Q. What do doctors suggest to address anti-aging and skin damage on decolletage/chest?

RealSelf actual patient comment:

I am interested in recommendations from the community to address anti-aging on my chest. I am starting to see skin damage and fine lines. Do doctors recommend BBS with Halo and Sculptra for chest or other suggested treatments from community of respected doctors.

 

A. The female aging chest skin is treated with a combination of Ultherapy, Fraxel Dual laser, and Sculptra in our practice. In some patients we add microneedling with platelet rich plasma (PRP.)  Please feel free to contact us with any further questions.  Good luck and be well.

Q. What work could be done to improve the aesthetic of my nose? Also, are under eye fillers right for me?

RealSelf actual patient comment:

What can be to be done to “fix” my nose? There’s a dent in the side of my left nostril, and the bridge is pretty narrow. I don’t like the vertical shape and width of my ala and my tip is practically nonexistent. I’m curious whether or not I have a deviated septum. I have breathing issues, especially when sick. The skin under my eyes is thin and asymmetrical, especially when smiling. Would fillers be able to improve the symmetry and reduce the dark circles?

 

A. Rhinoplasty will address your nasal aesthetic concerns and fillers under your eyes will improve the shadowing of dark circles.  Consult with a few expert rhinoplasty surgeons and then choose your surgeon most carefully based on their skill, experience, knowledge, and natural artistic vision.  A few experts whom I would recommend are Ari Hyman, MD (Los Angeles, CA), DeanToriumi (Chicago), and Steven Pearlman, MD (New York City).  Good luck and be well.

Q. 50th birthday blues – What procedures can be done (under $10,000 hopefully) to look younger?

RealSelf actual patient comment:

I’m a single mom and about to turn 50. But looking in the mirror I feel more like mourning than celebrating. What procedures can be done (under $10,000 hopefully) to look younger? I’m open to anything at this point and not afraid to go under the knife. Thank you in advance for any direction or deals you can offer.

 

A. With a $10K budget, the biggest bang for your buck would be upper blepharoplasty and neck liposuction.  In the $15-20K range, a neck/face lift with bleph would be best.  You may achieve nice non-surgical results with fillers, neuromodulators, and devices that lift and tighten for $10K or less.  The most important thing for you is to make sure that your carefully choose your treating physician based on their skill, knowledge, experience,care, and natural artistic vision.  Good luck and be well.

Q. Fix uneven saggy under eye – What procedures (surgical or non surgical) should I look in to?

RealSelf actual patient comment:

I’m a young college student but since I was I was little I have had saggy under eye and one of them being noticeable saggy and darker than the other one. When I smile the same under eye has a bigger bulge. Its so uneven and it’s cause of great insecurity for me and I want an idea of what I can do to fix it What procedures (surgical or non surgical) should I look in to? I just want some ideas on how to make my eyes more even. I attached some pictures to show what I am talking about

 

A. I would not recommend surgery, rather a small amount of properly placed filler should help you achieve your aesthetic goals and restore your confidence.  Make sure to choose your expert injecting physician carefully for this delicate and unforgiving undereye area.  Choose based on their skill, knowledge, experience, care, and most importantly their natural artistic vision.  Good luck and be well.

Q. What is the best non surgical/laser type intervention to gain mild lifting on a 33-34 year old?

RealSelf actual patient comment:

There are so many diff technologies out there and its a bit overwhelming (fractora, refirme)? I have East Indian skin tone and use RetinA 3x a week. I noticed my cheeks are in a slightly lower position. Id like to start on a preventative/corrective treatment plan. I want to avoid filler but wouldn’t mind something like sculptra to top things off at the end if needed. I’m mostly trying to address the mid face, no jowling or jawline issues yet.

 

A. The most non-invasive, safe, and efficient lifting and tightening treatment with no downtime for a young woman experiencing the earliest signs of aging is Ultherapy.  I perform all of the treatment in our practice to insure that patients get their best possible result.  Make sure to choose your treating physician most carefully as aesthetic procedures are not “commodities”, but rather art and science.  Your aesthetic results are dependent on your physicians skill, knowledge, experience, care, and most importantly their natural artistic vision.  Good luck and be well.

Q. Looking for long-lasting lips, what are my options?

RealSelf actual patient comment:

I have a very small upper lip and not sure what procedure would work that will have ever lasting results? I’ve heard of using my own fat would work? I would like to know what that is called? Or, any other options? Wondering the prices as well..

 

A. Fortunately I have found that hyaluronic acid fillers such as Juvederm and Volbella last for a very long time in lips when injected properly over 2 to 3 injection sessions.  I do not like permanent fillers in lips as the saying goes, “permanent fillers…permanent problems” which I have seen too many times in patients coming to our practice from other clinics where their injection results are “botched.”  Fat, like other permanent fillers is great when it works, but is very unpredictable compared to the great hyaluronic acid fillers available today.  Consult with expert physician injectors and then choose your injector carefully based on their skill, experience, knowledge, care , and most importantly their natural artistic vision to avoid “trout pout” and “duck” lips.  Good luck and be well.

Q. Can I get Juvéderm Voluma on top of Radiesse?

RealSelf actual patient comment:

I got 1 syringe of Radiesse on each side of my face and I definitely see a nice difference but I wish my cheeks could be a littler fuller and more structured. Is Juvéderm voluma on top of Radiesse a good idea or will I look crazy?

 

A. Facial fillers are an art and science, results are extremely dependent on the expert physician injector whom you are treated by.  Fillers are not a “commodity”, it’s not like buying a quart of milk, all fillers are not the same and all injectors definitely are not equally skilled.  In your case I would examine you in person, listen to what your facial aesthetic goals are, and then give you a plan for the best pathway to help you achieve and maintain your goals.  I love using Voluma to “beautify” faces in a most natural fashion.  The most important thing that patients can do to insure excellent facial filler results is to make sure that they choose their injecting physician very carefully based on the injectors experience, training, knowledge, and natural artistic vision.  Feel free to contact us with any further questions or concerns.  Good luck and be well.

Q. Am I able to have my nose with a rhinoplasty surgery be very close to what the right profile looks like in the photo?

RealSelf actual patient comment: (patient submitted photos with question)

With my photo attached below that I altered before being my natural nose on the left and the altered on the right. Is it possible for my nose to be very closely changed to how the photo on the right looks? Bring nose much closer to face, reduce nostril length and reduce bulbous tip?

 

A. Imaging is great for helping surgeons and patient communicate their vision – it is less great at giving a definitive estimate of an outcome. 2 dimensional lateral views like you’ve shown don’t reflect well what will happen on the front view – which in my opinion is the most important view. De-projection like you’ve shown can create significant width and decreased definition on the front.

In either case – a consultation with a rhinoplasty expert would be helpful.  Consult with a few rhinoplasty experts and then make sure to choose your rhinoplasty surgeon most carefully based on their skill, knowledge, experience, care, and natural artistic vision.  A few rhinoplasty experts I would recommend are Ari Hyman, MD (Los Angeles) and Dean Toriumi, MD (Chicago).  Good luck and be well.

Q. Is it possible to make skin thinner as I’ve been recommended to see a dermatologist?

RealSelf actual patient comment:

Hello, I just had my first consultation with a doctor. I asked him if an alar base reduction was possible, with some tip refinement. He felt my nose and informed me that my skin around the tip is extremely thick, so making it any smaller will not work. He recommended I see a dermatologist regarding my skin, but I feel that doing so won’t address my main concerns: making my nose look smaller. Any advice? I’m aware of the limitations due to thick skin but this advice was disheartening.

 

A. In the hands of an expert rhinoplasty surgeon you can achieve your rhinoplasty aesthetic goals.  It will likely require an open approach rhinoplasty with the use of your own cartilage to create a refined nose.  It is less about thinning your skin, more about creating an underlying cartilage support.  The best thing that you can do is consult with a few expert rhinoplasty surgeons and then choose your surgeon most carefully based on their experience, skill, knowledge, and natural artistic vision.  A few great rhinoplasty surgeons whom I would recommend are Ari Hyman, MD (Los Angeles), Dean Toriumi, MD (Chicago), and Steven Pearlman, MD (NYC).  Good luck and be well.

Q. Is Juvederm Ultra Plus better for mild nasolabial folds or Radiesse?

RealSelf actual patient comment:

When these two different kinds of dermal fillers get absorbed by the body, does it really get absorbed 100% or does it still leave some residue under the skin which will look like bumps? Which kind lasts longer?

 

A. Both fillers can correct nasolabial folds, both stimulate a little of your own collagen production so that there is some effect after they have been reabsorbed, though Radiesse is more stimulating.  I prefer to use Restylane Defyne in this area because it moves well with facial expressions.  Choose your injecting physician carefully.  Good luck and be well.

Q. What is the best option to get rid of eye bags and nasolabial folds?

RealSelf actual patient comment:

I am 38 but feel like I look a lot older than my age. I look too old and tired. When I see other people my age and even older than me they don’t have eye bags and nasolabial folds like me. The eye bags really wrinkle up when smiling. I am not aging well for some reason and I don’t even smoke or drink and I try to take care of my skin with a good skincare routine. What would be the best option to look younger and have the bags and smile lines look less pronounced? Surgery? Filler?

 

A. You can improve your lower eyelid area either with surgical blepharoplasty or with non-surgical proper filler placement.  It would be best to evaluate your anatomy in person to determine and discuss your best options.  The most important aspect of your treatment is making sure that you choose your treating physician/surgeon carefully based on their experience, skill, knowledge, and natural artistic vision.  Good luck and be well.

Q. Fillers or laser to fix uneven smile line from alarplasty?

RealSelf actual patient comment:

After my rhinoplasty in 2013, my plastic surgeon decided to do an in-office alarplasty to reduce nostril flare. Since the procedure, I’ve noticed that the scarring/tethering has made my smile line look very uneven and unnatural. The left side of my nostril now has a gap from the smile line and the right side of my nostril has scarring on top of my smile line. I have gone back to the office several times for Pico laser but it hasn’t made any positive changes. How can this be fixed?

 

A. It is difficult to assess your nose without examining  you in person.  For scarring fractional CO2 laser (Fraxel repair) works well.  The asymmetry of your nostrils may be able to be repaired with a revision alarplasty.  Consult with an expert rhinoplasty surgeon.  I have seen the beautiful scar repair work of Ari Hyman, MD in Los Angeles​.  Good luck and be well.

Q. How long after needle mesotherapy for face I can have Ulthera on jowls and jawline?

RealSelf actual patient comment:

Dear Doctors I will appreciate your advice. I will have needle mesotherapy on 24Sep2019 and then I plan to have Ulthera but do not know when and where, now I need to plan this. Can you advise how long I should wait for Ulthera?

 

A. You may have Ultherapy anytime after having had needle mesotherapy.  You may also have Botox anytime after mesotherapy.  Good luck and be well.

Q. Is it possible to lift this this kind of nose?

RealSelf actual patient comment:

I want to save the shape and un, but have the nose a little bit shorter.

 

A. Yes, an expert rhinoplasty surgeon can lift your nose to help you achieve your nasal aesthetic goals.  Consult with multiple surgeons and then choose based on their skill, experience, knowledge, care,and natural artistic vision.  A few rhinoplasty surgeons I would recommend are Dean Toriumi, MD (Chicago), William Silver, MD (Atlanta), and Ari Hyman, MD (Los Angeles).​  Good luck and be well.

Q. If I get fillers for my face, can I still do laser or microneedling treatments in the future? Will it dissolve/melt my fillers?

 

A. Yes, after facial fillers you may have laser and microneedling.  It is somewhat dependent on which fillers are used and the depth of their placement.  For patients who are contemplating both​ treatments we prefer to perform the skin tightening procedures (lasers, microneedling) before fillers as it is more effective to fill the face against tighter skin.  Unless your fillers are extremely superficial there should be no problem having those procedures.  Good luck and be well.

Q.Will Hyaluronidase injection to dissolve Juvederm affect natural volume in my lips?

RealSelf actual patient comment:

Got lip fillers 2.5 weeks ago, all swelling and bruising is gone and I’d like to get them dissolved just a little bit to make them less full. Also my skin above the upper lip looks lumpy – can this be corrected with Hyaluronidase? I was told that once injected it could dissolve more product than intended, so concerned that my lips will look smaller than before fillers and/or change shape – is this possible? Could the Hyaluronidase take away from the natural volume my lips originally had?

 

A. I would recommend consulting with an injectable filler expert physician to correct your concerns.  I usually prefer to smooth any irregularities and only use hyaluronidase if absolutely necessary.  Too much filler can be lost, and in some cases there can be some loss of the patients natural volume. It is difficult to answer your question accurately without seeing photos.  Good luck and be well.

Q. Is it is necessary to use rib cadaver grafts to project the tip in African American Rhinoplasty because the cartilage is weaker?

RealSelf actual patient comment:

Additionally, will the inside of the nose look thicker because of the grafts? Especially if rib cadaver is used? What is the success rate of using your own nose cartilage and having it work?

 

A. The cartilage used to project an African American nose depends on the individual nose, but in general the best results are from using the patient’s own rib cartilage graft.  I would recommend consulting with multiple rhinoplasty experts who use this technique and then choose your surgeon carefully based on their skill, experience, knowledge, care, and natural artistic vision.  A few expert rhinoplasty surgeons I would recommend  are Dean Toriumi, MD (​Chicago), Ari Hyman, MD (Los Angeles), and Steven Pearlman, MD (New York.). Good luck and be well.

Q. Can my crooked nose actually be corrected? I’m not convinced.

RealSelf actual patient comment:

No trauma to my nose, born with it. I just want my nose straight, & a corrected septum so I can breathe better. Hoping insurance will cover most of it. I have yet to see any results I like. They all still look crooked to me. I’m convinced this is something that cannot be corrected & I don’t understand. Most before & afters are bumps/side profiles. I don’t want to pay out of pocket for a rhino that isn’t going to straighten my nose. Somebody please ease my mind before I cancel my consultation.

 

A. Septorhinoplasty will improve your nasal breathing as well as straighten your external nose.  Correcting a crooked nose is one of the most difficult rhinoplasty indications to get “perfect”, but you should see marked improvement.  ​

Best to consult with a few rhinoplasty experts and then choose your surgeon carefully when you are ready based on their skill, knowledge, experience. care, and most importantly their natural artistic vision.  A few great rhinoplasty surgeons I would recommend are Dean Toriumi, MD (Chicago), Ari Hyman, MD (Los Angeles), and David Kim, MD (San Francisco).  Good luck and be well.

Q. Am I a better candidate for non-surgical nose Job or rhinoplasty?

RealSelf actual patient comment:

I’m unhappy with the frontal view of my nose and I wish I had a more refined tip.

 

A. You are definitely a better candidate for a rhinoplasty.  Do not bother with injectable fillers in your nose.  Best to consult with a few rhinoplasty experts and then choose your surgeon carefully when you are ready based on their skill, knowledge, experience. care, and most importantly their natural artistic vision.  A few great rhinoplasty surgeons I would recommend are Dean Toriumi, MD (Chicago), Ari Hyman, MD (Los Angeles), and David Kim, MD (San Francisco).  Good luck and be well.

Q. Does taking PREP affect a Rhinoplasty?

RealSelf actual patient comment:

Hi there, I am considering a Rhinoplasty soon (havent found a doctor – any recommendations would be great!). However, I read that some medications or supplements have to be avoided before surgery such as accutane or blood thinning medication. I am on PREP for the moment, should I be off PREP before , during an dafter Rhinoplasty? Thank you

 

A. The medication PREP​ does not include “blood thinning” as a side effect therefore it is ok to continue prior to your future rhinoplasty.  Consult with multiple rhinoplasty experts prior to deciding on your surgeon.

Choose your surgeon very carefully after multiple consultations based on their skill, experience, knowledge, care, and most importantly their natural artistic vision.  A few great rhinoplasty surgeons are Steven Pearlman, MD (New York), Dean Toriumi, MD (Chicago), and Ari Hyman, MD (Los Angeles.)  Good luck and be well.

Q. How do I know if I have any fillers left in my face?

RealSelf actual patient comment:

How do I know if I need more hyaluronidase to dissolve all fillers in my face, or if there are even any fillers left in my face to dissolve/? I do not know why I still have this dent like thing under my dam eyes I just don’t feel like living anymore

 

A. First and foremost please speak with a professional about your thoughts of not feeling like living anymore.  Your face can be taken care of.  The aesthetic repair requires consultation with a facial cosmetic expert physician to determine the best course of treatment.  There are treatments available to address your concerns.  Please do not do anything harmful to yourself, speak with a trained professional, and then consult with an expert physician.  Good luck and be well.

Q. Rhinoplasty, chin surgery, or both? Would just fixing my chin also fix my nose issue?

 

Looking for some insight on what treatments would be ideal based on my face shape. I’ve been unhappy with my side profile for quite some time now. I would love to have more of a jawline & I feel like my nose looks prominent in comparison to the other structures on my face which is not ideal. Would just fixing my chin also fix my nose issue? I’m struggling with what surgery to choose because I don’t want my face to look much longer on my front profile because I already have a long face.

 

A. A small chin implant will give the illusion of making your nose look smaller.  If you choose to undergo surgery, you should definitely have a chin implant, whether to add rhinoplasty depends on how much your nose bothers you otherwise, and on your in person examination. Choose your surgeon very carefully after multiple consultations based on their skill, experience, knowledge, care, and most importantly their natural artistic vision.  A few great rhinoplasty surgeons are Steven Pearlman, MD (New York), Dean Toriumi, MD (Chicago), and Ari Hyman, MD (Los Angeles.)  Good luck and be well.

Q. What procedure would I need to make my nose look like the picture on the bottom?

RealSelf actual patient comment:

My nose feels uneven and like it lacks definition on the bridge. I don’t mind my profile at all as I havea slope.First picture is me, no makeup, straight ahead and the second I photoshopped to look how I want. What kind of procedure would give me the desired result?

 

A. Nice work on your photo-shopping, those are realistic results.  You can achieve your aesthetic nasal goals with a properly performed rhinoplasty.  Choose your surgeon very carefully after multiple consultations based on their skill, experience, knowledge, care, and most importantly their natural artistic vision.  A few great rhinoplasty surgeons are Steven Pearlman, MD (New York), Dean Toriumi, MD (Chicago), and Ari Hyman, MD (Los Angeles.)  Good luck and be well.

Q. Which muscle stimulating device is best?

RealSelf actual patient comment:

Between the 3 new devices, emsculpt, cooltone and trusculpt flex, which is best and most effective? They seem to work very similar, except I don’t think cooltone has the fat sparing option for buttocks.

 

A. We have been using Emsculpt on our patients for the past year with excellent results. Emsculpt has the most clinically proven data on safety and efficacy.  Have fun building your muscle and losing some fat in the process. Good luck and be well.

Q. What kind of rhinoplasty would be best for me and what results can I expect?

RealSelf actual patient comment:

Hi, I would like to know what type of rhinoplasty I would need. I would like to get rid of the bump. Also, I would like to make it smaller and make the bridge of my nose more narrow. I want to know what I can realistically change and what results to expect from a rhinoplasty.

 

A. You are an excellent candidate for a reduction rhinoplasty which will reduce the size of your nose and result in an eloquent refined nose. At initial rhinoplasty consultations we use computer morphing to give our patients a realistic sense of what they can expect from their rhinoplasty. Consult with a few rhinoplasty surgery experts and then choose your surgeon very carefully based on their experience, skill, knowledge, care, and importantly their natural artistic vision. ​ Good luck and be well.

Q. Am I a candidate for non surgical nose job, or do I need surgery/rhinoplasty?

RealSelf actual patient comment:

I would like to know if I am a candidate for a non surgical nose job as this would be my ideal choice or if I would need rhinoplasty? One doctor said with a non surgical nose job the tip could be raised and bump flattened. I am 36 years old

 

A. It appears that you would benefit from a surgical rhinoplasty, I would advise against liquid rhino in your case.  Good luck and be well.

Q. Tear troughs filled – I think it looks worse. Is it the wrong filler or placement? Advice?

RealSelf actual patient comment:

Can someone advise on the problem here. I’ve gotten my tear trough filled for the first time on Saturday. 3 days ago. They don’t look any better and I think they could look worse. My dark circles seem darker. Could it be the wrong filler used or could it be an issue with placement? Please advise. Thanks

 

A. It appears that there is excess filler low on your right side.  If it is still that way next week, I would let your injecting physician know about it.  Depending on your trust, you may consider a consultation with another expert injecting physician.  Good luck and be well.

Q. Please tell me how to get rid of the orange-peel chin and deep lines above my upper lip?

RealSelf actual patient comment:

I moisturize daily but to no avail.

  1. Would filler help and if so, which filler would be best?
    2. If filler is recommended, how much would I need?
    3. Would the same filler (if that’s what you recommend) be used to remedy both chin and upper lip?
    4. If an injectable is used, typically how bad is the bruising in these two areas?
    5. Instead of filler, would laser treatment be more beneficial?

Thank you! Thank you!

 

A. The absolute best treatment for the area around your mouth is fractionated CO2 laser with PRP (platelet rich plasma).  There is downtime involved but the results are excellent.  Botox in your chin helps as does micro needling and less aggressive lasers depending on the amount of time that you have to recover.  Most importantly choose your treating physician carefully as these treatments are not standard commodities.  Good luck and be well.

Q. What is the difference between PPP 3D Facelift and Ulthera?

RealSelf actual patient comment:

I am looking for some non-surgical anti aging SMAS lifting treatment recently. One of the clinics offers a treatment called PPP 3D Face Lift, and they told me it’s milder than Ulthera. So what is the difference exactly? And also is it less painful compared to Ulthera? Any potential after effect that I should be aware of?

 

A. PPP 3D facelift is a treatment name coined by a clinic and is not a standard treatment modality used by other physicians.  Ultherapy has been used in hundreds of thousands of patients with excellent results.  Choose your treating phsyician carefully.  Good luck and be well.

Q. Can you tell if the bump on my nose is natural or I got it from injury?

RealSelf actual patient comment:

I bumped my nose harshly on the stairs of a shallow pool when I was around 9 years old. No one in my family has a bump on their nose like me, and I was just wondering if it was genetic or an injury.

 

A. It seems like the bump is different from each side which usually from trauma.  Whether it is from trauma or genetic won’t matter should you decide to correct the hump with rhinoplasty.  The most important aspect of any aesthetic procedure is choosing your surgeon carefully based on their skill, knowledge, experience, and natural artistic vision.  A few great rhinoplasty surgeons whom I would recommend are Dean Toriumi, MD (Chicago), Steven Pearlman,MD (New York), and Ari Hyman, MD (Encino, CA).  Good luck and be well.

Q. Is it possible to remove my dimple?

RealSelf actual patient comment:

I have an issue where my smile is affected by a dimple that I believe I acquired after getting a cortisone shot for a cyst years ago. The dimple causes a crease when I smile and makes one side of my face look heavier. I have posted this question before a while ago and never really got a straight answer, I’m really hoping there is a procedure to fix this because it makes me very self conscious.

