fluid is long passed. At this point I would suggest massage and alternating hot and cold packs. Best of luck. JG 6.8.09
Answer: in most cases with massage and time it does dissolve. I think if it bothers you after a couple of weeks then hyaluronidase can be used. I think the lump will go down in most cases on its own. JG 6.7.09
Answer: I think from what you have described, in your case I would not fill it, I have on some occasions on other patietns. JG 6.7.09
Answer: I would leave it alone. JG 6.7.09
Answer: no, sorry. JG 6.5.09
Answer: a doctor that sees you in person should be able to tell. JG 6.5.09
Answer: a facelift can,if special attention is given to the muscles in that area, be improved.If the muslces are not tended to, then the festoon will remin. A skin only facelift will leave you with likely a more obvious festoon as the surrounding area will be smoother but not the festoon. JG 6.5.09
Answer: yes I have, it is different only in that it is a new form of collagen, no difference in its filling efects or longevity, we do not use it as the difference is none compared to what we already use. JG 6.4.09
Answer: sorry, but Botox will not help that. Sounds like an upper eyelid surgery thing. JG 6.4.09
Answer: well, you might have something called a festoon that is a seperation between the muscles of the cheek and eyelid and it looks like a sac of fluid, it is not truly swelling and the correction is not easy, in severe cases it needs to be cut out directly and that leaves a curved scar in its place. If a needle had penetrated a vein and caused bleeding, by now the bruising and blood should have gone, so that is not a likely case. All the best. JG 6.4.09
Answer: it involves making a cut over the lump and that will leave a tiny permanent scar. Stitiches are removed in one weeek and it is done under local anesthesia. I have removed probabaly 25-30 lumps from fillers. It costs $500. The side effects are the permanent scar. Hope that helps. JG 6.4.09
Answer: I think his comments are accurate, but not for all, there is no 100% correct solution for everybody as people all age differently. If you are pulled too tight with a facelift and there is not enough tissue to lift, you can look unnatural. If you have fat injections when all you have is loose skin and no tissue loss you will look sagging and full. So each has its advantages and detractors. What a person needs has to be individualized, and some people benefit from having both. Sorry but I likley did not give you the answer you were looking for. JG 6.3.09
Answer: I do not see how that would be possible. Vitrase injections will not cause that and the Vitrase is absorbed and gone in a few hours. Must be some other cause. JG 6.3.09
Answer: yes, they can be improved with fillers, our choice is Restylane or Perlane. JG 6.3.09
Answer: no, if anything it will make it worse as it loosens muscles, and you`rs are already loose. All facial fillers have about the same risk of bruising because it is not the filler, it is the needle and they all need the needle. JG 6.1.09
Answer: I do not think massage will push the filler down at this point as it has set into place, it might be sweling although that is usually gone after 10 days or so. I think filling in the area above it will be more reliable than trying to dissolve the Juvederm. JG 6.1.09
Answer: the ones between the brows we call wrinkles and the ones between the nose and mouth are folds. My usual filler for those areas is Restylane. JG 5.31.09
Answer: hard for me to say why there is asymmetry this far out, I think the filler by now has likely dissolved. I do not think more hyaluronidase will help. The asymmetry might be due to scar tissue or atrophy of the normal tissues from small hematomas resolving. JG 5.31.09
Answer: most likely some irritation of the nerve and should all go away in time. JG 5.27.09
Answer: fillers can be used on some patients to make the bags look less visible by filling in the area right below the bag. JG 5.27.09
Answer: lumps and nodules are highest risk wise with fat compared to other off the shelf fillers and if there is a problem the fat is hard to correct. It is safer for nasolabial folds and cheeks but still not predictable. JG 5.27.09
Answer: I do not thin you need to do anything now but removal of facial fat will in time speed the visble changes seen with aging. JG 5.26.09
Answer: should be OK. JG 5.25.09
Answer: I always have patiens massage for the 3-5 days after the injection to help smooth things out.JG 5.24.09
Answer: if too much is injected in one area the body can at times cause scar tissue to form around the filler and create the lump. In most cases the lump will go away but in rare cases they need to be cut out. JG 5.23.09
Answer: any filler can leave a nodule. I normally use Restylane for the tear trough area. If a nodule forms there is some scar tissue also and that is why it does not resorb totally. What you desire does not exist though. JG 5.22.09
Answer: it can be used, yes how long it lasts is unpredictable. JG 5.22.09
Answer: all sounds normal,just let it settle and I think all will be fine. JG 5.22.09
Answer: might suggest calling Northwestern Medical School department of Plastic Surgery or Dematology, tell them you need treatment for a lump of hyaluronic acid filler. JG 5.20.09
Answer: 7-10 days. JG 5.19.09
Answer: the incision inside the mouth is made in the lining above the gum line and teeth and then the anchoring device is placed in the temple area through an incison and then a drill hole into your skull is made to set the anchor into place. JG 5.19.09
Answer: Run away as fast as you can. JG 5.18.09
Answer: it is technique related. JG 5.18.09
Answer: highly unsual, especially with a filler that can last as long as Artefil, the company that used to make it has closed down so I think any issues are between you and the doctor. I am sorry to hear this has happened to you. JG 5.16.09
Answer: what he says could be true, and also the tinge could be due to some Restylane that was injected too superficially and is giving you a Tyndal effect, hard to say without me seeing you in person. The Vitrase injections work almost immediately so it might be worth trying it again. Best of luck. JG 5.17.09
Answer: for me to inject it is $635 and for my nurse it is $535. JG 5.17.09
Answer: research shows that the laser should not afffect the fillers. A Pearl laser might aggravate the Rosacea, at least temporarily. JG 5.15.09
Answer: leave it alone. JG 5.15.09
Answer: it will likely take 6 months for it to get to its final results, got to hang in there. JG 5.15.09
Answer: I would wait at least 10 days to let the swelling go down and be better able to estimate where it needs to be placed. JG 5.15.09
Answer: might want to contact the local county medical society for a list of plastic surgeons or dermatologists, I personally do not know anyone there who could do it for you. JG 5.14.09
Answer: yes, that is true, the numbing agent can distort the tissues in some cases. JG 5.13.09
Answer: 4-10 days. Thanks for visiting. JG 5.13.09
Answer: sometimes more filler will only make it look unatural. You just might need it injected more often is all. JG 5.13.09
Answer: I think that was OK to do. JG 5.13.09
Answer: yes, true.JG 5.17.09
Answer: any filler since it is placed with needles can cause bruising, it is not the filler but the needle that causes the bruise. I usually use Perlane or Restylane for those areas. As to the hand wrinkles, nothing safe and effective at present sorry. JG 5.13.09
Answer: I might suggest seeing Rollin Daniel in Newport Beack, Ca., he is an expert in revision rhinoplasties.JG 5.12.09
Answer: it would require surgery to lift the skin and scrape it out, you cannot see it from outside. JG 5.12.09
Answer: the only thing would be to try to remove the Radiesse on the rare chance it is what is causing the edema, otherwise there is not much I have to offer. Sorry.JG 5.12.09
Answer: most times it is used within one year if stored under sterile methods. JG 5.12.09
Answer: They are not interchangeable, the Perlane is for deeper injection, deeper folds, Restylane is for more superficial use. I would not use Perlane in the lips. I understand the desire to have things last longer but using the wrong product can lead to lumps and problems. Perlane is a good choice for nasolabial folds though. JG 5.12.09
Answer: I do not recommend fat for that area, and I personally only use Restylane for that aea. As to filling out your cheeks, my preference there is Sculptra. JG 5.12.09
Answer: a 2mm cut should be enough if you can easily feel it and there should not be a pit after it is given time to heal. It should not cause a keloid as no skin is being removed. The cost varies depending on the surgeon and it is usually done in the office under local anesthesia. JG 5.11.09
Answer: it should as a new wound will be formed and that should scar down and heal in time. JG 5.11.09
Answer: It is OK to mix them. JG 5.11.09
Answer: might be able to be removed with surgery to scrape the material out, best done by a surgeon who does rhinoplasties. JG 5.11.09
Answer: yes, but the effect on your own hyaluroic acid only lasts 24-48 hours and your body makes it back. JG 5.9.09
Answer: 2-4 months or so, depends on how much motion there is in the area, the more motion the less time it lasts. JG 5.9.09
Answer: I do not think there is any need for you to remove the Restylane, the problem was the Botox used inappropriately, not the Restylane. Not much to do now until the Botox wears off, sorry. JG 5.8.09
Answer: Botox will not make the Restylane move but weakening the muscle with Botox can alter the appearance, not sure what they were thinking because that will not work. All the best. JG 5.8.09
Answer: might not have taken effect equally, the only way to make it symmetrical now is more Botox. JG 5.8.09
Answer: it should not look weird after the injections. JG 5.7.09
Answer: the lumps come from the injection technique. We also recommend massage ater the injections. I use Restylane in that area. JG 5.7.09
Answer: pretty normal, it can last 2-5 days in some cases, apply some ice and that should help some. JG 5.6.09
Answer: I have seen that when the Restylane was not injected into the proper place. JG 5.6.09