 

A. Yes, I would need to evaluate you in person to determine the best treatment for you.  It appears that you should benefit from a filler that will be determined after examining you.  Good luck and be well.

Q. How can I get rid of or mask the wrinkle on my outer BOTTOM eyelid?

RealSelf actual patient comment:

I don’t want to put any botox there because I have seen numerous cases where the smile was affected due to cheek muscle being paralyzed. If fillers are the solution, which filler would be best?

 

A. I agree with Dr. Martin, a neuromodulator (I prefer Dysport in this area) used properly will not affect your smile.  Microneedling with microdosing of Restylane and Botox is helpful, as is micro needling with platelet rich plasma (PRP).  The most aggressive and​ effective treatment would be fractional CO2 laser but there is significant downtime.  As with any aesthetic procedure it is important that you choose your treating physician carefully based on experience, knowledge, skill, and natural artistic vision.  Good luck and be well.

Q. How many times must Profound laser be done?

RealSelf actual patient comment:

I want to tighten the skin on the lower part of my face. I’m investigating Profound Laser. Because it involves at least a week of down time, how many treatments are optimum? I am 68 years old and have taken good care of my skin.

 

A. Most of our patients are treated one time with Profound RF.  We usually combine our treatment session with Platelet Rich Plasma (PRP) and Sculptra.  As the face and neck are numbed with local anesthesia, I offer our patients a light fractionated CO2 laser at the end of the Profound RF treatment.  This combination gives very nice results with a single treatment session.  As with any aesthetic treatment, choose your physician most carefully.  Good luck and be well.

Q. One side of face has deep crease, can this be fixed with filler?

RealSelf actual patient comment:

Asymmetrical smile line (only on left side). Can this be fixed with filler? How much? Would it look unnatural?

 

A. I just treated someone with your exact concerns.  She was immediately very happy.  Filler can be used to even an asymmetric face.  The amount of filler and the cost depends on the individual patient and their degree of asymmetry.  Facial filling is not a commodity, it is very dependent on your injecting physician.  ​As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision. ​Good luck and be well.

Q. Saggy skin around jawbone in early 20s. Any recommendations on treatments?

RealSelf actual patient comment:

Hello. I’m in my early 20s and I have a problem with my jawbone. I think it’s excess of skin and I’m trying to work out which procedure would led to eliminate my problem. Two first photos are of how it looks now, last photo is the effect I would like to archive. I would appreciate any recommendations on the treatment. Thank you

 

A. I would treat you with a conservative Ultherapy treatment which will tighten the skin and muscles of your face and neck as well as giving you definition of your jawline.  I would also consider Botox to your masseter muscles to narrow your posterior lower jaw area resulting in a more V-shaped face.  Choose your treating physician most carefully.  Good luck and be well.

Q. What are non invasive skin tightening options for my abdomen?

RealSelf actual patient comment:

I am looking for stomach skin tightening options. I had my daughter when i was 18 and have hated and hidden my stomach ever since. I have quite a few stretchmarks but mainly would like to tighten the skin especially around the belly button. I do not want a tummy tuck full stop. I am not looking for or expecting miracles.. just some improvement. Based on my pic is there realistically anything other than tummy tuck that can help me? Thanks in advance 🙂

 

A. We have had success treating patients with loose abdominal skin with Emsculpt, Venus Freeze , and Profound RF.  Good luck and be well.

Q. Can I get a fat graft to a narrow face?

RealSelf actual patient comment:

Thin gal. Would like a less lean looking face, could a fat graft be done to my jawline?

 

A. Fat transfer grafting can restore volume to a thin face nicely.  The problem is that fat grafting is unpredictable and is difficult to correct if there is a problem.  I prefer to treat my non-surgical patients with more reliable facial fillers such as Sculptra and Voluma.  All of these filler treatment options are not commodities, they are very dependent on the injecting physician.  ​As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision.  Good luck and be well.

Q. 30 days until 30th reunion. What can I do to look and feel better about face?

RealSelf actual patient comment:

So I had been planning to get some Botox done in about 2 weeks, which would hopefully show good results in time for my reunion. Now I’m wishing I had maybe tried some more things to smooth my complexion, sun spots or maybe even some filler (lips or cheeks?). Have I waited too late? I only have 30 days until my reunion for any procedures to be healed. What would you recommend?

 

A. First you will have to promise to wear a good physical sunblock at all the Tennessee football games this year, go Vols!  In your case I would treat you immediately with Fraxel Dual brown spot reduction laser (5-7 days of downtime peeling), botox, Voluma filler in your cheeks, and a oxygen infusion facial a few days before the reunion.  Choose your treating physician most carefully.  Good luck and be well.

Q. Is eyelid surgery best done by an eye surgeon or a plastic surgeon? Does preventative functional eyelid surgery exist?

RealSelf actual patient comment:

I can see my eyelid future & it isn’t pretty. Both of my parents qualified for (but never got) functional blepharoplasty. Now at age 51, I have skin dipping below my lid (only my lashes keep them up). I’m exploring surgery, but the doctor choices are overwhelming and I’m not sure what type of doctor to go with. Also, I can wait a decade and (likely) have functional surgery, but by then the skin will be thinner. Is preventative surgery a thing? Or is that wishful thinking?

 

A. You appear to be an excellent candidate for upper eyelid surgery (blepharoplasty.)  Consult with multiple surgeons until you find one that you are comfortable with.  Your surgeon should be board certified in plastic surgery, oculoplastic surgery, or facial plastic surgery.  As with any aesthetic procedure you should make sure that you choose your treating physician/surgeon based on their skill, knowledge, experience, care, and most importantly their natural artistic vision.  A few great blepharoplasty surgeons that I recommend are Guy Masry, MD (Beverly Hills), Steven Dressner, MD (Santa Monica​), and Ari Hyman (Encino, CA.). Good luck and be well.

Q. How effective/reliable will nasal turbinate reduction by radio frequency be for me?

RealSelf actual patient comment:

Recommended by physician and deciding whether to have turbinate reduction by radiofrequency (treatment in the office, no general anesthesia). How exactly does the ENT physician determine how much to reduce? I’m assuming all patients are different. And, can it be done on one side only of the other side isn’t as swollen? Finally, how deep does the probe go?

 

A. Great sinus X-rays!!!  It appears that you should get great improvement of your nasal breathing and air flow  from RF Inferior Turbinate reduction.  I will treat the areas of the inferior turbinate​ that are swollen,  usually involves treating 3 spots on each inferior turb, anterior, mid, and posterior.  A preset amount of energy is given in each area to reduce the turb.  The insulated RF probe needle is inserted 2-3 centimeters into the turb tissue.  It can be done unilaterally, but most patients prefer having both sides done at the same time.  The nose feels congested for 2 to 5 days, like a cold but you are not sick.  Good luck and be well.

Q. Do I look like a candidate for a blepharoplasty/do I have ptosis?

RealSelf actual patient comment:

I would love to have slightly bigger eyes and more space on my eyelid.
Do I I look like I have ptosis ? Treatment for eyelids just starting to sag?

 

A. I totally agree with the great Toby Mayer, MD, your eyes (and face) are beautiful.  Do not let anyone touch your eyes for many years. If you consult with enough surgeons you find someone to ruin your naturally beautiful looks.  Enjoy your youthful beauty.  Good luck and be well.

Q. Will filler in cheekbones give me fuller checks then I already have?

RealSelf actual patient comment:

I have a really round face with full cheeks. One side of my face has more volume then the other. I thought Botox in the jaw could slim down my face and correct the asymmetry, but my doctor said Botox would not work on me as the volume in my lower face is due to fat and not the jaw muscle. He said that I should get filler in the cheekbones to remove the focus and my lower face and also in the chin. I do not wish a fuller face. Filler in the cheekbones, would that not make my face look fuller?

 

A. Your face can be made to appear more symmetric and thinner if your fillers are placed properly by an expert injecting physician.  ​As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision. Good luck and be well. ​

Q. Can I get a Rhinoplasty if I have epilepsy?

RealSelf actual patient comment:

I take keppra everyday 1 in a half in the morning and 1 in the night and the – milligrams Are 1,000 but I been wanting to get a nose job and I’m concerned if I’ll be able to get one

 

A. Yes, patients with epilepsy may under rhinoplasty but only with a medical clearance from their neurologist.  Good luck and be well.

Q. Does rhinoplasty affect a smile crease?

RealSelf actual patient comment:

I want to get a rhinoplasty but I am not sure whether this would have an effect of my smile crease (horizontal line above my lip). I really like this crease and i think it looks cute. I would appreciate an answer! 🙂

 

A. You have a beautiful smile, rhinoplasty should not have affect your smile once the immediate post-operative healing period is over.  Sometimes during rhinoplast y the muscles that connect the nose to the lip are freed up to keep them from pulling down on the nose while it heals.  Please make sure to discuss this with your rhinoplasty surgeon.

As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision. A few great rhinoplasty surgeons that I would recommend are Raj Kanodia, MD (Beverly Hills), Ari Hyman, MD (Encino), and Dean Toriumi, MD (Chicago). Good luck and be well.

Q. What can I do to achieve a more symmetrical face (lips/cheeks/double chin)?

RealSelf actual patient comment:

There is nothing symmetrical about my face. It has never bother me until it got worse and way more noticeable as I have gotten older (I am 25). It could be due to pregnancy/weight loss, spending more time outside due to running, aging, dental work, clicking jaw that has gotten worse over the year. Anyways, my main concerns are my uneven lips/corner of mouth, volume loss and unevenness in my mid face, and my jawline/double chin. What do you suggest to help with this? Thank you!

 

A. The best procedure to treat the aspects of your ethnic nose that bother you would be a rhinoplasty, best likely via an “open” approach. Injections of filler on the top of your nose (profile) may give an illusion of a thinner nose, but cannot address your nostrils. I would advise consulting with a few rhinoplasty experts. As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision. A few great rhinoplasty surgeons that I would recommend are Raj Kanodia, MD (Beverly Hills), Ari Hyman, MD (Encino), and Dean Toriumi, MD (Chicago). Good luck and be well.

Q. Jeuveau and other drug interactions- Is this dangerous? Can it ruin my filler or counter it?

RealSelf actual patient comment:

I read that you weren’t supposed to mix jeuveau with other drugs. I had jeuveau done a couple days ago for my crows feet. I forgot that in June i had xeomin but in a different area when i got filler done. I had 1.5 cc of radiesse as well in june. Is this dangerous ? can it ruin my filler or counter it?

 

A. NTW (Not to Worry.)  Whatever you read was Fake News!!!  There is not contradication or danger to having Jeuveau with other medications, neuromodulators, or fillers as long as the unit dosage remains in the safety zone.  Good luck and be well.

Q. Can my loose columellar skin be fixed?

RealSelf actual patient comment:

I have a good bit of excess caudal septal cartilage at the base of my nose. This forces my philtrum to protrude and creates a very obtuse nasolabial angle. If this is corrected, how can the skin be addressed? Will it be sutured up and back into place? I’m afraid that skin will remain loose and hang. I have no interest in changing my whole nose, just the columellar area and lip where it protrudes.

 

A. Excellent question.  Fortunately in rhinoplasty when the nose is reduced, the skin always contracts down to “fit.”  In your case, your nasal spine at the base of your nose as well as some of your caudal nasal septal cartilage can be removed to decrease the obtuse lip-nose angle to a more masculine angle of about 90 degrees.​

As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision.  A few excellent rhinoplasty surgeons I would recommend are Sam Lam, MD (Plano, TX), Rod Rohrich, MD (Dallas), and Ari Hyman, MD (Encino, CA). Good luck and be well.

Q. What’s the best approach for hereditary hooded eyes that make me looks sleepy/eyeless?

RealSelf actual patient comment:

Hooded eyes, eyes always feel. Little heavy and sleepy. Would surgery help? I want my eyes to look open and refreshed. 33 y/o female.

 

A. An upper eyelid blepharoplasty would help you achieve your aesthetic goals.  It may be performed under local anesthesia in the office with about a one week downtime. As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision.  Good luck and be well.

Q. While waiting for Ultherapy results should there be other treatments done to the treated area?

RealSelf actual patient comment:

I just received ultheraphy by someone other than the dr. i consulted with. I dont know if she is a nurse or esthetician? can anyone be trained to use this device? Who is qualified to do Ultherapy? In between breaks she said that she loves this machine because theres no guess work. After treatment she advised getting mircroneedling to get rid of crepiness. I thought the treatment was going to get rid of that?After reading some comments on here I see that other treatments help the neck look tighter. what would you recommend?

 

A. Ultherapy is a good non-invasive device treatment for lifting and tightening the skin of the face, neck, and jawline.  I encourage my patients to combine Sculptra injections as well as microneedling with PRP for optimal rejuvenation results.  I personally treat all of our Ultherapy patients as it is important to customize Ultherapy treatment to each individual patient’s anatomy by reading the ultrasound screen.  Most practices delegate the treatment to peripheral office staff.  As with any aesthetic treatment it is essential to choose your treating physician carefully based on their experience, skill, knowledge, care, and most importantly their natural artistic vision.  Good luck and be well.

Q. Would Morpheus8, PDO threads, or Ulthera be better to tighten the skin?

RealSelf actual patient comment:

I am 38 years old, had my masseters treated with Botox and now feel and see laxity in my skin around my jaw line. Would Morpheus8 or ulthera be better to tighten the skin? Or, is there something else that could tighten the skin around the jawline with long term results?

 

A. I would treat you with Ultherapy, it would tighten the laxity of your jawline and re-establish a nice jawline contour and sharpness.  It will also address the early minimal jowls and lift your cheeks.  Your eyes will likely look more rested and youthful as well.  ​I have not been impressed with the long term results of PDO threads.  Morpheus8 is a very superficial treatment.

As with any aesthetic treatment it is imperative that you choose your treating physician most carefully based on their skill, experience, knowledge, care, and their natural artistic vision.

Q. Can I get Emsculpt on my stomach if I had my gallbladder taken out and internally closed with metal staples?

RealSelf actual patient comment:

Can I use EMSculpt on my stomach if I had my gallbladder taken out and they used small metal staples to close off the duct/artery? They are located internally on my right side just under my rib cage…where my gall bladder used to be. What is the acceptable distance from a metal object?

 

A. Unfortunately metal staples are a contraindication for Emsculpt over the area.  It is thought that the energy of Emsculpt penetrates about 7 centimeters deep from the paddles.  My wife also has staples in her abdomen and we are not treating her.  On the bright side, she did treat her buttocks as they are far enough away as to not be a problem.  You may also treat your triceps, biceps, and legs with the newly released applicators.  Good luck and be well.

Q. Is it possible to have Emsculpt if I have a testosterone pellet?

RealSelf actual patient comment:

I have tried everything to build muscle in my glutes, years and years of training with no success. I contemplated a BBL, but I’m really interested in building muscle. I’m on my 3rd T pellet in 18 months in combo with intense flute training. Can I have emsculpt while I still have a pellet in my glute?

 

A. Yes, you may have Emsculpt of your glutes with a testosterone pellet in place.  Good luck and be well.

Q. What are my options regarding rhinoplasty? Would my nose be a good applicant for this surgery?

RealSelf actual patient comment:

I have a long, bulbous, wide nose. It has a very unique shape. Is it possible to get an elegant (not cutesy) nose from my current one? A narrower bridge and smaller tip, as well as the sides next to my nostrils. When looking through before and after pictures, I have yet to find a nose that looks like mine, so I cannot see similar results. In your expert opinions, doctors, what would I realistically be able to expect from a rhinoplasty? Thank you!

 

A. You are an excellent candidate for rhinoplasty.  A properly performed rhinoplasty will result in an elegant nose that no longer distracts the focus on your face away from your eyes. Your nose can be deprojected and made proportionately smaller without creating a “cutesy” nose or a nose that looks like it had an obvious rhinoplasty.  The key for you is making sure that your choose your rhinoplasty surgeon carefully after multiple consultations.  Base your decision on the surgeons experience, knowledge, skill, and most importantly their natural artistic vision.   A few top rhinoplasty surgeons whom I would recommend are Steven Pearlman, MD (NYC), Ari Hyman, MD (LA), Jamie Derosa (Boston), and Dean Toriumi (Chicago).  ​Good luck and be well.

 

Q. Could I have a closed rhino or will a nose filler look good with my nose?

RealSelf actual patient comment:

I’m sick and tired of the bone I feel like it is growing and getting bigger I wish it was smaller I want either filler or a closed rhino. I like the bottom of my nose and I do not like how my nose is so skinny I honestly am confused on what to do I just do not like this bone it’s so hard and manly and too big for my face, also certain angles the bone looks obnoxious. I just feel like my bone is GROWING.

 

A. Rhinoplasty is your answer to help you achieve your aesthetic goals.  I would not recommend filler to your nose as it will only make it look larger.  The bone and cartilage that make up your profile nasal hump can be taken down by a closed rhinoplasty.  Make sure to choose your rhinoplasty surgeon most carefully based on their skill, experience, knowledge, and natural artistic vision.  A few top rhinoplasty surgeons whom I would recommend are Steven Pearlman, MD (NYC), Ari Hyman, MD (LA), and Dean Toriumi (Chicago).  Good luck and be well.

Q. When getting Voluma, how can you immediately tell the difference between a bad reaction (blindness) and a vasovagal response?

RealSelf actual patient comment:

I have an abnormally strong vasovagal response (get pins and needles in my eyes and can black out for eyedrops, dilation, and even when I got my lips injected). I want Voluma in my cheeks but am nervous because I heard their is an increased risk w/the blindness complication and while I know it is rare, I would just like to know how in the moment I can know if I’m having a complication or a simple vasovagal syncope like I might normally have.

 

A. The most important thing that you can do is make sure that you choose your facial filler injecting physician most carefully.  With experience, knowledge of facial anatomy, skill, and natural artistic vision the injection of Voluma should be extremely safe and effective.  We have treated hundreds of patients without adverse events or complications other than occasional minimal bruising​. We would advise you to use relaxation breathing techniques during your Voluma treatment, if you show signs of a vasovagal reaction, we immediately stop injecting until you recover fully.  We have many patients like yourself who were nervous and anxious at their first injection visit who have returned many times finding their treatment very easy and reminisce on how far they have come where the injections no longer bother them at all.  Again, choose your injecting physician carefully and you should have nothing to worry about.  Good luck and be well.

Q. Am I a good candidate for rhinoplasty? I want more narrow nostrils

RealSelf actual patient comment:

Hello! I want to make some adjustments to enhance my face. I love my nose but I’m unhappy with the flare of my nostrils. Do I need an entire rhinoplasty or is it possible to just slim my nostrils?

 

A. Great question.

Being a good candidate for a rhinoplasty is less about what your nose looks like and more about your expectations and rational for seeking one. A wide base of the nose is a common reason people seek rhinoplasty. For extreme widths a “synching suture” can help narrow the nose. Alar base surgery is an option but must happen with extreme caution and meticulous execution because scarring in this area is hard to correct.

Lastly, in black noses, increasing projection often will narrow the base. Perhaps not completely but may lessen the need for alar base surgery or any “alar-plasty.” I would recommend someone with expertise in ethnic and African American noses.

Be sure to choose your rhinoplasty surgeon carefully based on their skill, knowledge, experience, care and most importantly their natural artistic vision.  A few excellent rhinoplasty surgeons that I would recommend are Rod Rohrich, MD (Dallas), Dean Toriumi,MD (Chicago), and Ari Hyman, MD (Encino, CA).

Q. I want to know if it is possible to shear the top bone of the nose without breaking the nose?

RealSelf actual patient comment:

I’d like someone who is a real artist. I don’t want my nose broken if that is possible.

 

A. You are correct in seeking a true artist to perform your rhinoplasty.  It is possible to take down the top of your nasal bone without breaking the nasal bones as long as the nasal bones are relatively narrow and the hump is not too large. We often perform “subtle rhinoplasty” on patients who share your request.   From your photos it appears that it may be possible in your case.  As you have indicated in your question, choose your rhinoplasty surgeon most carefully based on their natural artistic vision as well as their skill, experience, knowledge, and care.

A few excellent rhinoplasty surgeons that I would recommend are Anthony Bared, MD (Miami), Richard Davis, MD (South Florida), and Ari Hyman, MD (Encino, CA).  Good luck and be well.

Q. How fast does bruising show up after Voluma in the cheeks? Can you see bruising as quickly as an hour or two after?

RealSelf actual patient comment:

How fast does bruising show up after Voluma in the cheeks? Can you see bruising as quickly as an hour or two after? Also, is there any tell tale sign that a discolored area is not a bruise but a necrosis in the early stages? Thanks.

 

A. Most of the time we don’t see bruising with Voluma injections.  As with any injections, if a blood vessel is hit with the needle, there will be some bleeding.  Bruising is minimized by applying pressure for a few minutes.  Voluma is injected deep to muscle and just over bone in most areas where it is used.  Occaisionally a deep blood vessel may be hit and delayed bruising does not show up for a day or two. Early vascular compromise and necrosis are entirely different and much more serious than bruising.  If the filler is injected into a blood vessel the patient will feel intense discomfort.  The area supplied by the vessel immediately blanches.  The resulting discoloration is mottled unlike a typical bruise.  Should this occur, it is essential to seek treatment immediately to dissolve the filler.  Always choose your injecting physician most carefully.  Good luck and be well.

Q. What procedure will fix the sagging skin on my chin?

RealSelf actual patient comment:

I am a 36 years healthy women. Lately noticed the sagging skin around my chin, what procedure would help attenuate the look a bit? I don’t think I am ready yet for a mid face lift , i am also not too keen to fillers as they are temporary. Would fat grafting help ?

 

A. I would treat your chin area with Profound RF and may use Sculptra which is a long lasting collagen stimulating injectable.  I am not a fan of fat grafting in the chin area as it can be unpredictable, and can be very difficult to adjust or remove. Choose your treating physician most carefully.  Good luck and be well.

Q. My nose is wide and very flat. Can a a Rhinoplasty give me more definition in my face?

RealSelf actual patient comment:

I feel like I have a very Flat face and flat nose. When I turn to the side you can see how my cheeks goes past my nose. I want to get work dont but I haven’t seen much work on a nose like mine.

 

A. You should consult with an expert surgeon in ethnic noses.  A structural rhinoplasty will give definition to your nose.  Nasal cartilage, ear cartilage, and sometimes even rib cartilage may be used to give your nose definition.  The most important aspect of any aesthetic procedure is to make sure that you choose your physician carefully.

Choose your rhinoplasty surgeon  based on their skill, knowledge, experience, care and most importantly their natural artistic vision.  A few excellent rhinoplasty surgeons that I would recommend are Anthony Bared, MD (Miami), Richard Davis, MD (South Florida), and Ari Hyman, MD (Encino, CA).  Good luck and be well.