Answer: will likely need to be cut out. JG 5.6.09
Answer: Restylane is a hyaluronic acid while Radiesse is a sugar matrix into which synthetic coral particles are floated into it. The Radiesse claims longer results but that has not been proven out and the Radiesse should not be used around the lips or eyes. I use much more Restylane than Radiesse. JG 5.6.09
Answer: I think CO2 will offer the most, next would be the Rhytec Portrait, I do not think the Titan or Thermage will do much, and remember the results will be temporary, a few years likely no more. JG 5.6.09
Answer: I do nto think it is a good choice for that, the amount needed to lift the cheeks by filling the cheeks makes the price very high and to fill in the jawline to hide a jowl will by definition make the jaw more broad as how it is done is by filling in the normal area to the level of the saggy area. Best of luck. JG 5.6.09
Answer: different people age differently, so everyone shows the aging process in different locations of the face. JG 5.5.09
Answer: It is called New Fil all over the world and Sculptra here in the US. Now I will say that the prodcut has been changed as the particles are smaller now due to larger dilution so the risks of having lumps is less. Sounds like you got some lumps or granulomas and when that happens it will last longer than normal. It is more likely due to the technique used at that time for the injections, we inject smaller amounts now over larger areas. JG 5.5.09
Answer: should not affect the filler. JG 5.4.09
Answer: there are no fillers that I feel will safely and reliably correct the hollow of the eyelid itself and I do not inject that area. JG 5.3.09
Answer: well, I would never expect Sculptra to show much change for 4 months so it is way too early, but I think that is not a great place to use Sculptra in, it is intended for deeper injections. JG 5.3.09
Answer: well, it probably more accurately thickens the tissues below that support the skin, but it does help lessen the ability of ths skin to fold upon animation. Sounds like Sculptra would fit your needs. JG 5.3.09
Answer: would never use Botox there, the only way is to surgically lift the cheek pads. JG 5.3.09
Answer: caused by the cheek skin getting loose and falling foward, I normally use Restylane or Perlane there. JG 5.1.09
Answer: it is not usual to remove and reposition at the same time, no, and i usually use Restylane for the rim but that will not correct overresected fat, just the rim. JG 5.1.09
Answer: I would never do that. That is why there is a single identifier strip on the syringe that goes in the treated patient`s cahrt. JG 4.30.09
Answer: they are used to minimize fine lines and smooth the skin. JG 4.30.09
Answer: on the tummy maybe a tummy tuck,not much on the legs. JG 4.30.09
Answer: we use Restylane or Perlane there. The filler does not make the lines get deeper, but while using it the aging process proceeds and people forget that their lines without the fillers were going to get worse anyway. All the best. JG 4.30.09
Answer: no, in some people that have deep lines that is about right. The surgery to correct it is a cheek lift or a facelift. JG 4.28.09
Answer: in general very satisfied and it will last typically 8-10 months in most but not all cases. JG 4.28.09
Answer: I think Juvederm is fine, I usually use Restylane or Perlane. JG 4.27.09
Answer: sounds like a granuloma reaction to whatever filler was placed, I think at this point the vibration massage is past its point of helping and you might need to get the lumps cut out. An MRI will not give much information as the material is quite small and even if you have it cut out, it might not be able to be determined as to what the type of filler it was, wish I had more to offer you. JG 4.27.09
Answer: in a place whre the needed scar for excision will be acceptable to you and also where the lump is easily felt so the surgeon will not need to injure other normal tissues in order to get to the lump. JG 4.27.09
Answer: I usually use Restylane or Perlane. Lifting the corner of the mouth with a filler can be difficult at best. JG 4.26.09
Answer: it is possible, yes. JG 4.26.09
Answer: some studies have shown it to last 5 years, and if injected in a large amount in one place could last longer, in some cases when injected thinly it has been found to breakdown over less than 5 years. I think all you can do is wait, or have it cut out if easily accessable. JG 4.26.09
Answer: I think they could be injected at this time. JG 4.26.09
Answer: it should be used for deeper injections only and nasolabial folds and marionette lines need superficial injections. JG 4.26.09
Answer: it works within hours. It is not uncommon for it to be repeated in many cases. I would wait about a month or more to injected more, but it depends on what happens when you dissolve it, so it might vary on the patient and the problem. JG 4.23.09
Answer: it is not uncommon for differnt fillers to be layered, should not be a problem. JG 4.23.09