Q. Is it possible to correct this area above my lip with a rhinoplasty?

RealSelf actual patient comment:

There’s a slant above my upper lip and below my nose. I have searched for before and after photos for someone that has the same thing as I do and I have not found one single piece of evidence that shows me it can be done. My jaw surgeon recommends a rhinoplasty instead of re-doing the double jaw surgery. Is it actually possible to correct this issue with a rhinoplasty?

 

A. Yes, rhinoplasty with reduction of your nasal spine will correct the area above your lip.  ​

Be sure to choose your rhinoplasty surgeon carefully based on their skill, knowledge, experience, care and most importantly their natural artistic vision.  A few excellent rhinoplasty surgeons that I would recommend are Rod Rohrich, MD (Dallas), Spencer Cochran, MD, Dean Toriumi,MD (Chicago), and Ari Hyman, MD (Encino, CA).  Good luck and be well.

Q. Is it possible to significantly reduce a large/bulbous nose tip with thick skin?

RealSelf actual patient comment:

I’ve always been self conscious about the shape and size of the tip of my nose. I’ve been considering a rhinoplasty but have been told by friends and family that it would be difficult/impossible to significantly reduce/change the size and shape of my nose due to the fact that the skin is very thick there. How much change would it be possible for me to see?

 

A. Yes, a properly performed rhinoplasty will help you achieve your goals of a pretty nose.  You will need a structural rhinoplasty where cartilage is used to give your nose definition and reduce your bulbous tip and overcome your thick skin.  The most important aspect of your rhinoplasty is making sure that you choose your rhinoplasty surgeon most carefully.  I would recommend Ari Hyman, MD who is an expert at structural rhinoplasty having been fellowship trained by Dean Toriumi, MD in Chicago.  Dr. Hyman is practicing in Los Angeles.  Good luck and be well.

Q. Can I have TMS treatments for depression at the same time as Emsculpt?

RealSelf actual patient comment:

Both TMS and Emsculpt use electro-magnetic pulsing. While TMS is highly localized, is there any problem with receiving too much electro-magnetic stimulation?

 

A. There is not any problem with receiving both Emsculpt and TMS electromagnetic therapies concurrently as long as you have no contraindications to either treatment.  I hope that you are feeling better!!! Good luck and be well.

Q. What are the best techniques to change the symmetry of my face?

RealSelf actual patient comment:

I’m 37 years old and my facial features are rough and over the years tried to change my hair color or contour with makeup but i came to a conclusion that i want to make changes like on my bone structure i want to look more feminine i love Angelina’s Jolies face and Marilyn Monroe , i was impressed how drastically Kyle changed her face.I want to look younger i feel i dont have a glow and i want a drastic change even having a nose job.

 

A. I agree with my esteemed colleague, Toby Mayer, MD.  Your face is symmetric, symmetry is not a facial feature that should be changed.  If you would like to have a smaller, more refined nose then rhinoplasty would help you achieve that aesthetic goal.  There are many great treatments and products that can help you look younger and give you that “glow” without going all out Kardashian crazy.  Good luck and be well.

Q. Can I get emsculpt on my butt if I’m 4 weeks pregnant?

 

A. Congratulations on your pregnancy!!!  There have probably been many women in their first few weeks of pregnancy who have been treated with Emsculpt before they were aware of their early pregnancy.  It is one thing to be treated unknowingly, it would be against the standard of care if a known pregnant woman is treated with Emsculpt.  Enjoy your pregnancy and new addition to your family.  The good news is that Emsculpt on your abdominal muscles post-partum will help the muscles return toward normal.  Good luck and be well.

Q. Can Botox fix my asymmetrical smile?

RealSelf actual patient comment:

My right (picture left) corner of mouth pulls way further than the other side when I smile and kind of makes the corner of my mouth look like female genitalia and there is an extra c shaped wrinkled on that side that doesn’t exist on the other. Can Botox keep that side from pulling so far and balance my smile?

 

A. The corner of your mouth certainly does not look like female genitalia!!! (if so, it is the prettiest female genitalia in the world.)  I would be very hesitant to use neuromodulators (Botox) to attempt to even your smile because it could lead to severe asymmetry issues (still would not look like genitalia, male or female!!!)  After examining you in person, a little filler in the corner of your mouth may help your achieve your aesthetic goal.  Good luck and be well.

Q. As a 50 year old female struggling to build arm muscle and lose fat, what kind of results could I expect from Emsculpt?

RealSelf actual patient comment:

I am a 50 year old female (5’8”, 142lbs). I walk 4-5 miles a day w/my dog. I also do yoga 2-3 times a week, and have recently added resistance training 3 times a week, and HIIT into my routine. I am in good health and eat well, but am struggling with my ability to build muscle (my arms being my biggest issue). In addition to building muscle, I have to lose body fat. Would Emsculpt help my arms? And is it recommended that you do both the biceps and triceps for best results and balance?

 

A. The new Emsculpt arm and leg paddles work similar to the paddles for the abdominals and glutes.  you may expect a 16-20% increase in muscle mass of the arms over a 6 to 12 month period.  I would recommend treating both the biceps and triceps for optimal results.  With you commitment to staying in shape, you are likely an excellent candidate for Emsculpt.  Good luck and be well.

Q. Restylane won’t dissolve after 19 months and 9 injections of hyaluronidase and 3 of Kenalog. Will microneedling RF help?

RealSelf actual patient comment:

It’s been 19 months. I’ve had hyaluronidase injected 9 times (massive amounts) and Kenalog 3 times (2.5mg). The material around my mouth will not dissolve. Will Radiofrequent microneedling help? It swells up every morning. I’ve been told it could be scar tissue encapsulation. Please read this post before advising me to get hyaluronidase.

 

A. It is very unusual for Restylane to not dissolve with hyaluronidase.  Are you sure that it was Restylane that was injected?  Radiofrequency with microneedles may help although there is no guarantee.​  It is porbably worth trying given all that you have been through and its continued problems.  Good luck and be well.

Q. My nose is very bulbous and fat with thick skin can I have a prettier nose by doing rhinoplasty?

RealSelf actual patient comment:

I recently asked someone and they said that my nose would not be that defined because its si big and thick the results that I want won’t happen and will no show this got me so sad. My whole life I wished for a pretty cute nose but now I feel that it would be impossible that’s why I need a real expert opinion.

 

A. Yes, a properly performed rhinoplasty will help you achieve your goals of a pretty nose.  You will need a structural rhinoplasty where cartilage is used to give your nose definition and reduce your bulbous tip and overcome your thick skin.  The most important aspect of your rhinoplasty is making sure that you choose your rhinoplasty surgeon most carefully.  I would recommend Ari Hyman, MD who is an expert at structural rhinoplasty having been fellowship trained by Dean Toriumi, MD in Chicago.  Dr. Hyman is practicing in Los Angeles.  Good luck and be well.

Q. I feel my nose needs to be ‘pulled back up’ and lifted higher with a better bridge bone?

RealSelf actual patient comment:

Hi, over the years my nose which used to be lovely, taut and neat has gone broader with lower, floppier, wider nostrils which really flair when I smile. I feel it needs to be ‘pulled back up’ and lifted higher with a better bridge bone and tighter, neater nostrils. I love Adele’s nose. Any thoughts?

 

A. You are not alone.  Many patients complain that their nose drops, widens, and flares as they age.  We perform many rhinoplasties on aging noses to restore the taut, neat proportions, giving the nose (and patient) a lift.  It appears that your rhinoplasty can be performed endonasally (closed without an external incision) to refine your nose.  I agree, I like Adele’s nose too, though all noses are different, her nose could serve as a nice template for your rhinoplasty aesthetic goal.  Choose your rhinoplasty surgeon carefully based on their training, experience, skill, knowledge, care, and most importantly their natural artistic vision.​ Good luck and be well.

Q. I would like to do Botox to make the movement less without freezing it. Is there a specific Botox treatment for this?

RealSelf actual patient comment:

Every time I’ve done botox even injecting a minimum amount it seem to make it freeze and the eyebrows go down just a tiny bit. Is there a way to prevent this and keep some movement in the forehead but just less “Animated” the way the botox acts when it’s wearing of the last months???

 

A. Many of our patients share your concern.  Patients wish to look fresh, rested, and natural without looking unnaturally frozen and plastic.  The use of Botox is both an art and science.  Getting your Botox is not a commodity, like going to the store and buying milk, not all Botox injectors are the same. Each patient must be evaluated and treatment is based on the size and strength of their facial muscles as well as the patient’s personal aesthetic goals. Each treatment in our office is customized, Botox treatments are not “cookie cutter” where every patients gets the same amount in the same areas. In your case you are likely a candidate for specialized “micro-dose” Botox treatment. The most important aspect of your Botox treatment is making sure that you choose your physician injector most carefully.  Choose your physician based on their skill, experience, knowledge, care, and their natural artistic vision.  Good luck and be well.

Q. What can I do about heavy, puffy upper eyelids at the age of 66?

RealSelf actual patient comment:

My upper eyelids are getting heavy and puffy. I am 66. Will this procedure help me? I really don’t want to get a surgical eye lift.I hear the results are better the younger you are and that women my age, whose skin is getting thin and papery, don’t get nearly the results. Let me know what you think, thanks!

 

A. An upper eyelid blepharoplasty will correct your heavy puffy eyes.  I am not sure what procedure you are asking about in your question, but blepharoplasty is your answer.  Good luck and be well.  Choose your treating surgeon carefully based on their experience, skill, knowledge, and natural artistic vision.  Good luck and be well.

Q. Does a nose with lots of graft look fake in real life?

RealSelf actual patient comment:

I need revision rhinoplasty. And it seems like I will need a lot of grafts, to project the tip, build the bridge and widen the nose as well. I am Caucasian male with regular skin. Based on the photos noses with grafts look fine, but I have never seen one in person. Do they appear fake? That is something that I cannot afford due to my work as senior manager in in the company.

 

A. When performed properly, a revision rhinoplasty using grafting should look natural.  The most important aspect of revision rhinoplasty is making sure that you choose your rhinoplasty very carefully based on their experience, skill, knowledge, and natural artistic vision.  With any aesthetic surgery or treatment, we fail our patient if the result is obvious, fake, and unnatural.  Good luck and be well.

Q. Is it possible to use Emsculpt protocol 1 (for abs) on butt instead of Emsculpt protocol 2?

RealSelf actual patient comment:

I had Emsculpt on my stomach and got spectacular results, so I added my butt. On my butt the results were not noticeable. I think it is because I have more fat on my butt than I would like to have. I finished my last of 4 treatments last week. I know the protocol for the butt does not eliminate fat the way that the stomach protocol does so could I have the stomach protocol done on my butt? Or should I just have more treatments on butt?

 

A. Yes, you may have either the fat sparing or fat reducing settings of EmSculpt when having your glutes treated.  Some patients wish to build muscle and reduce fat when lifting their glutes with EmSculpt while the majority of patients wish to build muscle and preserve the fat on their behind.  Let your physician know what you prefer and you will be treated with the appropriate EmSculpt settings.  Good luck and be well.

Q. What’s your advice on how to fix abdomen after pregnancy?

RealSelf actual patient comment:

I have a very small diastasis recti as well as loose skin from my pregnancy. I am 5’6 and 110 lbs. Most of the skin is below breasts and above c-section scar. Wondering if Emsculpt with Bodytite would fix my problem? Is Emsculpt something and should be done prior to Bodytite? Do these two work well together? Is there a certain order I should have these done in? Are there any other treatments out there that I should consider? Thank you!

 

A. We use EmSculpt to build abdominal muscle and reduce fat.  Body tite is fine but is more invasive than Venus Freeze or Legacy which we use in our new moms who do no wish to have any invasive treatment, only topical.  Good luck and be well, enjoy your new addition to your family!!!

Q. Emsculpt for diastasis recti?

RealSelf actual patient comment:

Hi there, when seeking a consult for Emsculpt, the technician said wasn’t a candidate because she thought I had an umbilical hernia. It never occurred to me before but I think she is right and upon research and self examination, I also think I may well have diastasis recti. I’m not sure the best course of action from but I’ve actually read Emsculpt can help heal DR?? Thoughts?? Not sure where to start.

 

A. Definitely have your umbilical hernia repaired prior to having EmSculpt.  EmSculpt will help with diastasis recti.  Good luck and be well.

Q. Does Emsculpt work for diastasis recti after a pregnancy?

RealSelf actual patient comment:

I have gotten two opinions about my diastasis recti with two plastic surgeons that recommend a surgical option, I am not ready at this moment to go under the knife. Would Emsculpt help me?

 

A. Yes, Emsculpt does reduce diastasis recti (the separation of the abdominal muscles) by about 11%.  The company has another great technology called Emsella that strengthens the abdominal floor muscles in new moms.  It restores strength, it’s the equivalent of doing 12,000 kagels per 28 minute session.  Emsella is also great for urinary stress incontinence.  Congratulations on your new baby!!!

Q. Can I get Emsculpt after BBL?

RealSelf actual patient comment:

I just got BBL 3.5 weeks ago and would like to get EMSculpt at some point to build muscle as well. How long do I need to wait after the BBL surgery so I don’t jeopardize the fat? My surgeon does not have experience with EMSculpt so he really couldn’t comment on my question.

 

A. Yes you can have EmSculpt after BBL.  You may wait for 3 to 4 months after your BBL for your treatment.  Make sure that the fat sparing protocol setting is used for your Emsculpt muscle building butt lifitng treatment. Good luck and be well.

Q. Will Emsculpt be safe if I have dental implants?

RealSelf actual patient comment:

I have the. “ALL ON FOUR UPPER DENTAL ARCH ” will emsculpt treatment on stomach be safe

 

A. Yes, EmSculpt is safe in patients who have metallic dental implants (as long as you are not treating your facial muscles!)  As long as the metallic implant is more than 7 centimeters from the EmSculpt paddle surface it will not heat and the treatment is safe.  Good luck and be well.  Brush your teeth!!!

Q. Would Emsculpt make me loose the little fat I have in my butt?

RealSelf actual patient comment:

I am considering emsculpt but not sure if I should use it for my stomach or butt. I have a very flat butt and heard emsculpt could help because it exercises the muscle but it also says it burns fat and I cant afford to lose any fat in my bottom.

 

A. Fortunately there are two settings of EmSculpt for the treatment of the buttocks.  For those who wish to preserve their butt volume (fat), there is a fat sparing setting.  For those who wish to lose a little from their behind, there is a setting for that as well.  Make sure to let your physician know prior to presenting your tush on the EmSculpt table.  Good luck and be well.

Q. Emsculpt muscle spasms? Could this be a side effect?

RealSelf actual patient comment:

I recently had two emsculpt treatments to my abdominal area. I’m already fit and have a BMI around 21. The procedure was very uncomfortable and sort of painful at times because of such such contractions. A couple days after my second treatment I noticed very frequent, small muscle spasms in my legs. Could this be a side effect? Will this issue resolve?

 

A. Fortunately EmSculpt is a very effective and safe treatment.  I have not heard of delayed muscle contractions or spasms of leg muscles after EmSculpt treatment.  It is possible that you may be experiencing a very rare unreported side effect or it may just be coincidental.  The issue should resolve on its own.  Definitely share your symptoms with your physician who is treating you.  Let us know how you are doing.  Good luck and be well.

Q. Can I do EMsculpt on my abs with Essure coils in Fallopian tubes?

RealSelf actual patient comment:

I’ve had Essure for about ten years. I did Emsculpt on my butt and thighs without any issues and I’m wondering if doing EMsculpt on my abs is not advised? I know the company says metal implants are a contraindication, but from looking at Essure it seems there’s very little metal (titanium and nickel?) and I’m curious if it really is absolutely not advised in my situation? Thank you!!!

 

A. Not a good idea to have EmSculpt abdominal treatment if you have a metallic IUD.  Best to have it replaced with a non-metallic IUD if you want to have abdominal EmSculpt.  Good luck and be well.​

Q. Can I do anything after the last Emsculpt treatment to improve my results? Drink water, or sauna etc?

RealSelf actual patient comment:

Emsculpt – do i do anything afterwards?

 

A. The best way to insure that your EmSculpt results are optimal is to maintain a healthy life style.  That includes a healthy balanced diet, multivitamins, drinking at least five 8 oz.​ glasses of water per day (stay hydrated), and regular exercise.  Over 6 months, your treated area should gain 16-20% muscle mass and lose the same in fat.  Good luck and be well.

Q. Nonsurgical options for lower abdomen? Will Emsculpt work?

RealSelf actual patient comment:

I have 3 kids and have developed a slight bulge in my lower abdomen that will not go away with diet and exercise. I have a fear of surgery so I have been looking into non surgical options. Emsculpt was recommended. But will it really work for this? I hate to go to multiple offices for consultations as I just don’t have the time for that.

 

A. EmSculpt will build your abdominal muscles and decrease your abdominal fat bulge.  It also helps to bring the abdominal muscle gap that occurs after pregnancy (diastasis recti) closer together.  It appears that you are a very good candidate for EmSculpt treatment.  If your fat bulge does not decrease enough then a session or two of CoolSculpting may be added.  Good luck and be well.

Q. Will the tear troughs improve with time once my sleep is restored?

RealSelf actual patient comment:

I am a 32 year old female. I’ve had severe insomnia for the past 10 months, and have a lost a lot of fat volume in my face, elasticity in my skin, and now have two very noticeable creases (tear troughs) under both eyes that are hyperpigmented. Also, will I recover some of the fat volume in my face once I’m sleeping again?

 

A. Unfortunately adequate sleep time will not restore lost facial volume.  You will​ be best served with some Voluma volume replacement in your cheeks with possibly Restylane under your eyes.  Good luck and be well. Pleasant dreams!!!

Q. What can I do for my under eye hollows, fuller lips, marionette lines and forehead?

RealSelf actual patient comment:

I’m 22 but I’ve been through many traumatic experiences and illness and consequently I’ve already damaged my “youthful” look. I have always had some serious hollow eyes, which you can’t see in the first photo due to lighting and expensive concealer. I also want to get fillers for my lips and marionette lines and Botox for my forehead (again, not visible in first photo, but lines on forehead as well as “concern” lines are becoming a serious problem.) I have added a before and after photo of me now and the results I’m looking for, as well as what I looked like before life damaged my youthful face.

 

A. First of all you look beautiful.  Second of all, as a 24 year old friend once told me when I asked her, “Does anything on your face bother you?’…she replied, “Nothing beats youth!!!”  At age 22, you should consult with a great aesthetician and have a quality skin care regimen.  I ask all of my millennial patients to see Kayla, our superb aesthetician, to have a personalized skin care regimen.  As far as treating undereye hollows, I would likely treat you with a very small amount of Voluma and Restylane.  Less is more!!!  Millennial lips are best treated with a small amount of Volbella.  Forehead lines are prevented with micro doses of Botox, Dysport, or Juveau.  Again, less is more, if your treatment is obvious or unnatural then your treating physician has failed you.  Choose your treating physician most carefully based on their knowledge, experience, skill, and most importantly their natural artistic vision.  Good luck and be well. ​

Q. Is more than 4 Emsculpt sessions needed? What power level should be used?

RealSelf actual patient comment:

I am intrigued by Emsculpt. I called a Dr’s office who provides it and the receptionist said that a “bare minimum “ of four treatments (at $3000!) would be needed. Everything I’d read suggested it was four treatments. $3000 is already a heavy lift for me. I don’t want to waste my time and money if I can’t afford more than four treatments. Any thoughts? What power settings should each treatment be at?

 

A. Emsculpt was studied treating patients with 4 30-minute sessions over a two week period.  There was 16-19% muscle mass increase and 19% fat reduction.  What has not been studied is the optimal maintenance regimen.  We are seeing results being maintained one year out, these patients have had a fifth treatment session at about 6 weeks after completion of their series.  I believe that with continued exercise and a healthy diet/life style patients should be able to maintain their results. As with investing in speculatively in stocks or options, you never want to invest more that you can comfortably afford to lose.  If you are worried about the cost, 24 Hour Fitness may be better for you, though you will be hard pressed to match the 20,000 supra-maximal muscle contractions per 30 minutes.  Good luck and be well.

Q. I am not currently pregnant, but what are the consequences of a treatment overlapping a very early pregnancy?

RealSelf actual patient comment:

I am considering Emsculpt for my buttocks, however am also trying-but-not-thing to conceive with my husband. I am not currently pregnant, but what are the consequences of a treatment overlapping a very early pregnancy, as in a pregnancy that is not yet detectable on at home test? If there is a known risk I will not pursue but I’d like to gain the muscle strength from the treatment

 

A. There obviously have not and will not be any studies on the effects of EmSculpt on a new conceived fetus.  If by chance an early fetus survived the treatments, I would imagine that the baby would have an incredible 6-pack and a butt lift to make the Kardashians jealous.  All kidding aside, I would wait until after pregnancy for your EmSculpt treatment as it is also beneficial for diastasis recti (separation of abdominal muscles.)  Your other option is to make sure that you are not pregnant yet, use condoms or abstinence for the two weeks that it takes to have your treatment and then get back to work with your hubby.  Good luck with getting pregnant and having a healthy baby.  Be well.

Q. Can Emsculpt be used for pectoral muscles?

RealSelf actual patient comment:

I would like to know if emscuplt is effective for young men, to build up their shoulders and chest muscles.

 

A. The strong electromagnetic waves of EmSculpt would be very dangerous directly over the heart muscle, one of the muscles of our body that we certainly do not wish stimulate with supra-maximal contractions.  Unfortunately, the pectoral and other chest muscles must be built the old fashioned way​…with physically toiling.  Good luck and be well.

Q. Do your female patients see Emsculpt results on abdomen?

RealSelf actual patient comment:

A nurse practitioner told me that men seem to have better fat burning results with Emsculpt than women. What are your experiences? I’m a woman looking for both fat burning and strengthening. (And it’s so expensive that I can’t afford to drop this $ for nothing). Am told am not a cool sculpturing candidate because I don’t have enough pinchable fat (fat is there! Just under the muscle)

 

A. We have not noticed a difference in EmSculpt results between men and women.  In general, the more fit a patient is prior to EmSculpt the better results​. EmSculpt does build muscle and reduces fat.  It sounds as if you are a good candidate for EmSculpt.  Good luck and be well.

Q. Can you use emsculpt on hamstrings?

RealSelf actual patient comment:

I had ACL reconstruction10 years ago, with a hamstring graft. Unfortunately the “donor” hamstring remains significantly weaker and smaller than the other hamstring, despite my efforts to build it up. Is there an emsculpt protocol for hamstings? Are physical therapists using emsculpt yet?

 

A. Yes, Emsculpt may be used on the hamstring leg muscles.  There are new EmSculpt paddles for the legs and arms that will be available to the public very soon.  We have been treating our patients with the current abdominal paddles and getting excellent results. I am not aware of any physical therapists currently using EmSculpt though it makes sense to use this technology on people who are unable to workout due to various reasons.  Good luck and be well.