Answer: I do think it is the best but it is not cheap. I think you need to look for a surgeon who is comfortable in doing it, I rarely inject more than one vial on each cheek per time, and then I wait 4-6 weeks and re-evaluate to see how they are responding before injecting any more. If the sagging of thevface is due to loss of facial fat, it can appear to give a lift after the Sculptra injections. JG 4.21.09
Answer: I honestly have nto heard of it, sorry, and since they both lasted about the same, go with the less costly, I would likely use Perlane, best of luck. JG 4.21.09
Answer: Botox is a muscle paralyzing agent and does not cause any numbness. The amount of Botox used for migraines is much lower than in other applications so certaily one bottle is very safe. The use for migraines is to help with muscle spasms that can trigger the migraine.JG 4.21.09
Answer: well, it is a good choice, whatever effect you get will not last as long as the Artefil as the tissue that are sagging will continue to fall regardless of the Artefil as it does not stop the sagging. Artefil can last as long as 5 years or more, but the company recently went bankrupt so I am not sure how much longer you will be able to get it here in the US. Marionette lines are not always able to be corrected with fillers, it many times takes surgery to correct, the fillers can only temporarily slow the need for surgery. JG 4.18.09
Answer: Wwll, by now all of the Juvederm should have dissolved if it was real, I do not think anymore hyaluronidase will help at this point. Might want to se a plastic surgeon who does facial surgery for an evaluation. Best of luck. JG 4.18.09
Answer: hard for me to tell without seeing you in person, if you press lightly on it, if it is fat, it should flatten where if it is a filler, it usually will not flatten. In most cases fillers in that area dissolve in 8-10 months so it sounds like your case is more one of fat if it has been this long. JG 4.18.09
Answer: not common, no, but I also would not have used Sculptra in that area, it is meant for deep injections and the area around the eyes needs superifcial injections. I think at this point all you can do for the bruising is give it time, sorry. JG 4.17.09
Answer: I have not seen it cause anything faster than it would have happened without it. I feel different fillers are better for certain things so you need to tell me what area you are using the filler on. JG 4.17.09
Answer: Radieese probably, but not much longer. JG 4.16.09
Answer: doubt granuloma, it is either fat or filler. JG 4.15.09
Answer: doubt granuloma, either fat or filler. JG 4.15.09
Answer: well, if the granolma is really deep, then it might be hard to appreciate how hard it is, as to telling the difference between fat and a granuloma, that should be pretty straight forward unless there has been surgery done in the area before. Also, if there has not been surgery before, the fat around the eye is not a small ball, it is longer and more sausage shaped so that should be easier to distinguish from the others. JG 4.15.09
Answer: they can, unusual, but yes, the granuloma would feel like a hard lump. JG 4.15.09
Answer: I do not feel that injecting the Vitrase would harm anything. JG 4.15.09
Answer: well, Restylane is thinner than Perlane, does not have more volume as 1cc is 1cc, it lasts about the same, is meant for a deeper injections so there are subtle changes. If your time is short you really do not have many choices as other fillers like Sculptra will not build up in time. I think the Perlane can be used, I suggest sing it about two weeks before you need to look good as I think the effects, especially in the filling of the hollowed cheek will not last long. The marionettes will lood good for awhile though. With your age and time constraints, you need to understand this is a quick short fix and is a compromise due to the limitations. JG 4.15.09
Answer: it is a slow dissolution. I think if you are going to do all of that I would do the filler last. JG 4.15.09
Answer: I think you can use both. JG 4.14.09
Answer: in most cases it does not get lumpy and if it does, again in most cases it goes away.I do not think fat is a good choice for that area as survivability is no longer and the needles required are larger. I use Restylane for that area. JG 4.14.09
Answer: should not cause any long term problems, just maybe a bruise from the needle. I have not seen any bad side efects from Vitrase. Best of luck. JG 4.13.09
Answer: yes, but your body makes it back as part of the body`s natural process, and since the lump is a larger spot, it is affected to a greater degree. It does not result in scar tissue though. JG 4.13.09
Answer: You can try steroid injections but the effects are mild at best and do have side effects. Steroids and cortisone are the same thing. A facelift would elevate the skin and tissue and possibly, if the filler is seen at that time, it could be removed. Best of luck. JG 4.12.09
Answer: i$t shoudl get better but it takes 6-8 weeks for the carrier gel to dissolve. I fear you will be like that for a long time, I never inject through the mouth, it is very difficult to place the material in the location needed that way and the infection rate is higt due to the bacteria in your mouth that cannot be sterilized. JG 4.12.09