Q. Why does it take time to see my Emsculpt results on my stomach and butt?

RealSelf actual patient comment:

How long does it take to see my results on emsculp on my stomach and butt. I had 5 sessions that ended 3 weeks ago.

 

A. Rome was not built in a day, nor will your ab and glute muscles build in day (or week) after EmSculpt.  It takes time for muscle mass to build and for fat cells to disappear following EmSculpt treatment.  Many patients find that they can feel that their muscles are more firm, some even see improvement after a few weeks.  We emphasize to our patients that the muscle building and fat reduction from EmSculpt continues for up to 6 months.  Good luck, be well, and enjoy your EmSculpt results.

 

Q. Sculptra in right cheek. Two hours after injection napped for 2 hours. Got a deep crease line from the pillow. Will this smooth?

RealSelf actual patient comment:

Had Sculptra in my face (right cheek) this morning. Got home two hours after injection and went to sleep for 2 hours. Woke up with a deep crease from my pillow right in the middle of the recipient area. Any general advice about this. For ex; how likely would it be for the crease line to pop back smooth…in general? Thank you.

 

A. As they say NTW, not to worry.  Most of the areas where Sculptra is injected are over bone, the injections should be deep and not affected.  We recommend deep massage for our Sculptra patients for 5 minutes, 5 times a day, for 5 days.  This helps to increase your circulation to the area and in turn helps your body break down the Sculptra particles and replace them with your own collagen.  Always best to contact your injecting physician with any questions or concerns.  Good luck and be well.

Q. Is EmSculpt safe if have a small PFO?

RealSelf actual patient comment:

Is EmSculpt safe if have a small PFO? I ask since the procedure acts like an intense exercise that breaks down and rebuilds muscle fibers.

 

A. I copied and pasted this information about patent foramen ovale (PFO) :

Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but most often closes shortly after being born. PFO is what the hole is called when it fails to close naturally after a baby is born.​PFO’s typically do not disrupt heart function and people are able to exercise and carry out all activities normally. However, some people with PFOs can be at an elevated risk of stroke or suffer other symptoms due to a significant drop in oxygen levels.​

Emsculpt should be safe in patients with PFO since there is no aerobic increase from the treatment.  To be on the safe side it is always prudent to have your treating physician check with your cardiologist before your treatment.   Good luck and be well.

Q. How soon after Emsculpt should I expect results?

RealSelf actual patient comment:

I just had my second session (of four, to be spaced out over two weeks). I see absolutely no difference, but in others’ reviews, it seems like they are seeing visible results immediately following each treatment. One other woman went so far as to say that she saw she had abs the second she got off the bed after one session. Now I’m concerned that it simply isn’t doing anything for me. How long does it typically take to begin to start seeing results?

 

A. Like snowflakes, all abdominals are different.  Some patients may see Emsculpt result sooner than others.  We have had some patients notice improvement after 2-3 weeks, while for others it may take months.  The technology is still too new for us to know why some patients respond quicker and better than others.  Be patient as the results are usually seen about 2 to 3 months after treatment and may continue to improve over 4 to 6 months.  Good luck and be well.

Q. Emsculpt ok on abdomen after abdominal liposuction over 8 years ago?

RealSelf actual patient comment:

I had abdominal liposuction about 8 years ago. I’d like to have 4 sessions of Emsculpt to tone up and get rid of my remaining tummy pooch. Does previous liposuction impact Emsculpt results?

 

A. Yes, Emsculpt works well on patients who have had abdominal liposuction in the past.  Good luck and be well.

Q.What if it takes longer than 2 weeks to complete 4 sessions?

RealSelf actual patient comment:

I had my first 2 sessions as planned, 3 days apart. My 3rd session was supposed to be Thursday, but was rescheduled to Monday because the EmSculpt machine was not working. Now my Monday appt has to be rescheduled because the technician won’t be there. I have to travel for a week for work. There will be 2 weeks between my 2nd and 3rd sessions. Can I still get the results I was originally expecting? It feels unfair given that the doctor’s rescheduling. What should I do?

 

A. The studies on Emsculpt were done with patients having 4 sessions a few days apart over a 2 week period.  We do not have enough information to tell you whether your delay in treatment sessions will affect your ultimate outcome.  Since the delay was due to no fault of your own, It would be reasonable to ask your provider to give you a standard series of treatments.  Since the machine was down, the company should be able to reimburse the physician the cost of running the machine.  Good luck and be well.

Q. Will Emsculpt ever be covered by insurance to help my scoliosis by building my core?

RealSelf actual patient comment:

I have scoliosis which causes me to suffer with back pain and poor posture. The only treatment I can do is workout my core. It is an ongoing effort and not sustainable. Emsculpt could help me build a stronger core more rapidly and consistently. I believe this could help me heal. Will insurance ever cover Emsculpt for this reason? How can I help the process along?

 

A. Emsculpt is used in patients who are unable to workout due to certain conditions.  Emsculpt can build muscle mass and strengthens core muscles.  It would be sensible for insurance to eventually cover Emsculpt treatments in patients who are otherwise unable to workout, but who ever said that insurance companies are sensible.  At this time, Emsculpt is not covered by insurance.  Good luck and be well.

Q. Should 2 paddles be used on abdomen when doing emsculpt? or can 1 do the trick?

 

A. They say “Two heads are better than one!”  With Emsculpt 1 or 2 paddles can “do the trick.”  If the abdomen is wide enough to accomodate two paddles without the paddles touching each other then 2 are used.  If the abdomen is not wide then one paddle is enough.  In both cases the abdominal muscles are stimulated to supra-maximal contractions and the results are equivalently good.  Good luck and be well.

Q. 30 year rhinoplasty results are wearing down: tip projection is lowering. What can be done?

RealSelf actual patient comment:

I had a closed rhinoplasty 30 years ago to remove a hump and refine the tip. The operation was a success that it produced a satisfactory concave profile and refined tip. But over the years the shrink wrap effect has decreased the projection of the lower half of the nose (upper lateral cartilage to the tip), while the top half (nasal bone) is staying at the same height. Is it possible to re-achieve a concave profile, by shaving more on the bridge? Keep same tip, closed or open rhinoplasty?

 

A. Post rhinoplasty noses tend to shrink wrap over time.  That is why it is essential that your initial rhinoplasty surgeon leave an adequate structural support of nasal bone and cartilage.  You may either have a revision rhinoplasty or have a non-surgical filler injection to raise the tip of your nose.  If you were my patient, I would try to use fillers first.  Make sure to choose your injecting surgeon most carefully as previously operated upon noses have a much higher risk of complications.  Should you decide upon the surgical route, once again choose your surgeon very carefully.  Good luck and be well.

Q. What can I expect in the coming week after occlusion?

RealSelf actual patient comment:

Juvederm injections three days ago. No pain but obvious occlusion. Immediately small dose of hyaluronidase. Was pink and swollen over weekend but not bad. Today this developed and I’m on steroids and nitro-bid as well as doing warm compresses. This is day 3. Am under care of plastic surgeon.

 

A. Sorry to see that you have suffered from vascular occlusion from filler injection.  Best to follow the plan of the plastic surgeon taking care of you.  Inquire about more hyaluronidase at the site of where the injection caused the occlusion.  The affectedd by the occlusion should get darker over the next few days, it may form little blisters as well.  Hopefully the area will recover without any permanent effects.  Good luck and wish you well.

Q. Could this be vascular following filler then vein ablation?

RealSelf actual patient comment:

4 months after filler. Several people said it’s vascular. Had some veins ablated 10 weeks ago. What is this?

 

A. If it has appeared after your vein treatment then it is likely related to that.  Hopefully over more time it will resolve.  Good luck and be well.

Q. Will Botox and fillers help make my face more contoured or slim?

RealSelf actual patient comment:

Naturally rounder face, wonder what will help me look more contoured? Also wondering if a non surgical nose job is something that would work for me.

 

A. Botox and fillers used properly should result in a more contoured facial appearance.  I would not recommend non surgical nose job unless from profile view you wish to hide a bump/hump.  Be sure to choose your treating physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. I have 6 titanium screws at my L5-S1 lumber region and wonder if they will heat up during an abdominal Emsculpt?

 

A. Though metal implants are a contra-indication to having Emsculpt, many physicians have treated patients with titanium implants as titanium does not heat from electromagnetic energy.  Check with your lumbar surgeon to make sure that you have no metallic implants.  If your surgeon allows you to have a MRI after your back surgery then you should be safe to have Emsculpt treatments.  Good luck and be well.

Q. Can I use Emsculpt if I have a bladder sling?

 

A. As long as the bladder sling does not have any metal parts, Emsculpt treatment should be fine.  To be on the safe side, please contact your bladder surgeon and ask if there is any metal, and ask if the intense abdominal muscle contractions will adversely affect your sling.  Good luck and be well.

Q. Can you advise on my treatment plan for Emsculpt on the buttocks?

RealSelf actual patient comment:

4 months ago, I received an initial treatment of 4 sessions in 2 weeks. I do strength training twice a week. If I were to buy another 4 sessions, would I see better results from spreading those sessions once every month or doing another series of 4 sessions within 2 weeks? Is there a plateau of increased muscle mass after doing the initial 4 sessions or can you continue to see subsequent increased muscle mass in doing another full set in several months?

 

A. There have not been any studies or clinical research on which course is better after your initial Emsculpt treatment series.  We usually see our patients back about 6 weeks after they have completed their initial treatment sessions for post treatment evaluation, photos, and a maintenance​ session.  For those patients who wish to continue their treatments we prefer to space them a month or two apart.  Good luck and be well.

Q. What happens if you get a pimple on a filler treated area? Will it leave a hole or damage the filler?

RealSelf actual patient comment:

Is it possible that pimples on (HA) filler treated areas leave holes or negatively impact my results?

 

A. No need to worry. having had filler in the area will not affect how a pimple heals.  Please make sure that the “pimple” is not an infection from the filler injection (more likely if you have new “pimples” in the places where you were injected.)  Although many of my dermatology colleagues love to say, “Popping pimples never gets old!”, please do not “pick” your pimples to avoid scarring.  Good luck and be well.

Q. What longterm treatment should I get for this texture on my face? Are these pores or scars?

RealSelf actual patient comment:

Hello! I’m wondering what kind of treatment I should get for this texture on my skin. The photos are with makeup on, I’ve had microneedling in the past and IPL and chemical peels. I want long term results. Also would you describe these as pores or scars ?

 

A. It appears that you have small scars causing the uneven texture of your skin.  I would recommend a series of four Fraxel restore laser treatments spaced about 3 weeks apart with a small amount of Sculptra injected beneath the areas of your scars.  Choose your treating physician most carefully.  Good luck and be well.

Q. Is raised upper lip line inevitable or can it be avoided?

RealSelf actual patient comment:

Hello docs I have had approx 2cc’s of Juvederm Ultra injected into my lips over approx 2 months. It had been over a month since my last injection. I am wondering if the upturn on my upper lip (raised lip line area, especially at Cupid’s bows) is avoidable. Wondering if this is a stylistic thing or something that is inevitable with fillers. Ideally (in my opinion) this would be a smoother transition between skin and lip. Any answers/feedback are much appreciated!

 

A. Lip augmentation with fillers is both artistic and technical.  It appears that your lip augmentation has emphasized your lip border which is causing the upturn.  This result is not inevitable with lip injections, you are correct, it is a stylistic thing.  I would share your preferences with your lip injecting physician in the future to keep your lips a bit more natural in appearance.  Your lips look relatively good at this time so I would not advise dissolving any of your filler.  Good luck and be well.

Q. I’ve had several laser treatments and chemical peels and now I have orange peel skin. What can I do?

RealSelf actual patient comment:

I have had several laser treatments. Chemical peels. It seems like every time something heals my pores come back worse. What can I do? I want my confidence back

 

A. I would likely treat you with a combination of microneedling with PRP (platelet rich plasma) and injection of Sculptra below the affected skin areas on your cheeks.  If your chin is affected then Botox works well in that area.  Good luck and be well.

Q. Is rasping after rhinoplasty typically performed just under local anesthesia?

RealSelf actual patient comment:

I need rasping done to take down a callus that formed on the bridge of my nose after rhinoplasty. I’m very nervous about going through the procedure just using a relaxation pill due to the numbing process and hearing the rasping taking place. Is this something typically performed just under local anesthesia and how do patients typically handle the process when awake?

 

A. Nothing funny about having a little more rasping of your dorsal nasal hump after previous rhinoplasty.

The procedure can be done in the office under local anesthesia with or without pain meds and Xanax, or it can be done under anesthesia in the operating room.  The advantage of doing it in office is saving the cost of the operating room and anesthesiologist fees, but if you’d rather not hear or see any of it, you may pay more and have general anesthesia.  Good luck and be well.

Q. Is this a typical upper blepharoplasty incision? I am concerned with excessive length.

RealSelf actual patient comment:

I am almost 2 wks postop upper bleph & concerned that my incisions are very long (extending 1/2 in. outside my eyelid which is hard to hide). I thought that incision would be isolated to eyelid & I’m very concerned with scarring/future appearance. For reference, this eye did not have significant hooding (my other eye did but the incision is not quite as prominent on that eye although also a bit long). I know I have lots of healing left to do but wanted to get a consensus before returning to Dr.

 

A. Yes, your incision is normal length, not to worry, within a few more weeks the scar should be minimal, once your incision line color returns to normal skin color it will be very difficult to see.  Good luck and be well.

Q. Is it normal to have jaw soreness, trouble chewing and swallowing after Botox?

RealSelf actual patient comment:

I recently got 42 units of Botox in my forehead, bunny lines, brow lift and crows feet. About 3 days ago. Since then, I’ve had trouble swallowing, chewing and overall soreness in my jaw and feel like I can’t really move my mouth. I have seen other posts on here saying it’s not related but find it strange that 3 other people have reported the same problem. What should I do?

 

A. The small dose of Botox that you have received should not cause the adverse symptoms that you have been experiencing.  I would advise you to contact your injecting physician and discuss.  Most likely your symptoms should resolve on their own.  Good luck and be well.

Q. Are my lips swollen or are they that big after Juvederm?

RealSelf actual patient comment:

i just got my lips done on friday at 4pm. It is now monday and i still feel like my lips are huge, especially the top. I got 1 syringe of Juvederm and i’m wondering if someone can tell me if its swollen still or if they are that big. Please help. It’s Monday 7pm now

 

A. Your lips are very swollen 3 days after Juvederm.  The size of your lips is much greater than what 1 cc of Juvederm would look like unless your lips were very large to begin with. I would discuss this with your injecting physician. Good luck and be well.

 

Q. Liquid nose job or traditional rhinoplasty? Bothered bulbous tip of my nose as well as the slight hump.

RealSelf actual patient comment:

I have been bothered by the bulbous tip of my nose as well as the slight hump for some time. I would like a more refined tip and a more narrow bridge. I am considering either a traditional rhinoplasty surgery but if I could get similar results with filler that would be my preference.

 

A. I would advise you to stick with traditional rhinoplasty as liquid rhinoplasty adds volume to your nose and will not address your concerns regarding your bulbous tip.  Be sure to choose your rhinoplasty surgeon most carefully.  GoBlue!!!  Good luck and be well.

Q. Can Injectable fillers be used on nipples?

RealSelf actual patient comment:

After a vacuum expansion session on nipples,  can a dermal filler be used to keep the nipples enlarged?

 

A. Yes, fillers can be used to enlarge and perk up nipples.  Many professional dancers use this filler method to make their nipples more prominent.  Good luck and be well.

Q. How long after the first Emsculpt treatment do you see results?

RealSelf actual patient comment:

I just did my second sessions and don’t see much of a difference.

 

A. Most Emsculpt patient​s can feel firmness in their muscles before they can see actual results.  We have had some patients who see some improvement early but the majority of patients see their results about 4 to 6 weeks after their last session (complete treatment is 4 thirty minute sessions over two weeks.)  We see our Emsculpt patient back about 6 weeks for their post treatment photos at which the majority see and feel increased muscle tone and decreased fat.  It does continue to improve for months after the treatment.  Good luck and be well.

Q. I had bad results from Smart Lipo on my abs and have scar tissue inside. I want to try Emsculpt to break the scar tissue.

RealSelf actual patient comment:

Emsculp will help? Please advise.

 

A. Unfortunately Emsculpt will not break up scar tissue from previoius abdominal liposuction.  I have seen the appearance of uneven lumpy abs from previous liposuction improve after Emsculpt.  It is thought that the increased muscle mass and tone improves the appearance of the abdominals.  Good luck and be well.

Q. I have metal pins along side of my femur bone. Is it safe for me to have Emsculpt?

RealSelf actual patient comment:

I had a broken femur bone and the surgeon put a rod and pins along side of my femur bone. The rod was removed in 1972 but the pins remain. Is it safe for me to have EMSCULPT on my butt and stomach?I have heard that it is safe to have EMSCULPT if you have metal in your body as long as the machine is not placed over the area where the metal is. Should I have an x-ray first to see exactly where the metal pins are? I’m hoping to find a Doctor in New York, NY that performs EMSCULPT. Thank you for your answers.

 

A. If the pins in your femur are truly metal then you should not have Emsculpt.  If they are titanium then and your orthopedic surgeon has said that it is okay for you to have MRI’s then you should be able to have Emsculpt.  Be sure to discuss with your physician at your consultation.  Good luck and be well.

 

Q. Can I get Emsculpt while on my period?

 

A. We advise our female Emsculpt patient to try to schedule their abdominal Emsculpt treatments around their menstrual cycle, though it is not an absolute contra-indication.  There is the risk of increased cramping, flow, and discomfort when treating patients with Emsculpt who are menstruating.  Treating the buttocks while menstruating is safe. Good luck and be well.

Q. My nose looks like it was punched to the side 10 days post op. What’s going on?

RealSelf actual patient comment:

I had a rhinoplasty and septoplasty 10 days ago. The goal was to straighten my nose, correct my very deviated septum, and straighten my nostrils. He had to rebreak my nose and also used grafts. My nose literally looks like it was punched in the opposite direction. I am freaking out. It appears to be even more distorted than it was presurgery. Any idea what may be going on. This looks absolutely terrible. What’s going on? Help!

 

A. Best to consult with rhinoplasty surgeon at this point.  There is not anything to be done to your nose at such an early time after your surgery.  If your concerns are still present in 6 to 12 months then you have your nose re-evaluated.  Good luck and be well.

Q. Will temple filler and neurotoxin be able to balance my eye and brow asymmetry?

RealSelf actual patient comment:

One eye side is flatter than the other due to different bone size and has always been that way. But over time I notice the right temple  is getting more hollow and the asymmetry is getting worse. The outer corner of the right eye isn’t as “pulled up” or cat eye angled like the left one. Surgery isn’t an option for me right now. I have had one or two units of Botox to “lift the tail” but I don’t think it did much. What are some noninvasive ways to bring more harmony and balance?

 

A. I would use fillers and neurotoxin (Botox) to balance your face.  I would likely start with Sculptra to your right temple and and lateral brow. There are other fillers that may be used should they be required.  Be sure to choose your treating physician based on their knowledge, experience, skill, and most importantly their natural artistic vision.  Good luck and be well.

Q. Is this nose job possible for me? Rhinoplasty

RealSelf actual patient comment: (Patient included her photos and Monroe’s)

Could I achieve Marilyn’s results based off what I’m starting off with. I’d definitely like to retain the bulbous-ness but would that work out proportionally? Thank you!

 

A. Noses are like snowflakes, no two snowflakes are the same, the same holds for noses.  I appreciate when patients know what bothers them about their nose and what they would like.  Together at consultation we discuss these things and devise a plan to help our patients achieve their aesthetic rhinioplasty goals realistically.  Computer imaging is used to preview what rhinoplasty results could be expected so that our patients have realistic expectations prior to their surgery.  That said, I believe that rhinoplasty can help you achieve your goals.  Rhinoplasty is not a “commodity”, it is essential that you consult with rhinoplasty surgeons and choose your surgeon based on their skill, knowledge, experience, results, and most importantly their natural artistic vision.  Good luck and be well.

Q. Does Emsculpt actually make you stronger?

RealSelf actual patient comment:

Does Emsculpt actually make you stronger? I’m having trouble strengthening my leg from knee surgery. I’m wondering if I have Emsculpt treatments done on that thigh, would it help me strengthen my upper leg muscles?

 

A. Yes, Emsculpt not only builds muscle mass and reduces fat but also stregthens the muscles treated. We have treated patients who are rehabilitating from injuries and have been pleased with their results.  Good luck and be well.

Q. Does this work on visceral fat? I have been told that liposuction will not work on visceral fat.

 

A. Unfortunately Emsculpt does not reduce visceral fat.  Diet and exercise are the best way to reduce the fat that lies beneath your abdominal muscles.  Good luck and be well.

Q. Will Emsculpt work for me If I have some flaccid skin ? I have more fat than skin. My skin doesn’t hang…

RealSelf actual patient comment:

I also have a hernia that’s going to be removed before having the procedure done & I was told that I have some diastasis recti

 

A. First and foremost, have your hernia repaired.  The hernia repair should help with your diastasis recti.  Once you have recovered and your surgeon gives you clearance, then you may have Emsculpt to help build your muscle mass, strengthen your core muscles, and decrease some fat.  You may also benefit by combining Emsculpt with other skin tightening and fat reducing technologies such as Venus Legacy, CoolSculping, etc.  Good luck and be well.

Q. Can you use Emsculpt if you have metal tooth implants or gold teeth?

 

A. It is safe to have Emsculpt with metal tooth implants and/or gold teeth as long as they are greater than 7 centimeters from the treatment paddles.  Good luck and be well.

 

Q. What happens if you only do one emsculpt treatment, or just less than the recommended minimum number, or weeks/months in between?

RealSelf actual patient comment:

What happens if you only do one emsculpt treatment, or just less than the recommended minimum number, or weeks/months inbetween? Does the procedure need to be done multiple times in a short timeframe to be effective?

 

A. There have not been any studies on the effect of just one Emsculpt treatment.  For those who only have one treatment I believe that there should be some benefit from stimulating your muscles to contract 20,000 times in 30 minutes.  It is like they say about treating a cold with chicken soup, “It couldn’t hurt!”  Some have found good Emsculpt results with one treatment per week. The studies and treatment protocol for Emsculpt effectiveness are based on four 30-minute Emsculpt sessions over a two week period.  Good luck and be well.

Q. Is Emsculpt for everyone? Or only those who workout regularly and already have good muscle mass?

RealSelf actual patient comment:

Not sure that muscle “mass” is the right term but I am wondering if emsculpt is actually for everyone? I’ve had 3 sessions on my butt now and 2 on the abs. It has done SQUAT for me! I am not a regular in the gym and definitely don’t have a good muscle definition generally speaking in my body (be it arms, legs, core anywhere). Think I might have wasted the money!!

 

A. Emsculpt works well for almost everyone.  It is important that prospective patients be carefully examined and evalulated prior to their treatment.  It does work well on those who are not regulars in the gym, we have even found it beneficial in patients who are unable to work out because of other problems (injuries, etc.)  Although some patient may see results as early as a few weeks, the muscle building effects of Emsculpt continue for months after your last treatment.  Give it at least 2 months, at which time you should have your follow up appointment with your physician to compare before and after photos as well as having an additional “maintnenance” treatment session.  Good luck and be well.

Q. Can you affect the intensity/results of the treatment by stretching out your muscle?

RealSelf actual patient comment:

Can you affect the intensity/results of the treatment? e.g. if you stretched out your muscle more like putting your arms above your head, is the treatment more intense/encourages the muscle to develop differently? I want a tighter core, not a thicker one Also does the treatment only target the abdominal muscle? Thank you

 

A. Emsculpt works by electromagnetically stimulating the nerves of the abdominal and Gluteal (buttocks) muscles resulting in supra-maximal muscle contractions which in turn increases muscle mass and tone and decreases superficial fat.  There have not been any studies comparing the results of Emsculpt while stretching versus being relaxed.  We recommend that patients relax as it is the muscle stimulation and contraction that causes the benefits of the treatment.  Other than the abdomen, the buttocks, thighs, and calfs are currently also being treated.  Emsculpt has just announced new smaller curved paddles specifically to treat the arm biceps and triceps as well as the inner thighs.  Good luck and be well.

Q. Is the Emsculpt treatment ‘wasted’ if you are dieting? Would someone on a big calorie deficit not really benefit from it?

RealSelf actual patient comment:

From what I hear Emsculpt is like a really strenuous exercise, so would someone on a big calorie deficit not really benefit from it? Because the muscles wouldn’t be able to grow?

 

A. Emsculpt will build muscle mass and reduce fat in patients who are dieting.  The treatment will add to the benefits of your diet, exercise, and weight loss program.  Good luck and be well.

Q. Will Emsculpt destroy the fat graft to my buttocks?

RealSelf actual patient comment:

I recently had a lower body lift and fat graft to my buttocks and I love the result, however subtle. I think I have retained about 30% of the fat taken from outer/inner thighs. I do exercise regularly but I find it difficult to gain muscle, especially now at 52. Emsculpt for buttocks (and off label thighs?) is an appealing idea to build a bit more projection under the fat, I just don’t want to lose the fat that I have. Is this possible?

 

A. Emsculpt builds muscle in the buttock and may preserve fat when used with the proper settings on the device.  Many patients wish to build their gluteal muscles, lifting their butt while preserving the fat volume of their glutes.  If a patient wishes to both build gluteal muscle and reduce fat, then a different treatment protocol is used.  Be sure to discuss this with your Emsculpt physician prior to your treatment.  Good luck and be well.

Q. Will another Fraxel help fix this texture, depressed marks, lines, etc?

RealSelf actual patient comment:

I have bad Fraxel results from Fraxel Restore. I got fraxel restore 11/21/2018, I have had fraxel’s in the past many years ago . All the lasers I have had in the past were ablative. I got horrible results from this fraxel, my face is super tight like I got a face lift, massive orange peel texture on my forehead, upper cheeks and around my mouth. On the lower half of my cheeks it looks like I have small slits, and some white lines. Would another fraxel fix this problem. I didn’t have this prior to having this restore.

 

A. It is difficult to answer your question without knowing the settings of your laser​ treatment and whether the laser was an authentic Fraxel laser.  Usually 4 months after a Fraxel restore treatment the facial skin has recovered.  Best to consult with a laser expert for an in person evaluation for what your best options to resolve your concerns would be.  Good luck and be well.

Q. Is it safe for me to get Emsculpt on my abdomen after laparoscopy?

RealSelf actual patient comment:

I had a laparoscopic myomectomy 4 weeks ago (2/7). 7 fibroids removed (1 big, almost all pedunculated). Healing perfectly so far. My surgeon cleared me today to resume all exercise (boxing, strength training, etc.). I want to do Emsculpt on my abdomen but need to know when it will be 100% safe for me to do it? I don’t want to ask my surgeon, I’m worried she might judge me… (she’s wonderful, never been judgmental, I just feel embarrassed asking about cosmetic procedure). Thank you

 

A. Prior to having your Emsculpt treatment sessions you must get clearance from the surgeon who did your myomectomy.  If you have been cleared for all exercise as you have stated then you should be fine for Emsculpt.  I would advise calling your surgeon to make sure, and also make sure that they did not use any metallic staples during your surgery.  Good luck and be well.

Q. Are there any devices that can tighten & lift the skin of the lower face drastically, almost as well as lower face lift?

RealSelf actual patient comment:

I’m 32 years old and a few years ago I had Botox in my jaw for TMJ. I feel the practitioner was too aggressive with the Botox. I don’t grind my teeth anymore, but now my lower face is starting to prematurely sag. I’m getting deep laugh lines and my lower face looks and feels heavy. I’m hesitant to do a lower face lift since I’m still young. Are there any skin tightening devices that can correct this issue? Profound radiofrequency? Lasers? Or would you recommend a lower face lift?

 

A. There are a few technology non-surgical devices that can lift and tighten the skin and muscles along the jawline, lower face, and neck.  In patients who are experiencing the earliest signs of facial aging, sagging skin, and jowling, I recommend either Profound RF with PRP or Ultherapy.  If you are able to have one week of downtime due to swelling and bruising then I would recommend Profound RF, if not then you could have an Ultherapy treatment which has no downtime.  As with any facial aesthetic treatment, please be sure to choose your treating physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Is there a difference between the FDA approved ‘Flex Belt’ and EMSculpt, besides cost? And if so, what is it?

RealSelf actual patient comment:

The only difference that I can tell is that the Flex belt can only claim to strengthen your muscles, while EMSculpt can claim to build muscle and lose inches off your waist, but don’t both use EMS technology?

 

A. The Flex Belt does stimulate muscles at a much lower intensity than Emsculpt.  The Flex Belt causes about 150 abdominal muscle contractions per 30 minute session while the Emsculpt stimulates 20,000 supra-maximal abdominal muscle contractions per 30 minute session.  The Flex Belt does not decrease abdominal fat while the Emsculpt decreases abdominal fat by about 20%.  The Flex Belt requires constant repeated sessions while the Emsculpt uses 2 sessions per week for 2 weeks.  Clinical research studies have proven that a series of Emsculpt treatments result in 16% increase of muscle mass and 20% decrease in fat.  Good luck and be well.

Q. Would botox be able to fix uneven eyebrows?

RealSelf actual patient comment:

My right eyebrow is way higher than my left eyebrow. It really irritates me! Is botox the right treatment to fix this issue? Will it bring up the left eyebrow? Thanks !

 

A. Botox can treat uneven eyebrows.  It is easier and more reliable to lower the higher brow.  It is more risky to raise the lower brow.  Either way it is most important to choose your injecting physician very carefully based on their skill, experience, knowledge, and natural artisitic vision.  Botox and fillers are not just another “commodity” rather beautiful consistent results are a function of both the art and science of the physician.  Good luck and be well.

Q. Turning 34 and noticed a loss of volume in my face. What’s the best filler for under eye circles and sagging face?

RealSelf actual patient comment:

I had restylane just a month ago , didn’t think it helped under my eye area, my eyes still look very tired. What’s the best filler for under the eye? Or was one syringe not enough?  I was recommended to instead I get my cheeks bone for a lift? Am I a candidate for surgery to correct under my eye area? Any suggestions please. I’m very unhappy. Thanks

 

A. Great question as many of our patients in their 30’s to 40’s share your concerns.  From about age 25 on the face loses volume, mainly from facial bones and fat, that is what causes early facial sagging.  The best treatment to reverse these early signs of aging in young patients is to restore the lost volume.  The most important aspect of any aesthetic treatment is to make sure that you carefully choose your physician based on their skill, expertise, experience, knowledge, and natural artistic vision.  If you were my patient I would use 1 to 1.5 cc of Voluma carefully placed on your cheek bones.  When injected properly, Voluma corrects facial sagging, and without injecting directly in the under eye hollows and nasolabial folds (smile lines), Voluma improves the tired appearance of those areas as well.  It may also improve the corners of your mouth, jawline, and jowls.  Once the Voluma is in place, if needed, a small volume of Restylane can be used in the eye hollows.  In some patients with volume loss around their mouth, RestylaneDefyne is used to restore their natural beauty in a healthy restful manner.  Again, choose your injecting physician most carefully.  Good luck and be well.

Q. Can you do a lip lift by Ultherapy?

RealSelf actual patient comment:

Can I lift my upper lip by doing Ultherapy around my mouth? Is it safe to be done there? Any details and what I should expect of this procedure?

 

A. Ultherapy has been used on the upper lip for lifting and wrinkles.  I have seen patients who have responded very well with nice lifting, and others have not had the results that we were looking for.  The treatment is relatively quick and easy though when I perfom Ultherapy on the upper lip I use the maximum number of pulses which results in significant lip swelling for a day, two, or three.  If your lip bothers you enough then it is worth trying Ultherapy to lift it, just know that the results cannot be guaranteed since the results vary from patient to patient.  Good luck and be well.

Q. My nose is Bulbous and long. How can I fix it? Is there a way where I can fix this but without it looking botched.

 

A. A bulbous tip is corrected by rhinoplasty.  The most important aspect of your surgery is carefully choosing your rhinoplasty surgeon based on their expertise, experience, skill, knowledge, and natural artisitic vision.  Good luck and be well.

 

Q. If Vitrase is injected directly under the eyelid, can it migrate around the orbital rim?

RealSelf actual patient comment:

I had some vitrase injected directly under my eyelid where I have had puffiness from the area being aggravated and over-filled. It dissolved the filler that led to the puffy look under my eye, but also left a significant indentation to the right of my outer eye. I realize this can be filled and corrected but I’m still distressed. If an aggressive dose of vitrase is placed under the eye, is it common for it to affect the entire orbital rim up to about 1/4 inch from the other eyelid?

 

A. Yes, it is probable that vitrase caused your indentation.  If you wish correction, either return to your injecting physician or choose a new injecting physician carefully based on their expertise, experience, skill, knowledge, and natural artisitic vision.  Good luck and be well.

Q. 4 weeks post op Septorhinoplasty. Can I get my ears pierced after my Rhinoplasty?

RealSelf actual patient comment:

I am almost 4 weeks post my septorhinoplasty, and I wanted to get my third and fourth ear lobe piercing. I was wondering if this should be avoided and if it will impact the healing process even though it is not around the nose.

 

A. Pierce on! There is no problem with piercing your ears a month after your rhinoplasty.  Good luck and be well.

Q. Can you get Emsculpt on your glutes if you have a copper IUD?

 

A. Metal implants within 7 centimeters of the Emsculpt treatment area are a contra-indication for Emsculpt treatment.  Each of our Emsculpt patients are examined and evaluated on an individual basis. Depending on their anatomy some may be treated, others not.  We are more likely to treat the gluts than the abdomen. There are some practicioners who will treat women with a copper IUD, our policy has been to avoid treatment until the IUD has been removed or replaced with a non-metalic alternative if it is located within 7 cm of the Emsculpt treatment area.  Good luck and be well.

 

Q. Will 8 Emsculpt sessions for buttocks firming, rather than the recommended 4 sessions, yield significantly better results?

RealSelf actual patient comment:

My backside is pretty flat, so my esthetician recommended I complete 8 Emsculpt sessions in a three week period. I can see some improvements in the first two weeks (six sessions). Are two more necessary right now? Or might it be better to use those for maintenance in a few months? Other posts I’ve read on here suggest diminishing returns after the initial four sessions.

 

A. It’s like they say about chicken soup, “It can’t hurt!”  The recommended Emsculpt protocol is based on the clinical studies where patients were treated twice a week for two weeks, a total of 4 30-minute sessions.  In your case, if you are seeing nice results after 2-4 sessions, you may wish to wait 2 to 3 months before your next session, and spread the remaining sessions over 2 to 3 month periods.  Good luck and be well.

Q. Does Emsculpt reduce cellulite or is there a better approach for this?

RealSelf actual patient comment:

I am 41, BMI 21, healthy eating, doing crossfit and HIIT. I have a 4 pack in my upper stomach with some nice side definition, and even my lower abdomen is generally pretty flat. However, the skin on top of my abdomen is no longer right as it used to be. In certain light it looks like a thin layer of cellulite (or just loose skin?) on top of nicely-defined muscles below. This is what I would like to target – so my stomach looks “young” and tight again. What would you recommend for this? Thanks!

 

A. Emsculpt will build muscle and reduce fat.  It does not treat cellulite. With increased muscle mass some of the loose skin slack may be improved after Emsculpt.  We treat our patients who have the lax abdominal skin​ that you have described with a combination of Venus Freeze (radiofrequency heat that tightens skin) and Emsculpt (to build the muscle.)  Each patient should be examined and a treatment plan tailored to their specific needs.  Good luck and be well.

Q. Can only manage one EmSculpt session a week for 4 weeks. Is this possible/advisable?

RealSelf actual patient comment:

EMSculpt, 4 sessions spaced in two weeks. Unfortunately my nearest center is 500 kms away , so I can only manage one sesión a week, for 4 weeks. Is this posible/advisable? or may compromis the final result? Thank you

 

A. The Emsculpt protocol was studied with 2 treatments per week for two weeks.  Having 1 treatment per week for 4 weeks was not studied, but practices who have treated some patients on that schedule have reported excellent results as well.  I do not believe that your results will be compromised.  Good luck and be well.

Q. Can I do Emsculpt if I want to get pregnant in a few months?

RealSelf actual patient comment:

Is the electromagnetic too strong for the ovaries? Thanks!!

 

A. Emsculpt is completely safe if you are planning to get preggo in the next few months.  The electromagnetic wave energy of Emsculpt causes the nerves of muscles to be stimulated which in turn causes the abdominal and glutteal muscles to contract supra-maximally.  Fortunately, organs such as the uterus, ovaries, and fallopian tubes do not have muscles that are stimulated by Emsculpt energy.  Good luck with your future plans and be well.

Q. Can I have Emsculpt done with a copper IUD?

RealSelf actual patient comment:

I have my first Emsculpt treatment today. When I signed the consent form it asked if I had any metal in my body such as an IUD. I said I had the Paraguard IUD and the nurse said BTL rep said it was ok and would not effect treatment. I didnt have any issues after the treatment but in doing research I am reading contradictory answers. BTL website does not have any information on it either.

 

A. Metal implants within 7 centimeters of the Emsculpt treatment area is​ a contra-indication for Emsculpt treatment.  I am happy to hear that you did not suffer any adverse effect from your treatment.  There are some practicioners who will treat women will IUD, our policy has been to avoid treatment until the IUD has been removed or replaced with a non-metalic alternative.  Good luck and be well.

Q. Are there any doctors doing Emsculpt on thighs?

RealSelf actual patient comment:

I’m wondering if I am able to have Emsculpt done on my thighs? I had knee surgery done about 8 months ago and my legs are very weak. This would be amazing to help me strengthen my leg before returning back to playing sports. I just had Emsculpt done on my stomach and my core went from weak to strong in just a week. The doctor that preformed my Emsculpt doesn’t have a option for thighs.

 

A. Yes there are some doctors who are treating the thighs with Emsculpt. Emsculpt of the thighs is an “off-label” use, yet providers have found it to be safe as long as there are no metal implants in the area.  We have also found that many of our patients state that during their buttock Emsculpt treatments they feel some quadraceps contraction and strengthening.  Good luck and be well.

Q. I had two back to back pregnancies. My sons are now 5 and 4 years old. The rest of my body is firm but my lower abdomen.

RealSelf actual patient comment:

I have some extra fat on my lower abdomen. It doesn’t matter how much weight I lose it’s there. Could it be hormonal? Or from pregnancies? It’s not just loose skin, it feels like fat to me. It’s soft. Will Emsculpt help me?

 

A. Emsculpt is an excellent safe, easy, effective and quick treatment for improvement of post-partum tummies.  You should be examined by an Emsculpt physician to determine if you are a good candidate for the treatment.  In general it sounds as if you should benefit from Emsculpt.  Emsculpt builds muscle and reduces abdominal fat by about 20% after four 30-minute sessions over a two week period.  You may also benefit from a targeted CoolSculpting treatment.  Good luck and be well.

Q. Is EmSculpt safe for patients with metal tubal ligation clips?

RealSelf actual patient comment:

I’m getting EmSculpt on my buttocks and I had my first session today. I have metal clips on my fallopian tubes from a prior tubal ligation surgery. My doctor’s office said I should be fine but I felt slight cramping in my lower pelvic area during the treatment that happened around 6 hours ago, and as of now my pelvic area feels much more sore than my buttock area. I cannot find any information on this online, and I have contacted BTL with my question but have not heard back.

 

A. Metal in the body close to the Emsculpt treatment area can heat up from the electromagnetic energy.  In your case, especially with your lower pelvic cramping I would advise that you not continue your Emsculpt sessions.  Good luck and be well.

Q. Does Emsculpt tighten skin? Does it help with cellulite?

 

A. Emsculpt is a clinically proven safe, effective, quick, and easy non-invasive treatment that builds muscle in the abdomen and gluteus muscles (that would be in the butt Bob), and reduces fat when desired.  As muscle builds, there is usually a small amount of improvement in the slack of the skin, though I would not use it as a stand alone treatment to tighten skin or help with cellulite.  In our clinic we add Venus Freeze or Venus Legacy  as a complimentary adjunct to Emsculpt in patients who have loose crepe’ skin or cellulite.  Excellent question!!!  Good luck and be well.

Q. What’s your opinion on this Emsculpt protocol?

RealSelf actual patient comment:

Went for Emsculpt consult and I have some questions about there protocol. Need help to see if it’s necessary. Went in for emsculpt consult and they said it’s 3200 for 4 sessions and it will be done in 2 weeks. They also said i need to come in every month for one touch up for an additional 2400 for entire year. Is that one session every month necessary after the initial 4 sessions. Am I getting a good price/deal?

 

A. The initial treatment price is the standard price of $800 per treatment session.  The additional 11 treatment sessions for $2400 works out to $218/session which is a good price.  For the best deal, ask your provider to give you the $218/session treatments first…just kidding.  There has not been studies to document the difference between sticking to just 4 sessions vs. the additional monthies for a year.  I would imagine that the more treatments, the better the result.  Some practices will offer their patients an Emsculpt “membership” plan which allows them to have unlimited treatment sessions.Good luck and be well.

Q. Can I get Emsculpt after Sculptra in the buttocks?

RealSelf actual patient comment:

Is it possible to do Emsculpt for the buttocks after having received Sculptra? Anyone with experience on this? If so, is there a recommended time frame between the two procedures? Or perhaps reversed – Emaculpt first, followed by Sculptra to address any cellulite? Would like the lift and increase in muscle, but also the possibility of minimizing appearance of cellulite. Thank you!

 

A. Yes you may have both Sculptra and Emsculpt on the same tushy.  Sculptra is not affected by Emsculpt and vice versa….no ifs, ands, or butts about it!!!  Good luck and be well.

 

Q. Can I have Emsculpt with a small umbilical hernia?

RealSelf actual patient comment:

I have a small umbilical hernia. I have no pain or problems. Just an outty where it use to be in. I am postpartum 3 pregnancies and would like to have emsculpt done, is that possible or could it cause it to rupture? I am 5 months postpartum at this time.

 

A. If you were my patient I would have you see a general surgeon for examination of your umbilical hernia, and ask for clearance for the Emsculpt procedure.  Emsculpt is a great procedure for postpartum women as it strengthens the abdominal muscle and helps to diminish the diastasis recti.  Good luck and be well.

Q. Is it normal to be very itchy after Profound?

RealSelf actual patient comment:

I had the profound treatment on my lower butt and thighs 9 days ago and I am very very itchy. The skin is completely healed and all the bruising is gone, but the itch! Is this normal?

 

A. It is best to contact your treating physician when experiencing any untoward reaction after a treatment.  Most patients are not severely itchy after Profound.  Most likely an oral antihistamine for a day or two will take care of the problem.  Good luck and be well.

Q. Is Profound RF treatment safe for Fitzpatrick 4 skin type?

 

A. Profound RF is safe on all skin types including darker skin types such as Fitzpatrick 4.  Most importantly choose your treating physician most carefully based on their skill, experience, knowledge, and natural artistic vision.  Good luck and be well.

Q. Is it safe to have a facelift in a few years after having a skin tightening procedure like Profound?

RealSelf actual patient comment:

I am considering getting Profound RF but had a consultation with a plastic surgeon who warned about a patient who had undergone such a treatment and then subsequently had a facelift who suffered necrosis on her face due to underlying scarring caused by the heat used in the procedure. Have any of you seen this? He warned not to have any skin tightening procedures if I was ever planning to have a facelift down the road. Is this a concern for Profound?

 

A. I have never seen or heard of a patient who had problems with a facelift after having had a previous Profound treatment.  Thousands of patients have had Profound RF and I am fairly certain that we would be hearing much more about this complication if it were occuring. Necrosis of a skin flap after facelift surgery may be related to the patients health, their smoking history, and the surgeon leaving the flap too thin or too tight.  Patients should always share their past history of medical problems and treatments with their facelilft surgeon prior to surgery to ensure a safe and excellent outcome.  Good luck and be well.

Q. Will RF treatments help soften scar tissue from lower face liposuction?

RealSelf actual patient comment:

i had face liposuction. Looked great until scar tissue started to form two – 4 weeks later making me more swollen and worse than before. My Dr. said that rf will soften scar tissue. Can I do RF two-three months after this procedure? Any difference between Fractora, Profound, Exilis etc?

 

A. We do use radiofrequency in patients after neck surgical treatments to tighten and smooth the skin.  In our practice we use Venus Freeze for this purpose.  Exlexis and VF are non-invasive while Fractora and Profound use needles and are minimally invasive with more recovery time.  Good luck and be well.

Q. I had Profound RF performed on a swollen area, on my upper lips, received multiple passes on another area. What should I do?

RealSelf actual patient comment:

2 wks ago I asked about canceling Profound RF b/c I was swollen a/f being bumped in the mouth 2 days earlier. The nurse assured me that it was fine & wouldn’t change my results. Then she did my treatment unevenly- 2 passes on non-swollen side & 1 pass on swollen area. Also did my upper lip. 2 pass side stayed red & still burns. My lips have large depressions & the swollen areas never got red or had any tightening sensation like everywhere else. What should I do?

 

A. I would speak with the physician who had the nurse treat you.  You need to be evaluated.  It is difficult to answer your question without photos.  Good luck and be well.

Q. Is Emsculpt safe with Skyla IUD?

RealSelf actual patient comment:

I have a SKYLA IUD, which is made of plastic but has a silver ring near the tip. Is it safe for me to do emasculpt on my abdomen? Thank you

 

A. Emsculpt is contraindicated in patients with metal implants because they may heat from the electromagnetic energy and cause a burn.  If your IUD is completely plastic then it would be safe.  I would not treat you if there is silver.  We have had patients who had their IUD’s removed prior to their Emsculpt treatment.  In that case, unless your looking to have kids, use an alternative method of birth controll.  Good luck and be well.

Q. Can I get Emsculpt if I had gallbladder removal surgery 20 years ago?

RealSelf actual patient comment:

After having laparoscopic gall bladder surgery as a teenager there were some small metal staples/clips left in place as is standard in the procedure. I’m not sure of the exact location of the metal (nor its makeup) and how close it would be to the Emsculpt abdominal treatment area. Is Emsculpt a possibility for me?

 

A. In general, Emsculpt is contra-indicated in patients who have any metal implants.  There are some providers who have safely treated patients with Titanium staples from previous surgery as it is felt that titanium does not heat up from elctromagnetic energy.  It is essential that prospective Emsculpt patients share with their treating physician all implants in their body to ensure a safe treatment without adverse complications.  Good luck and be well.

Q. Small Platinum coil in adrenal gland- it’s non-magnetic- is it ok for Emscuplt machine?

 

A. In general, metal implants are a contraindication for Emsculpt treatment.  The danger is that electromagnetic energy may heat the implant which could cause internal burns.  Though all metalic implants are contraindicated, there are some types of metal implants that do not attract the EM energy and do not heat up.  Patients considering Emsculpt treatments must discuss any metallic implants with their treating physician prior to any treatment.  Good luck and be well.

Q. Am I able to get Emsculpt after liposuction?

RealSelf actual patient comment:

I got lipo in my entire abdomen and flanks about two weeks ago. I’m interested in getting the emsculpt treatment . Am I a candidate? If so when can I start?  If so how long would I have to wait?

 

A. It would be safe to have Emsculpt treatments about one month following your abdominal liposuction.  We have found that our patients have loved their Emsculpt results following liposuction.  The improved muscle tone helps to decrease the uneveness left after many abdominal liposuction procedures.  Good luck and be well.

Q. Can I get an abdominal Emsculpt treatment before or after breast augmentation (within a day or two)?

RealSelf actual patient comment:

Would it be safe a day or two before surgery or shortly after?

 

A. It would be best to wait until you have completely healed from your breast surgery prior to having Emsculpt, or you could choose to have a complete 4 sessions Emsculpt treatment before surgery.  It would be okay to have the final of your 4 Emsculpt treatments a day or two before your breast surgery.  Good luck and be well.

 

Emsculpt is contraindicated in patients with metal implants because they may heat from the electromagnetic energy and cause a burn.  If your IUD is completely plastic then it would be safe.  I would not treat you if there is silver.  We have had patients who had their IUD’s removed prior to their Emsculpt treatment.  In that case, unless your looking to have kids, use an alternative method of birth controll.  Good luck and be well.

Q. Emsculpt or tummy tuck? Which one can help with diastasis recti?

RealSelf actual patient comment:

I had twins 2 months ago via c section. I have diastasis recti and I have been going to physical therapy but it’s not helping much. Do I need a tummy tuck with muscle repair? Would I be a candidate for emsculpt or coolsculpting? Can emsculpt help with diastasis recti? What would be the best option for flattening my abdomen?

 

A. Congratulations on your twins.  I would recommend waiting for some time before considering extensive tummy tuck surgery.  Exercise, diet, and time should help some with your diastasis recti.  If after time the separation of your abdominal muscles remains large, then abdominoplasty is the answer.  It there is a great deal of improvement and your diastasis recti is minimal then Emsculpt will help.  Time will tell.  Enjoy the new members of your family.  Good luck and be well.

Q. What if I cannot tolerate 100% power on Emsculpt?

RealSelf actual patient comment:

I have had 3 sessions with Emsculpt, spaced about 3 days apart. I gradually moved up in power each session. The 1st session, I was able to get up tp 65% power at the final 5 minutes. The 2nd session, I was able to get to 95% power for the final 5 minutes. The 3rd session I got to 75% power for the final five minutes. Third session was the most painful. Is it worth continuing if I cannot tolerate Emsculpt at 100%? They place it in the middle of my abs. Will it reduce fat on my flanks?

 

A. Emsculpt treatments should feel intense but never painful.  It is not necessary to reach the 100% treatment level during treatment to get good results with Emsculpt.  It is still worthwhile for you to continue your treatment program.  As long as your muscles are contracting during the treatment, you should see improvement.  Good luck and be well.

Q. Should I do more CoolSculpt now or try Emsculpt?

RealSelf actual patient comment:

I’m 36, no babies, 5’5”, and 130 pounds. I work out 4-6 times per week and try to eat a fairly healthy diet with. I have never felt my tummy was flat enough even when I was much thinner than I am now. I did 2 coolsculpt treatments on my lower tummy in 2015. I feel it made a subtle difference but when looking at my before and after photos, it looks no change.  I’d love links to studies and/or statistics.

 

A. It appears that you would be a great candidate for Emsculpt treatment.  Emsculpt will build your abdominal recti muscles (6 pack) by about 16% and decrease the abdominal fat by about 19% over the course of your 4 treatment sessions.  Studies have shown that Coolsculpting decrease abdominal fat by about 24% per treament session in the area treated.  They can be combined.  Since you have already had a couple of CS treatments, I would treat you with Emsculpt.  Good luck and be well.

Q. Will Emsculpt for buttocks regime permanently destroy all the fat there? (patient included a photo)

RealSelf actual patient comment:

I’m interested in starting EMSCULPT treatments, with a touch up routine every few months as needed to give a lift to my buttocks. However, I am concerned that this will permanently destroy all fat cells in my butt? I exercise regularly/eat well and don’t believe I have much fat in my buttocks, and I wouldn’t want to permanently destroy the fat cells existing there.

 

A. Fortunately there are two different settings for the Emsculpt treatment.  One preserves fat while building muscle (this is the setting that would be used on your buttocks), the other setting builds muscle and decreases fat.  You can put your fears of losing buttock fat “behind” you.  Good luck and be well.

Q. What can be done to my face to have a fresher/younger face?

RealSelf actual patient comment:

I have never done any fillers in the past and losing some volume on my face . What can be done to look younger and less tired ? Thanks

 

A. Fortunately you have been blessed with a very beautiful face.  You may be beginning to see the earliest signs of facial aging mainly because of volume loss.  For patients like you, it is most important to not over do things…less is more!!!  I would treat you with a little bit of Sculptra and Voluma to maintain your beauty naturally.  Unfortunately there are patients who go to the wrong injector and end up looking over-filled, the same as a much older woman who gets the same result from the same injector.  As with any facial aesthetic treatment it is essential to choose your injecting physician carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. How long will Profound for the face last? What is the length of any trials on the product?

 

A. Thank you for your inquiry about Profound RF.  It is thought that the results of Profound RF continue to improve over a 6 to 9 month period following the procedure.  As with any facial/neck rejuvenation treatment (including face/neck lift surgery), the best answer for “How long will it last?” is that for the rest of the patient’s life, they will look alot better than if they had not had the treatment.  We have been treating patients for the past two years with Profound RF and have found the results to be lasting.  I am not aware of the length of time that studies have documented the results.  I will be presenting my experience over two years with Profound RF treatments at the 2019 Vegas Multispeciality Conference in June.  Good luck and be well.

Q. What are the current best non surgical treatment options for sagging of the jowls?

RealSelf actual patient comment:

The sagging is relatively mild right now but as I enter my early 40s I am noticing it more. There seems to so much advertising that it is difficult to know what are really good options.

 

A. You look great, the best treatment for early signs of jowling​ in a patient like you would be Profound RF with PRP.  The downside is that there is a one week downtime due to swelling and bruising.  The best alternate treatment would be Ultherapy with simultaneous injection of Sculptra along your jawline.  Make sure to choose your treating physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Can I get Emsculpt and SculpSure together in the same month?

RealSelf actual patient comment:

Hi- can one get both treatments in the same month, for additional fat loss?

 

A. Yes you may have Emsculpt treatment and Sculptsure together during the same month.  The mechanism of action is different for the two technologies.  Good luck and be well.

Q. Does Emsculpt build muscle better than electric muscle stimulation from a machine?

RealSelf actual patient comment:

I am considering Emculpt to build muscle and reduce fat but I am skeptical about the muscle build part. Electrical muscle stimulation machines have mixed reviews. Is the science behind the muscle building from Emsculpt different than electrical muscle stimulation?

 

A. Great question.  Emsculpt has been studied in seven independent centers that have shown that there is a 16% increase in muscle mass and surprisingly a 19% decrease in superficial abdominal fat.  The technology is one of a kind, far superior to any previous electrical stimulation (although a review of the internet will reveal old film footage of Bruce Lee and Muhammed Ali connected to electrical machines for muscle stimulation), and Emsculpt is the first and only FDA approved device for building muscle.  Choose your treating physician most carefully.  Good luck and be well.

Q. Do I need to shave before an Emsculpt session on the abdomen?

RealSelf actual patient comment:

Does EMSculpt require hair removal before a session or not

 

A. Fortunately the electromagnetic waves of Emsculpt have no difficulty penetrating through a hairy abdomen.  No need to shave or remove hair for Emsculpt, but a little “man-scaping” may make the beach a more beautiful place.  Good luck and be well.

Q. Am I a candidate for Emsculpt if I have a titanium hip replacement?

 

A. Most Emsculpt providers recommend not treating patients with metal implants close to the treatment area.  Others believe that titanium, unlike metal implants, does not conduct electromagnetic energy, and will treat patients with titanium.  At this early time in the use of Emsculpt it is better to err on the side of safety.  Stay tuned, as those providers who do treat patient with titanium implants share their patients’ experiences, we may feel better about treating over these implants.  Good luck and be well.

Q. Is Emsculpt dangerous if you have had surgery and or arthritis?

RealSelf actual patient comment:

Hi, i am curious about Emsculpt but I have arthritis and have had surgery with some titanium screws. Will this be a problem?

 

A. Emsculpt is absolutely safe in patients with arthritis.  Emsculpt is safe in patients with Titanium screws as long as they are away from the area treated.  Many providers will treat patients with Titanium even when the screws are closer to the treatment area sinceTitanium does not heat up as other metals do.  Make sure to discuss with your provider prior to any treatment.  Good luck and be well.

Q. Is Emsculpt a good choice for someone with loose skin due to pregnancy?

 

A. Emsculpt is a muscle building treatment, in addition it reduces superficial abdominal fat.  It is not considered a skin tightening technology, though with increased muscle mass there will be some improvement as the new muscle takes​ up some of the slack in the skin.  We recommend other radiofrequency skin tightening devices such as Venus Legacy for post partum moms.  Emsculpt is quite effective at improving diastasis recti after pregnancy (the widening of the connective tissue between the abdominal muscles.)  Congratulations on the new addition to your family, much good health, love, and happiness.  Good luck and be well.

 

Q. Is Emsculpt safe for people with knee replacements?

RealSelf actual patient comment:

I have had bilateral knee replacements. I’m not sure it’s safe to work on my stomach area and then buttocks. Can it heat up the metal in my body?

 

A. Most experts in the use of Emsculpt agree that it is safe to have the abdominals and buttocks treated in patients who have knee replacement since the electromagnetic waves do not travel far enough to heat metal implants in the knees.  Good luck and be well.

Q. Are my expectations for rhinoplasty doable?

RealSelf actual patient comment:

I’m planning on getting my rhinoplasty next year. These are the things I would like to fix, – my nose when I smile widens and appears to look “wide and flat” – remove the bump on my nose – my bridge is wide, I want something more feminine -when I turn to the side, my nose looks flat and isn’t as projected as I’d like. -overall my biggest concern is my wide nostrils when I smile. I just want a nose that fits my face. -would I need a chin implant? Is my procedure complicated?

 

A. Yes, your expectations for rhinoplasty are doable.  ​as with any facial aesthetic surgery or treatment, please make sure to choose your treating surgeon most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.​

Q. I am really insecure about my face profile! Which surgery do you I should do to improve it?

RealSelf actual patient comment:

I don’t understand what makes my face so ugly from the side, I mean from the front it is beautiful, but from the side, ugh I can’t stand it. Which part of my face should be enhanced?

 

A. First of all your face is not ugly!!!  I believe that on profile your chin is small​ which gives the impression that your jawline is proportionally short for your face.  I would consider a conservative chin implant with or without a little liposuction of your neck at the same time.  The lateral edge of your nostril is slightly elevated and could be addressed as well with either a cartilage graft or filler.  Make sure to choose your treating surgeon most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. 38, lax skin under neck. What to do?

RealSelf actual patient comment:

I’m 38 and have been diligent about sunscreen, hats, sun protection. But a couple months ago I noticed a flap of skin under my chin, noticeable mostly on my left side. I got my platysmal bands botoxed once about a month ago but I’m thinking I need to address the lax skin. I’m researching Ultherapy, Infini, Thermage? What can I do? Thanks!

 

A. There are both surgical  and non-surgical treatments to address the loose skin in your neck.  From your question, it sounds as if you are looking for non-surgical correction.  I prefer to treat my patients who have loose neck skin with either Ultherapy or Profound RF with PRP.  Micro-Botox intra-dermal injections are helpful as well, but only last for 3 to 4 months.  Profound RF is the most effective, it is a one time treatment in contrast to Infini and Thermage.  As with any aesthetic treatment, choose your treating physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Would Botox or any kind of filler help with these lines from the end of my eye down to my cheeks?

RealSelf actual patient comment:

Hello, I’m 20 and I’ve always had these really bad lines extending from the end of my eye down my cheeks. I’m not sure what it’s from but I’ve always had them and wanted to know what kind of treatment I should do or treatment is even possible. I also have one really hooded lid that I would like to fix as well. I’m half Asian and I get bullied a lot about my eyes and the weird lines that come with it. If you have any advice I’d be grateful, thank you.

 

A. People are cruel, you are beautiful and do not deserve any bullying.  My best advice would be to consult with an expert facial aesthetic physician for an in person evaluation.  Without examining you, it is difficult to give you accurate advice.  As with any aesthetic treatment, choose your treating physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. How much filler would I need to get fuller cheeks? Do I need more than 1cc of Voluma?

RealSelf actual patient comment:

Do I need more than 1cc of voluma or another type of filler?

 

A. You should see very nice results with 1 to 1.5cc of Voluma in your cheeks if properly placed.  ​The most important aspect of your treatment is that you choose your injecting physician most carefully based on their skill, experience, knowledge, and natural artistic vision.  Good luck and be well.

Q. Rhinoplasty disaster, how do I know what my surgeon did to my nose?

RealSelf actual patient comment:

Rhinoplasty 3 weeks ago: I know swelling takes months, but I wanted drastic changes. I asked for width to be narrowed significantly, giving my nose a new shape along with nostrils brought in and the tip brought up. I asked for the nose of different ethnicity -when I stretch skin bones haven’t been shaved off or touched at all -if she didn’t touch width of the nose due to fear of breathing collapsing, can I get a refund since she isn’t skilled enough to perform a revision? How do I know if she did surgery?

 

A. It is best to speak with your rhinoplasty surgeon for an explanation of what was done.  Ask for the operative note (although many times, depending upon the individual surgeon, the note may not reflect the surgery.)  Consult with a rhinoplasty expert, bring your pre-op photos and the operative report.  You may ask that the new surgeon personally speak with your first surgeon. It is too early at this point to do anything, unfortunately you should wait 6 to 12 months before considering any revision rhinoplasty.  Good luck and be well.

Q. Is it safe to undergo Ultherapy 4 months after FaceTite?

RealSelf actual patient comment:

I had a FaceTite procedure four months ago, and while there was definite improvement, I was hoping for a little more tightening along the jaw line. Is it safe to follow up with an Ultherapy treatment at this point?

 

A. Yes, it is safe to have Ultherapy one month after Face Tite, in fact most patients who have had some sort of previous facial procedure (facelift, Sculptra, Profound RF) respond better than expected in many cases.  Good luck and be well.

Q. Can I prevent further collagen from forming from Sculptra 1 month ago?

RealSelf actual patient comment:

I had sculptra injected and he put it in the opposite side of my face that needed it (one side was good on its own & another side needed a little extra filling) but he ended up overfilling the side that was already full and then placed sculptra in my jawline unevenly and it’s been a month and now one side of my jaw is heavy and masculine looking. He injected 7 syringes which was about 3/4 of a vial. I turned 24 the week after I was injected. Please help. What can I do to prevent it from growing?

 

A. Sorry that you have had this experience.  Best to consult with an expert Sculptra injector.  Fortunately you have received only 0.75 vial of Sculptra which should limit how much you react.  Best to see how you react and then restore your facial symmetry as needed.  I would recommend working with a physician injector whom you trust.  The most important aspect of your treatment is that you choose your injecting physician most carefully based on their skill, experience, knowledge, and natural artistic vision.  Good luck and be well.

Q. How many syringes of Juvederm or Voluma will I need to fill out my cheekbones?

RealSelf actual patient comment:

I have very small cheekbones and my face looks round. I want to have especially high cheekbones just like the guy in the picture. How many syringes of Voluma will I need to achieve this result?

 

A. You will get your best estimate of how many syringes of Voluma will be needed to give you your aesthetic cheek enhancement goal after an in person consultation.  As you are relatively young, I would be conservative and begin with 1 to 2 cc of Voluma, more can always be added.  When it comes to facial volume, often times less is more!  You should see an excellent result with only 1 to 1.5 cc if injected properly in the proper place.  The most important aspect of your treatment is that you choose your injecting physician most carefully based on their skill, experience, knowledge, and natural artistic vision.  Good luck and be well.

Q.Fillers vs. lasers for eye troughs? 30, female, non-smoker

RealSelf actual patient comment:

I’ve always had eye troughs. Recently, I went for two consultations. The first doctor told me that I needed 1-3 Fraxel sessions. At the second consultation (which was with a Patient Coordinator and not an actual doctor), I was told that I needed 8 sessions with a Forma/RF laser. I had always thought I needed fillers to make my eye troughs disappear. Any advice or reasoning as to why I should go with Fraxel or RF laser instead of fillers? Or were these doctors maybe mistaken about the best treatment?

 

A. Lasers around the eyes are best used for crepe skin or slightly excessive skin as the treatment tightens the skin (I would use a fractionated CO2 laser such as Fraxel Repair.)  Fillers around the eyes are used to replace lost volume.  In your case based on your photo I would likely treat you with filler to take care of your hollows.  ​Make sure to choose your physician injector most carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. Smile lines: which filler do you recommend? If so, how many syringes do you estimate will be needed?

RealSelf actual patient comment:

I am 33 and have really become self conscious about my smile lines. Every day, it seems like they get deeper and more prominent in pictures and in person. I wanted to know what product is recommended. I’ve read Juvederm and Restylane could work how ever there are so many different types, I’m kind of overwhelmed. If all the product isn’t used, would I be able to put the rest in my lips or under eyes depending on the product? Thanks in advance!

 

A. I agree with Dr. Rifkin, you should be able to achieve your aesthetic goal using 1 to 1.5 syringe(s) of filler. When we teach other physicians how to inject facial fillers, we have unlimited amounts of filler supplied by the sponsoring companies.  What is often said is that “It is easy to get a nice result with unlimited fillers (and funds), the skill comes when we are able to get an excellent result with only 1 or 2 syringes.”   I would most likely use Restylane Defyne most likely in your case, though every patient is unique and we determine what would be best after examining each patient in person.  Make sure to choose your physician injector most carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. I have thick ropiness underneath the skin after blepharoplasty, what can I do?

RealSelf actual patient comment:

I had upper and lower blepharoplasty 18 days ago. Underneath the upper eyelid scars is a very thick rope. It is not above the skin. It is causing a visual ridge. It is continuing to get thicker despite massaging. In one large area it is easily a quarter of an inch thick. It is somewhat painful when touched. What is the best treatment for this ropiness?

 

A. Great question as this is very common after blepharoplasty.
Fortunately the “ropiness” resolves with time.  You may ask your blepharoplasty surgeon to inject a small amount of Kenalog-10 (a steroid) in the “rope” to soften it and facilitate its disappearance.  The crows feet area should not be noticeable  once the redness of the incision scar goes away in 6 to 8 weeks.  Good luck and be well.

Q. How do I get rid of granulomas from Volbella filler?

RealSelf actual patient comment:

I had tear trough and lip filler with volbella in July. In October I developed multiple hard lumps/masses at all injection sites in October. No redness. Just hardened filler. They have tried dissolving with hyaluronidase three times with no success. My sinuses have since been a non stop issue. The tear trough hardened masses feel like they are growing and there is pressure in the eye area, inner canthus area mostly. Suggestions? I need help.

 

A. Sorry to hear about your complication with Volbella. I would recommend treatment with hyaluronidase along with Kenalog/ 5FU injections every three weeks.  I would also recommend oral Biaxin 500mg twice a day for six weeks.  There have been studies out of Israel on patients who received Volbella under their eyes who developed complications similar to yours.  Good luck and be well.

Q. Can anyone suggest how to get a Botox brow lift done so that I can tell providers?

RealSelf actual patient comment:

I can’t find anyone who can do a proper medial and outer brow lift in San Diego. I tried three providers. Before moving I had a nice brow lift. Can anyone suggest how to get it done so that I can tell providers? The last one only put 5 units per side in the corner of eyebrow – did not work.

 

A. Great question.  Botox treatment is not a commodity, rather it is an art and science based on skill, experience, knowledge, and most importantly natural artistic vision.  It is important to choose your physician injector most carefully.​ Unfortunately, there is not a “recipe” that we can give you to help your provider, each patient is unique. Good luck and be well.

Q. Can my jowls be fixed with filler?

RealSelf actual patient comment:

My jowl is sagging only on one side. I’ve had very short lived improvement with filler but would like to have this area fully corrected. Can this be treated?

 

A. Yes, properly placed fillers can help you achieve your aesthetic goal.  You are young, pretty, and your “jowl” is in a very early stage. Be sure to choose your injecting physician most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Safe to get more Voluma injections after a couple weeks by a different doctor?

RealSelf actual patient comment:

Is it safe to get more Voluma injections after a couple weeks by a different doctor? If I don’t want to go to the same doctor, is it typically not a big deal to go to another doctor to receive more Voluma injections? I had 2cc but want 1 or 2 more. Basically can more Voluma be added safely even if the doctor does not know you had Voluma?

 

A. Yes, it is fine to have more Voluma injected by another physician.  You should share with your new physician that you recently had Voluma injections.  The most important aspect of your Voluma treatment is that you choose your injector very carefully based on their skill, experience, knowledge, and natural artistic vision.  Good luck and be well.

Q. 29, male. Excess/sagging skin on the face and neck. Could Ultherapy give me my jawline back? Would I need a surgery?

RealSelf actual patient comment:

I would like to tighten skin on face, and have a defined jawline. My skin has been sagging progressively over the last couple months. I am unsure if I want fillers as the sagging/loose skin has already made my face look wider/bigger than it use to be, and i feel fillers would make it look even bigger. I use moisturizer, retin a, exfoliator scrub and aha.

 

A. I have found that men respond very well to Profound RF even more that Ultherapy.  Ultherapy should help and has less downtime, but if you have the time to recover, I would recommend Profound RF.  Good luck and be well.

Q. I just found out I’m 8 weeks pregnant and got a Juvederm filler one week ago. Could I have caused harm to the baby?

 

A. No, but your baby is going to look very young!!!  Congratulations, wishing you a healthy pregnancy and healthy baby!!!  Good luck and be well.

Q. Is this necrosis after Juvederm lip Injections?

RealSelf actual patient comment:

What is happening to my lip? (patient included a photo of her lip turning black)

 

A. I hope that you have already seen someone today, if not, you need to see an expert filler injector immediately to be treated.  Good luck and be well.

Q. I would like to have a rhinoplasty/septoplasty done. What are the suggested ways of achieving my goal?

RealSelf actual patient comment:

I do not want a small nose. I just want to refine what I have and improve it to fit my face better. I am part Italian and would like to enhance what I have, not take too much away. What would the best way to go about what I want?

 

A. You have a beautiful face.  I would recommend consulting with a few rhinoplasty specialists and be very careful in choosing your rhinoplasty surgeon based on their experience, skill,knowledge, and most importantly their natural artistic vision.  Please make sure that a subtle rhinoplasty is planned and carried out, the last thing that you want is a “cookie cutter” obvious rhinoplasty.  Good luck and be well.

Q. Is it bad to get fillers while you’re young and can they be used to prevent wrinkles and collagen loss?

RealSelf actual patient comment:

I’ve been getting filler in my lips at the age of 18 and I’m now 20. Have also been getting fillers in my face to create a defined jawline and in my chin to define and smooth out the dimples. Is it bad to get them while I’m young? When they fade and I decide not to get them again will my face look saggy or dull? I’ve also heard that getting fillers can also be a preventative procedure to wrinkles and collagen loss. Is this true?

 

A. The most important aspect of your aesthetic treatment is choosing your physician most carefully based on their skill, knowledge, experience, care, and natural artistic vision.  There is a saying that, “Nothing beats youth!” especially when it comes to facial aesthetics.  Any physician who is treating you at age 20 should be extremely conservative and limit treatment.  There is nothing more sad then a young woman who has been over “done” by a physician or nurse who lacks natural artistic​ vision.  It is terrible when these injectors treat young patients identically to how they treat their older patients.  We all have seen older patients who look funny because they are trying to look too young, unfortunately some young patients can actually look like these “younger looking older patients” because of irresponsible injectors. Enjoy your youth!!!  Good luck and be well.

Q. Can Sculptra be used to fill in hip dents after lipo/fat transfer?

RealSelf actual patient comment:

I’m a small frame woman, had 2 pregnancies. Did Brazilian butt lift 2 years ago. Although my butt is nicer than before, however I’m left with dents on the hips, below waist area which doesn’t give me that nice silhouette. I’m considering Sculptra but I’m open with suggestions of how to improve this as well as improve irregularities on stomach area. I appreciate your time to answer my question. Thank you.

 

A. Yes, Sculptra may be used to treat your concerns.  I would also recommend something that tightens the skin and builds the muscle and evens out the fat irregularities.  You may have a combination of Venus Freeze/Legacy for skin/fat, Emsculpt to build muscle and decrease abdominal fat as well as further lifting your butt, and CoolSculpting for fat irregularities.  Good luck and be well.

Q. What are these lines around my mouth?

RealSelf actual patient comment:

I’ve kinda always had these lines. They’re more like pockets of fat, I’m only 21 so hard to believe it’s pre mature aging. I do not smoke or drink but I smile/laugh a lot. I get my lips filled so I told my nurse and she told me it’s normal and I want to avoid filling the area so I don’t look like a blow fish. But they bother me bad. What are my options? As you can see they’re more obvious in certain lighting.

 

A. The lines that you are concerned about are due to the excessive amount of filler that someone has injected into your lips.  The distortion of your lips and disproportion of the size of your upper to lower lip by your nurse injector is the cause for your concern.  I would recommend laying off the lip injections for awhile and even having some of the excess dissolved.  No one, let alone a 21 year old should have that much filler in their lips.  Once again it comes down to making sure that you choose your injecting aesthetic physician carefully based on their skill, experience, knowledge, and most importantly, their NATURAL artistic vision.  Good luck and be well.

Q. Does Emsculpt build muscle and burn fat for the butt treatment or just build muscle?

RealSelf actual patient comment:

Thank you for clarifying!I know it does both muscle building AND fat burning for abs but wasn’t sure about the butt treatment and am reading conflicting opinions. Thank you! Also realistically if someone had no lbs to lose but poor muscle tone, would it help?

 

A. Good question.  Just this afternoon I asked my patient having her first butt lifting treatment with Emsculpt whether she wished to keep or lose the fat on her butt.  Emsculpt has two treatment protocol settings, one that burns fat and one that does not (both settings do build muscle.)  Prior to any Emsculpt treatment of the buttocks it is important to let your physician know what your wishes are, a thinner tush, or a Kardashian special.  Good luck and be well.

Q. Could Restylane Defyne cause an autoimmune problem?

RealSelf actual patient comment:

I don’t seem right. I am 53. I had Restylane defyne injected into nasolabial folds & marionette lines 3 weeks ago. No lip injections. My lips became puffy, painful, dry, pink and white after. I have developed a lot of floaters in my eyes & hot feelings in my ears and back. I had bruising after the procedure & a puffy line under my upper lip. I have hypothyroidism and possibly rheumatoid arthritis. Am I having an autoimmune response to the product and if so what do I do. It is making me really nervous.

 

A. Sorry that you are having this complication from your recent injections. I would recommend returning to your injecting physician for evaluation.  I have not heard of any autoimmune reactions to Restylane Defyne.  Make sure that the injections in your NLFs is not compromising the blood flow to the affected areas. Good luck and be well.

Q. Why hasn’t my face peeled/healed after Profound treatment and CO2?

RealSelf actual patient comment:

I had Profound treatment followed by CO2 in the same day. I said I was concerned to the Doc. but was assured it was fine. I’m very worried, I’m only on day 7 but have extreme uneven thick skin & extreme redness/neck & under chin area is swollen numb & saggy. I was assured things would be fine by now! there is NO way I can return 2 work looking like this!! I understand it takes time but I look horrible – my face doesn’t seem to be healing at all & hasn’t peeled at all – HELP

 

A. I would recommend discussing your concerns with your treating physician.  The combination of the two treatments at the same sitting is a very aggressive treatment.  One would expect longer healing times from swelling and bruising.  Peeling or lack thereof is not a concern.  Hopefully you should begin to heal more quickly over the next few days.  Please keep us informed of your progress. Good luck and be well.

Q. Can I have Radiesse after having Voluma in the same area to be treated?

RealSelf actual patient comment:

I had voluma on my mid face. However, I have read that radiesse has collagen forming/inducing properties, unlike voluma, so I’m thinking of having it for a retouch on my cheeks since i find it still lacking of volume. Is it okay? Can’t it cause any complications since both filler are made up of different materials?

 

A. Yes, you may mix and match the facial fillers Voluma and Radiesse.  The most important aspect of any aesthetic treatment is making sure that you choose your treating physician most carefully based on their skill, knowledge, experience, and natural artistic vision.  Good luck and be well.

Q. What is the likelihood that I could get a dorsal bump from this injury?

RealSelf actual patient comment:

I was putting something in the trunk, and I didn’t realize it was closing. As I was lifting my head up I hit my nose on the bottom of the trunk. I got a minor cut and some redness surrounding it. My nose itself didn’t bleed and it only hurts where the scratch and bruise is. As of right now there’s no swelling or bump. My question is, what is the likelihood that I could get a dorsal bump from this injury?

 

A. Very low chance.  Nothing to do about it for 12 months, if it does bother you then consult with an expert rhinoplasty surgeon.  Good luck and be well.

Q. Is Ultherapy safe for me after facial fat transfer 3 years ago?

RealSelf actual patient comment:

I have had full face fat transfer x 2. The last was three years ago. Or is there risk of destroying the fat i had transferred to my face?

 

A. Yes, both Ultherapy and Profound RF may be used to lift and tighten your face and neck after fat transfer.  The most important aspect of your treatment is that you choose your treating physician most carefully to absolutely minimize any adverse events.  Choose your treating physician based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

 

Q. Will these bumps under my eyes after Volbella injection go away?

RealSelf actual patient comment:

I had 1 syringe of volbella injected under each eye (total of 2 syringes) 8 days ago. This is my second time having filler. First time 1 year ago with no side effects. This time there are bumps under each eye that have yet to go away. My doctor said to give it 2 weeks. Is this a standard reaction? Should this smooth out within another week? Thanks in advance for any input.

 

A. Sorry that you are having an adverse reaction to your recent Volbella injections in your under eye hollows area.  This is not a standard reaction.  I would advise revisiting your treating physician for evaluation and treatment.  The most important aspect of facial filler injections is to choose your injecting physician most carefully based on their experience, skill, knowledge, and natural artistic vision.  I hope that your complication from the injections resolves very soon.  If your injector is unable to help you, then you should seek out help from an expert filler injecting physician. Good luck and be well.

Q. I am interested in Emsculpt for my hands, butt, and thighs (I know thighs are off-label) is this a potential tightening solution

RealSelf actual patient comment:

What are reasonable expectations of this treatment, cost, the and number of sessions required? Does this help cellulite? I understand it is great for decreasing fat and building muscle. Is tightening of skin a reasonable result of doing that? I live in Palm Beach County FL.

 

A. Emsculpt is FDA approved for use on the buttocks and the abdomen.  It builds muscle and can decrease fat when desired.  It is not used on hands.  Though off-label, it is being used to build thigh muscles.  The tightening from Emsculpt is derived from the increased muscle mass, Emsculpt is not a “skin tightening” device.  The cost of the treatment varies depending on the practitioner and the geographic location, in general a complete series of 4 sessions (1 session twice a week separated by 2 to 3 days for 2 weeks, a total of 4 sessions) costs from $3000 to $4500, individual sessions though not recommended are about $750 to $1125.  It may help with cellulite, though Emsculpt is not a “cellulite” device.  Our patients and staff have been very pleased with their Emsculpt results.  Good luck and be well.

Q. What are my options to fill out the loss of volume and lift jowls at 40?

RealSelf actual patient comment:

I’m 40 and have jowls and a long narrow face. I’ve been researching all of the options and at my age something more long lasting would be best since I’m fighting gravity hard from here on in. Is there something that will last a few years before I finally need a face lift or something more like that? Filler, fat transfer, or implants? Thank you for your time.

 

A. You are not alone, many patients have the same question when they come to our office in consultation.  Fortunately, there are many non-surgical, non-invasive treatments that can address your concerns of early jowling.  The best device treatments are Ulthera which uses micro-focused ultrasound to lift and tighten the face and neck, and/or Profound RF which uses micro-needles with radio-frequency energy to do the same.  It is usually better to add fillers to a tightened face so if you contemplate both tightening device and filler, then it is best to have the device treatment first.  If you wish a quick fix with filler, then I would treat your concerns with Voluma and Restylane Defyne in a natural manner, replacing your lost volume, not adding extra volume that you never had in the past.  It is always good to bring photos of your younger self to your consultation.  It is important that you do your due diligence and choose your treating physician carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Does adding PRP to the Profound Treatment on the face and neck, speed healing?

 

A. Excellent question.  Initially I treated my Profound RF patients without PRP, currently we encourage all of our Profound RF patients to have PRP with their treatment.  I agree with Dr. Treece that the healing time seems to be about the same, maybe a day or two sped up.  The benefit that I see with PRP, since the Profound RF treatment has already made about 8000 micro-needle holes in the skin, is improvement in fine lines, wrinkles, tone, and texture of the skin.  I believe that adding PRP to Profound RF is worth the small additional fee.  Good luck and be well.

 

Q. I’m thinking of getting the Profound procedure. The aesthetician is the one performing the procedure. Is this the norm?

RealSelf actual patient comment:

I’m 60 years old with deep skin wrinkles. I have an autoimmune disease and nervous about possible dangers. Can pigmentation be an issue.? Infection? Thank you for any input.

 

A. The most troubling aspect of your question is that an esthetician is scheduled to perform your Profound treatment.  I believe that Profound RF should be performed by a physician, I personally would not allow anyone but a physician to perform the treatment on me.  Profound RF is a great treatment for your deep wrinkles.  There should not be any problems or dangers due to your autoimmune disease as long as it is not active.  As long as you follow the proper protocol before and after your Profound treatment there should not be a risk of infection.  Please make sure to choose your treating physician most carefully.  Good luck and be well.

Q. How soon after the Profound RF treatment can I get fillers in my jaw line and chin and Sculptra for my uneven hallowed cheeks?

 

A. You may have fillers in your face as soon as the swelling resolves after your Profound RF treatment.  With Sculptra, I recommend that my patients have their Sculptra injection session just prior to Profound (on the same day.)  They can then return two months later for re-evaluation and any further Sculptra treatment.  As with any aesthetic procedure, it is essential that you take the time and effort to choose your treating physician most carefully based on their skill, knowledge, experience, and natural artistic vision.  Good luck and be well.

Q. Is Emsculpt really safe?

RealSelf actual patient comment:

I have read that electromagnetic energy can cause cancer. If that is the case then how can this new device be safe? I understand it is FDA-approved, but I’m still trying to understand the safety aspect.

 

A. Great question, many patients are concerned about the safety of Emsculpt.  Prior to offering any technology or new treatment to my patients I must be sure that the treatment is both safe and effective.  Emsculpt meets both of those criteria.  The National Cancer Institute has an article that explains the difference between safe and dangerous electromagnetic energy (see below under Web reference for complete article link.)  Basically, low frequency electromagnetic energy (used in Emsculpt) is safe, high frequency electromagnetic energy (like X-rays) are not.  BTL, the company that manufactures Emsculpt has used EM energy for many years in the therapeutic treatment of muscles without any adverse events.  There have been no reported complications of Emsculpt.  Prior to treatment, the treating physician must take a complete history of the patient to make sure that there are no contraindications to treatment that would cause problems such as metal implants, pacemakers, hernias, and other medical conditions.  Make sure to choose your treating physician most carefully. Good luck and be well.

 

Q. Is feeling sore after emsculpt to be expected?

RealSelf actual patient comment:

Just finished my 4th emsculpt treatment. Had my abdomen and buttocks treated. Is it normal to not have ANY soreness whatsoever after each treatment? Kept waiting to feel at least some sort of soreness. But, nothing. Not even a little bit. All four treatments were on 100% power. So far, not impressed with the results. I realize that results are supposed to show more after a few weeks. Is that correct? Thank you for your answers!

 

A. Some patients may feel a little soreness 2 to 3 days after Emsculpt, others don’t feel much at all.  Whether you have soreness or not will not affect your results. I personally had a single paddle 30 minute session immediately followed by a two paddle 30 minute abdominal session and did not feel sore afterwards.  Though some patients may see results after 2 to 3 sessions, we ask our patients to return for their initial post treatment photos at 6 weeks.  Results should be seen by 2 months.  Results vary depending on the individual patient, their body shape, their overall health, fitness, diet, etc.  Good luck and be well.​

Q. Emsculpt: are there any side effects and what does it cost?

 

A. Our practice was fortunate to be one of the first practices in the world to use Emsculpt.  Our patients and I have been very happy with Emsculpt.  Before incorporating any technology or treatment in my practice it must be proven to be both safe and effective. Fortunately there have been no complications reported in the Emsculpt studies over the past year, and no clinical adverse events reported.  It is important that your treating physician takes a complete medical history to insure that you are a candidate for Emsculpt.  There are a few absolute contraindications to the treatment such as metal implants, pacemakers, and poor health to name a few.  As long as you do not have any contraindications, Emsculpt is extremely safe and effective.  As with any treatment, choose your treating physician most carefully.  The cost ranges from $3000 to $4000 for either an abdominal or buttocks treatment.  In our practice we will be offering better prices for patients who wish to maintain their results over time.  We also work with our patients if they wish to pay per treatment it is about $750-$1000 depending on the treatment. ​Depending on the physician and practice, additional maintenance sessions of Emsculpt may be given at a discounted cost.  Good luck and be well.

Q. Can you have Emsculpt on the abdomen area if you have had a naval hernia?

RealSelf actual patient comment:

Can you have em sculpt on the abdominin area if you have had a naval hernia repaired 2 1/2 years ago? I am not overweight, work out 5 + times a week, and I am 20% body fat but can’t seen to loose the last of my belly. I am 65 and female.

 

A. As with any treatment it is most important to make sure that you are a candidate for Emsculpt and that there are not any contra-indications to having it prior to your procedure.  If you were my patient I would have you see your hernia surgeon to make sure that it is well healed and that your surgeon okays you having the treatment.  If your hernia is healed, you should be able to undergo the Emsculpt procedure.

There are a few contraindications for Emsculpt treatment.  Patients should not have any metal or electronic implants near the treatment area, no history of heart arrhythmia, cardiac pacemaker, implanted defibrillators, implanted neurostimulators, drug pumps,recent surgery, malignant tumors, excessive fat (the EM energy penetrates about 7 centimeters), epilepsy, pregnancy and breast feeding,the  procedure on women preferably should be done when not menstruating as it may cause period to come earlier and cramping may be greater, and recent surgery.  Make sure that your treating physician takes your complete medical history to avoid any adverse events or complications (no significant complications have yet to be reported with Emsculpt.)  Choose your treating physician most carefully. Good luck and be well.

 

Q. Will Emsculpt make my loose skin from childbirth worse?

RealSelf actual patient comment:

I am 62, 5’10” and 167 lbs. I do go to the gym and watch my weight. I now have a small belly but also already have some loose skin from childbirth, which has gotten worse in the last few years. What will happen with the loose skin? Will Emsculpt make it better or worse?

 

A. Emsculpt builds muscle by electro-magnetic energy stimulating the nerves that cause supra maximal contractions of the core abdominal muscles.  Emsculpt is the only FDA approved safe, easy, and clinically proven technology that builds muscle and decreases abdominal fat.  As your muscle mass increases, some of your loose skin slack should be taken up.  Emsculpt also is useful in post partum woman who have diastasis recti (separation of the connective tissue between the abdominal muscles after giving birth), strengthening the muscles and decreasing the separation/weakness caused during pregnancy.  In our practice we add Venus Legacy treatments if any loose skin persists.  Choose your physician most carefully.  Good luck and be well.

Q. Emsculpt: What is a good starting BMI. Is it effective for the deeper fat?

RealSelf actual patient comment:

170 pounds 50 years old . Upper abdomen fat. And hips is it effective for this area. I am about 33 bmi

 

A. Each individual should be examined by a physician prior to Emsculpt treatment to determine whether they are a candidate for the procedure.  Ideal patients are those with a BMI of 30 or below, but there are exceptions depending on the individual.  Most importantly a detailed past medical history must be taken insure safety and efficacy.  We had a patient today who remembered that as a child she had surgery and that metal clips were used internally in her abdomen.  Metal in the body close to the area treated is a contraindication to Emsculpt so she was not treated.  The fat that Emsculpt reduces is peripheral fat (that fat between the skin and muscle).  It does not decrease visceral fat (the fat below the muscle around the intestines, “beer belly” fat.)  Interestingly, the love handle fat is often decreased when the abdomen is treated with Emsculpt because of the supra maximal contractions of the core abdominal muscles.  Good luck and be well.

Q. Emsculpt and compression garments – will wearing them after Emsculpt help at all?

RealSelf actual patient comment:

Either in end results or speeding along the process? Or would they be problem in some way?

 

A. Just like you don’t wear compression garments after intensely working out, it is not necessary to wear them after Emsculpt.  There is no swelling though some patients may have minimal soreness of the muscles for a day or two, just like after a great workout at the gym.  Good luck and be well.

 

Q. Does Emsculpt hurt?

RealSelf actual patient comment:

How much discomfort is there?

 

A. Emsculpt is an exception to the old adage, “No pain, no gain!”  Emsculpt sessions should not ever be painful, they should be intense, not painful.  The Emsculpt device allows the physician to control the power intensity of the treatment while the patient gives real time feedback.  The power is gradually increased as the patient is able to tolerate the pulses.  The goal is to get to supramaximal contractions of the large muscles which the patient can feel, and the physician can see.  All of my patients have been able to reach 100% power shortly into their Emsculpt session.  The other old adage that Emsculpt seems to be an exception to is, “If it sounds to good to be true….”  Good luck and be well.

 

Q. Am I a candidate for Emsculpt? I’ve had a BBL years ago but over time my butt has drooped a bit.

RealSelf actual patient comment:

I’ve had a bbl years ago but over time my butt has drooped a bit and when I gain weight I gain a lil too much there . I would like to know will emsculpt help noticeably decrease some of this fat and lift the butt area ? Also does this tighten the skin area? Was interested in tummy tuck , will this help with tightening the ab/muffin top areas equivalent as a tt?

 

A. As your name and your question implies, there is a lot to cover in answering your inquiry.  Emsculpt should lift the buttock without reducing fat.  The tone of your skin should improve as muscle tone and mass increases.  We have seen improvement of the love handle area with abdominal treatment even though the love handles were not specifically treated.  As with most non-surgical procedures, if surgery such as a tummy tuck is really indicated because of excessive skin and fat, then Emsculpt will not be an equivalent treatment.  It is best to see an expert physician for an in person consultation and examination to determine what is the best treatment (or combination of treatments) for you.  Good luck and be well.

Q. Can Emsculpt be carried out on tummy and butt on the same day?

RealSelf actual patient comment:

For example, I will start with tummy and once 30 mins session done, I will do the treatment on my butt. Will it be too much or I should do it on a separate day.

 

A. You are now officially the Emsculpt Most Asked Questions on RealSelf Champion of 2018!!!!  Congratulations!!!  It is perfectly safe to have Emsculpt on your abdomen and on your buttocks during the same treatment session, just like we sometimes will work these same areas at the gym.  Good luck and be well.

Q. I am interested in Emsculpt but had a tummy tuck 5 years ago and was wondering if I would be a candidate?

RealSelf actual patient comment:

Are you able to use the emsculpt machine on your abs if you previously had a tummy tuck? I haven’t gained any weight and don’t have any fat on my abs, I would just like to increase my muscle tone in that area.

 

A. Having had a previous tummy tuck is not a contraindication for Emsculpt, it is a safe and effective procedure after a tummy tuck.  One should wait long enough for the tummy tuck surgery to have healed well before having Emsculpt, certainly 5 years is plenty of time for you to improve your abdomen with Emsculpt.  Good luck and be well.

 

Q. Can I do more than 4 Emsculpt sessions?

RealSelf actual patient comment:

Can I do more than 4 sessions. I am thinking if I can do 6 sessions for the period of 3 weeks to achieve better result or it is totally unnecessary?

 

A. With your xs to s size,as well as your doing Pilates (from your previous questions here on RS), and now doing an extra two sessions of Emsculpt​, you should be a poster woman for Emsculpt results.  The Emsculpt was studied at 7 independent US medical practices, the protocol for the treatment was 2 treatments a week, separated by 2 to 3 days for two weeks, a total of 4 Emsculpt 30 minute treatments.  One would think that adding more treatments should help you achieve a better result.  Good luck and be well.

Q. How to make Emsculpt more effective?

RealSelf actual patient comment:

I am Wondering if I should do Pilates after the 4 sessions of emsculpt to enhancing the muscle building. Pilates seems to work on core very effectively. I am doing emsculpt on both tummy and butt next week for 4 sessions each, 2 days apart.

 

A. Well, as it is said about chicken soup, “It can’t hurt!”  Pilates is an excellent exercise for toning the body and the core.  It should only enhance and help to maintain the results from your upcoming Emsculpt treatment. Good luck and be well.

Q. Will Emsculpt enlarge muscle?

RealSelf actual patient comment:

I am very confused. I read that building muscle will cause the muscle to grow in size. Will the growing of muscle cause a bulge or will it tighten up and shrink muscle? So it will be flattened? I am in between xs and s size person and I’m wondering if I should buy a dress in XS or S? i am getting the dress online for an occasion next week.

 

A. Emsculpt has been shown to increase muscle mass by 16% and decrease fat by 19% after a series of treatments.  Having said that, I would buy the dress size that you would normally get that fits you best.  I believe that the effect of Emsculpt “building muscle” and Emsculpt “toning the abdomen” will offset each other, I doubt that your clothing size will be affected.  Emsculpt patients should be toned, not built into a “Charles Atlas” or Arnold Schwarzenegger body builder type of result.  Have fun at your upcoming occasion, good luck and be well.

 

Q. Can this procedure be used on upper arms? I lost muscle tone in upper arms from having had a bilateral mastectomy.

 

A. Emsculpt has been FDA approved for the treatment of the abdomen and the buttocks.  There are practices that will treat other areas such as the arms.  I agree with Dr. Avaliani ​that it depends on the expertise of the practitioner to decide the safety and efficacy of treating “off-label” areas with Emsculpt.  There is not a contraindication to treating the arms of patients who have had mastectomy.  Good luck and be well, God Bless.

Q. Can I combine a PRP and Profound treatment?

RealSelf actual patient comment:

I am going to get a Profound treatment on my face in a couple of weeks. I would like to combine this with a PRP treatment. Has this ever been done? I am thinking it might boost the effectiveness of the Profound treatment.

 

A. Great question, in fact in our practice we now routinely recommend that patients combine their Profound RF treatment with Platelet Rich Plasma (PRP).  When a patient​ arrives on the day of their treatment our nurse draws a small tube of their blood in a special PRP tube which is then centrifuged to separate the patient’s red blood cells from their plasma (the yellow part of blood serum which is concentrated with platelets.)  Profound RF uses micro needles which cause microscopic holes in the skin through which the platelets in PRP seep into, attracting growth factors and possibly stem cells which result in greater rejuvenation from the treatment.  You are correct in believing that PRP will boost the effect of your Profound RF treatment.  Good luck and be well.

Q. Profound microneedling. Is it safe?

RealSelf actual patient comment:

I am a 33 years old with great skin but need more volume in my cheeks.. I am looking for the most natural treatment that can safely build my collagen to more youthful plump skin look. A doctor advised me to try PRP with Profound Micro-needling. Then if I need more volume I can do fillers such as voluma Should I do what he suggests? is Profound Micro-needling safe? I heard it has swelling and bruises as side effects. .. is it right it has 100% response rate ?

 

A. One of the most commonly seen results with Profound RF treatment is that cheeks look elevated and larger, almost as if they have been lifted.  Not only is Profound RF effective but it is extremely safe when performed properly.  As with any facial aesthetic procedure, the most important aspect of the treatment is making sure that you choose your treating physician very carefully based on their experience, skill, knowledge, and natural artistic vision.  I have treated hundreds of patients with Profound RF and have fortunately not had an adverse event or complication.  There is significant swelling which maximizes at about 2 days and resolves by 5 days at which time we allow our patients to resume exercising.  There is also significant bruising which maxs out at about 3-4 days and is gone from 7 to 12 days after the treatment.  By 5 days concealer may be used. We have seen a response in all of our patients, though results may vary from patient to patient.  The young patients that we have treated such as yourself have enjoyed excellent results and have been very happy that they underwent the Profound RF treatment.  Good luck and be well.

Q. Can I gain weight after Emsculpt?

RealSelf actual patient comment:

If Emsculpt is taking away fat from my abdomen, what happens if I gain weight? Will it go back to the abs or will it go to another area so that my thighs, etc are bigger than they were before?

 

A. Emsculpt treatment results in a loss of abdominal fat and a building of abdominal muscle, just like working out intensely, say like doing 20,000 crunches or squats in 30 minutes!!!  Just like working out, if weight is gained, it will be distributed throughout the body in the usual areas that fat accumulates.  Hopefully your Emsculpt treatment serves as motivation to continue diet and exercise programs that keep you from gaining excess weight.  Good luck and be well.

Q. Strange side effect from Profound RF.

RealSelf actual patient comment:

Procedure was 16 days ago. The only bruising left is under my eyes. By day 2, I developed an indescribable smell inside my nose. Most everything I eat takes on the bad aroma. On day 5, I worried there was an infection & started amoxicillin. My only other symptom is tenderness around neck & lower cheeks. Antibiotics haven’t helped yet & now it seems the smell is also in my urine. Supplements: Arnica, Bromelein, multi-vitamin, extra c, e and added k on day 6. Please advise. Thank you.

 

A. I am sorry that you are having your most unusual symptoms after your Profound treatment. I have never heard of such a thing!!!​  It is likely due to something other than your treatment and the timing may be coincidental.  I would advise consulting with a ENT physician who will listen to your history, exam you, and hopefully find an answer and curative plan for your dysnosmia (stinky odor).  Now if you had said that you had eaten asparagus after your Profound treatment then I would be able to make the connection between the smell in your nose then showing up in your urine.  Good luck and be well.

Q. Can Profound be performed on the forehead, around eye areas?

RealSelf actual patient comment:

During my consult with a doctor, he said profound can only be done on lower face, not around eyes or forehead. Is there a reason why? And why are some doctors doing it on you tube?

 

A. I nearly always treat my Profound patients on their forehead and around their eyes.  As a facial plastic surgeon I am very comfortable using tumescent local anesthesia (the same type of facial injection of local anesthesia that is used during face, neck, and brow lifts) which is necessary to treat these areas.  The anatomy of the forehead and underlying skull bone requires tumescent infiltration of local anesthesia so that the dermal micro-needles which penetrate 1 to 2 millimeters beneath the skin do not hit bone and are damaged.  The company that manufactures Profound, Syneron, does not encourage treatment of the forehead or eye area.  Once again, as a facial plastic surgeon I am fully comfortable treating these difficult areas safely and effectively.  By treating a greater surface area, the results of Profound rejuvenation are greater.  It takes more time, skill, knowledge, and experience to treat the forehead and eye region, but it is worth the effort. As with any aesthetic procedure please be sure to choose your treating physician carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. Emsculpt and exercise during treatment period?

RealSelf actual patient comment:

I have another Emsculpt question. Think I’m gearing up to try it. Do you just refrain from exercising the body parts being treated during the two-week period but can do other exercise? So if getting abs and butt treated, avoid direct abwork and squats but could otherwise lift, run, and play sports during the 2 week treatment period? Thanks in advance!

 

A. Common sense is one of our greatest senses.  It is fine to maintain your activities after Emsculpt treatments, but if specific anatomic muscle groups are targeted during the treatment, then those areas should be rested for a day or two.  For instance if the buttocks are treated then squats can be avoided for a day.  If the abdomen is treated then avoid crunches for a day or two. Running, yoga, golf, and scrabble are all okay following your Emsculpt treatments. As with any aesthetic procedure please be sure to choose your treating physician carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. I had a hip replacement in December 2017. Should I avoid Emsculpt? Could it damage the new joint with the energy waves?

 

A. Emsculpt may be used on patients with hip replacement.  The electromagnetic energy should not be directed over the hips. Emsculpt should not be used immediately above any metal implants in the abdomen or buttocks.  As with any procedure it is very important that you share with your treating physician any history of implants.  Good luck and be well.

Q. Is Emsculpt cost effective? I don’t have much fat in me but like to tone and lift my bottom.

RealSelf actual patient comment:

Emsculpt cost effective. I don’t have much fat in me but like to tone and lift my. bottom Please give me advice I don’t want waste big cost if results are minimal and not long lasting. Thank You

 

A. Emsculpt is a great new safe and effective non-invasive treatment that lifts the “bottom” like no previous technology that I have seen.  Cost effectiveness is relative.  It has been said that most of us either have time or money.  For those with time and no money, it’s time to start doing your squats and crunches.  For those with money and no time, Emsculpt is a no brainer.  The treatments are fairly priced for having the equivalence of 20,000 crunches or squats in a 30 minute time period. That’s going to save you a great deal of time.  ​As with any aesthetic procedure please be sure to choose your treating physician carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. Will Emsculpt work for me?

RealSelf actual patient comment:

Dear Doctors please give me your opinion on none invasive laser technology EM SCULPT which is promise to induce strong muscular contraction not achievable through workout and promise to lift and firm buttocks. I am 48 years old woman in very good shape and weight 115 lb all my life but for several years my buttocks do not look firm and really need some lift, i even thought about fillers please give advise to woman who strives for perfection

 

A. Thank you for asking!  You appear to be a very good candidate for Emsculpt technology and treatments.  Emsculpt is a great treatment for individuals who are in good shape, who workout, and who wish to push their body to it’s greatest potential.  My office staff who have had the treatment relate that they have seen immediate lasting results on lifting their buttocks.  As with any aesthetic procedure please be sure to choose your treating physician carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. With Emsculpt how many treatments are needed for “maintenance”? 1? 2? Etc.

RealSelf actual patient comment:

I am going to give this a try. Everyone references maintenance. What number of treatments does it require?

 

A. I once asked three beautiful women, “What is Beauty?”  The first answered, “It’s a feeling in your heart.”, the second answered, “You know it when you see it.”, the third said, “Beauty is maintenance!!!”​  Once a patient has had their twice a week for two weeks treatment with Emsculpt, the “beauty” and effectiveness of their results will depend on maintenance.  There has not been a studied maintenance protocol as the safe and effective technology is brand new.  In my practice Emsculpt treatments are individualized.  As a baseline I recommend a maintenance single treatment anywhere from 3 to 12 months after the initial treatment.  Since the benefits of Emsculpt treatments are the equivalent of doing 20,000 crunches or squats in only 30 minutes, some patients will continue their “workout” maintenance treatment every month. As with any aesthetic procedure please be sure to choose your treating physician carefully based on their skill, knowledge, experience, and most importantly their natural artistic vision.  Good luck and be well.

Q. How many treatments of Emsculpt for abdomen? How long between treatments?

A. For the abdomen we treat patients for 30-min 2 times a week, spaced 2-3 days apart for 2 weeks, a total of 4 treatments.  Patients will likely be treated for maintenance after about a year.  Depending on the individual patient in my practice I may adjust the treatment for their particular needs.  Having had the treatment myself, I can see where Emsculpt can become almost addicting.  I am sure that the device will be used more than indicated, particularly by my staff, family, and friends during off hours.  As with any aesthetic procedure, make sure that you choose your treating physician most carefully.  Good luck and be well.

 

Q. Are Emsculpt results permanent?

RealSelf actual patient comment:

How long do Emsculpt results last if I maintain a normal body weight?

 

A. Emsculpt results are long lasting, permanency depends on the patient. Just like going to the gym and working out, the results that you see must be maintained.  Patients who have Emsculpt are loving their treatment results for up to a year before having “maintenance” treatment.  If a patient maintains their normal body weight through healthy diet and exercize then the results should last longer than someone who like the lazy kangaroo is a “pouch potatoe.”  For the abdomen, fat loss can be permanent but the muscle tone must be maintained.  Same for the buttocks, to keep the butt-lift up, one must maintain the muscle tone.  Many of the early patients using Emsculpt are finding that they like the results so much that they are having additional treatments for continued improvement.  Choose your treating physician most carefully.  Good luck and be well!!!

Q. Is the Emsculpt procedure known by a different name? I’ve tried Googling “Emsculpt” and only see realself.com in my results.

RealSelf actual patient comment:

Where do I go to get more information on this procedure, how it works, who is a good candidate, how much it cost, and who provides this service? Thank you.

 

A. Emsculpt is a brand new technology that flattens and tones the abdomen and lifts the buttocks without any cutting, needles, or pain.  It is a quick and easy, safe and effective treatment.  Paddles are placed on the area to be treated (FDA approved for the abdomen and buttocks), then electro-magnetic pulses cause the muscles to contract equivalent to doing 20,000 sit-ups or squats in a 30-minute time period.  The treatment is repeated twice a week for 2 weeks, results are usually seen shortly after the treatment.  If you google “Emsculpt” it should come up.  The technology is made by BLT (see video below).  Good luck and be well.

Q. Emsculpt for arms and shoulders (off label)?

RealSelf actual patient comment:

Wondering if any of you doctors have tried Emsculpt off label for biceps, triceps, or shoulders since the results for abs and butt are so great? Or does the present applicator not allow for it? Is the company testing/working to develop protocols for other body parts?

 

A. Great question, while I was getting my first Emsculpt treatment we discussed the treatment areas of the the body other than the FDA approved treatment of the abdomen and the buttocks.  The current hardware is able to be applied to other areas and the company (BLT) may be working on other applicators for other muscle groups.  The only area that will likely not be treated are the pectoral muscles as the heart muscle is under it.  The Emsculpt technology is unique and exciting.  Good luck and be well.

Q. I heard Emsculpt builds muscle in addition to melting fat. Can it help build my muscles for me?

RealSelf actual patient comment:

I recently lost 80lbs (went from 220 to 140) and was told by my personal trainer at the gym that I need to build muscle to help with my excess skin. Can Emsculpt help me with this? I do not want to get a tummy tuck.

 

A. Emsculpt does build muscle as well as decreasing fat cells in the abdomen in general.  It is a great treatment for those patients who do not wish to undergo tummy tuck or butt lift surgery.  Individual patients need to be evaluated by their treating physician to determine whether the treatment is indicated for their needs.  Most likely you will be a good candidate for the treatment.  Choose your treating physician most carefully.  Good luck and be well.

Q. How much does Emsculpt cost?

RealSelf actual patient comment:

Is the price per treatment or do you pay all at once?

 

A. Emsculpt is the newest cutting edge non-surgical, non-invasive technology that tones muscle and eliminates fat in the abdomen.  It can also create a non-invasive butt lift.  The treatment consists of 2 30-minute treatments, 2-3 days apart for 2 weeks, a total of 4 treatments.  The cost ranges from $3000 to $4000 for either an abdominal or buttocks treatment.  In our practice we will be offering better prices for patients who wish to maintain their results over time.  We also work with our patients if they wish to pay per treatment it is about $750-$1000 depending on the treatment.  As with any aesthetic procedure make sure to choose your treating physician most carefully.  Good luck and be well.

Q. I am thinking of having profound on my face and neck, is it safe to go to the beach 10 days later?

RealSelf actual patient comment:

I will be getting profound on my face and neck but will be leaving for the beach 10 days later, my skin gets dark very easily and even a pimple leaves a mark for days, also a scar leaves discoloration, thank you

 

A. One of the nice aspects of Profound RF is that you may resume normal activities relatively soon following the treatment.  Since your skin is sensitive, it would be best to plan your treatment at a time when you would not be exposed to intense sun for at least 3 to 4 weeks.  Usually all of the micro-needle tiny punctures are well healed by one week, but why take chances with your sensitive skin?  Of course make sure that you use and reapply sun block daily, especially when at the beach.  Good luck and be well.

Q. Is it ok to get Profound treatment when I have fillers and Botox in my face?

RealSelf actual patient comment:

I had Juvederm and Botox done a week ago, and love the results. My doctor suggested I have the Profound procedure in about a month. What will happen with the Botox and Juvederm? Will they be destroyed in the procedure?

 

A. Ideally patients should have any tightening, lifting treatment prior to having injectable facial fillers (other than Sculptra which is not affected by heat.)  It depends on the area and depth of the Juvederm or other facial filler that you have had and how long ago it was injected whether Profound RF will affect it.  We encourage our patients to have Botox treatment prior to their Profound RF treatment as studies with laser recovery have shown that the results are better when the treated area moves less (new collagen formation is facilitated.) Good luck and be well

Q. Has anyone used Profound for bra bulge? I was told it was fat.

RealSelf actual patient comment:

But lose skin from losing skin elasticity from menopause (my skin has dropped all over). I work out a lot. I am 5’8″, 157 lbs. I am 53 yrs old. Does anyone know if it will work for this area? I hate the bulge over a swim suit top.

 

A. I have not used Profound RF for “bra fat” though with the subcutaneous tip it should be effective.  We have successfully used CoolScupting in this area to help decrease the fat bulges.  Good luck and be well.

Q. Is Profound RF as effective as fat or Sculptra in restoring volume to the perioral area?

RealSelf actual patient comment:

I have three parallel folds a little over one inch long extending from below my oral commissure toward my lower cheeks (not mesolabial folds) on a bit of a diagonal (NW to SE) due to loss of fat and collagen and (maybe) bone. I have some lipstick lines as well. This is an aging problem, not a congenital problem. I do not have skin laxity, therefore I do not need skin tightening. I don’t want fillers in these areas unless absolutely necessary. About how many Profound sessions might be required?

 

A. In patients with your described condition, I recommend Profound RF with simultaneous use of Platelet Rich Plasma (PRP).  Profound RF alone stimulates the new production of collagen, elastin, and hyaluronic acid, and with the addition of PRP (the platelets attract growth factors and stem cells to the treated skin) there is a magnified synergistic response with improved results.  It is an excellent treatment for crepe skin. Sculptra and  pen Micro-Needling with PRP also help with problematic lines and wrinkles. As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Is there a danger with the Profound of similar problems like the Ulthera?

RealSelf actual patient comment:

There are several reviews on here of the Ulthera ” melting the face, skin sagging, needing facelifts andfat transfers after Ulthera procedure, I don’t want to take that chance w profound.

 

A. Your concern is shared with many patients that I see in consultation.  Since Profound RF dermal treatment is directed only 1 to 2 mm below the skin surface, it does not effect fat.  The subdermal Profound RF micro-needle tip is used to purposely eliminate fat cells (for double chins and body fat.) I do not believe that Profound RF patients need to worry about unde​sired fat loss with the consequent need for correction.  As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. My skin under my chin is loose and jiggly after Profound RF treatment?

RealSelf actual patient comment:

I had the Profound RF treatment 5-6 days ago. The swelling is still evident in my lower face and neck. My main concern is the skin under my neck is loose and jiggly like jello. It was not like this at all prior to the treatment. Will this go away? How long approximately?

 

A. It sounds as if your treating physician used the subdermal micro-needles which are inserted deep into the submental (double chin) fat to decrease fat and tighten the area.  When this is performed with Profound RF it is normal to have swelling along with the jiggles. It is the same swelling and jiggling that we see in patients who are treated with Kybella injections.  It does take some time (days to weeks) to resolve depending upon how aggressive your treatment.  As with any question or concern following a procedure, it is best to contact your treating physician.​ Good luck and be well.

 

Q. How does Ultherapy compare to Profound?

RealSelf actual patient comment:

I had Ultherapy a few years ago. It really did nothing. It was painful and expensive. If Ultherapy didnt work for me how can I expect Profound to be any different?

 

A. Sorry to hear about your poor experience with Ultherapy.  The results of both Ultherapy and Profound RF are dependent upon appropriate patient selection (age, life style, sun damage, tobacco use, etc.), realistic physician and patient expectations, as well as the treating physician.  These devices are not commodities, rather they are safe and effective non-surgical skin lifting and tightening tools that when used properly on carefully selected problems work well.  Profound RF is a different technology and works at a different depth of skin than Ultherapy.  As long as you are in good health with a normal healing response with collagen production then Profound RF (though also pricey) should help.  I would advise consultation with a few experts in the field before committing your time, money, and “comfort or lack thereof” to any treatment.As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Compare Ultherapy Results with Eprime Results?

RealSelf actual patient comment:

I suspect the downtime is longer with eprime and the pain is greater with ultherapy. However, I would tolerate both in exchange for results. Any head to head comparisons on skin tightening results? Thanks!

 

A. Profound RF is an improved more effective and safe evolution of “ePrime”.

Profound RF and Ultherapy are different non-surgical device skin lifting and tightening treatments that are both safe and effective.  Profound RF uses paired micro-needles that emit radiofrequency energy while deployed 1 to 2 mm beneath the skin for 3 to 4 seconds creating a controlled temperature of 67 degrees C.  Ultherapy uses the topical application of micro-focused ultrasound energy at different skin depths (4.5, 3.0, 1.5mm) creating heat.  Both technologies work by stimulating new collagen over time.  Both continue to improve over a 6 to 9 month period and both are thought to last about 5 years, though you will look better for the rest of your life compared to how you would have looked without having the treatment.  The downtime for Profound RF is 7 to 10 days due to bruising and swelling.  There is little to no downtime with Ultherapy.  In some patients, the two procedures may be combined for even better ultimate results. The results of each treatment are dependent upon the individual patient (age, health, skin damage, smoking, etc.), they are both effective, but in general Profound RF is a more aggressive treatment. The discomfort of both procedures is controlled in my practice with local anesthesia. As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Profound Laser: Can you tell me the pros/cons compared to Ultherapy and also compared to a facelift? I’m 47 years old.

RealSelf actual patient comment:

I am 47, fighting the aging battle and am looking into some options to help overall sagging appearance. My eyelids are sagging enough to have become uncomfortable and my cheek area is sagging so my face shape does not look defined… I’m not sure which option would be the best for me.

 

A. Profound RF and Ultherapy are both safe and effective skin lifting and tightening non-surgical procedures good for the face and neck.  Neither is a treatment of choice for eyelids, though both may help with crow’s feet wrinkles and slight elevation of the eye brows.  Facelift and blepharoplasty are surgical options to treat facial sagging skin.  To decide the best option for you, it would be best to consult with a few facial plastic surgeons in person (or at least with photos.)

Profound RF and Ultherapy are different non-surgical device skin lifting and tightening treatments that are both safe and effective.  Profound RF uses paired micro-needles that emit radiofrequency energy while deployed 1 to 2 mm beneath the skin for 3 to 4 seconds creating a controlled temperature of 67 degrees C.  Ultherapy uses the topical application of micro-focused ultrasound energy at different skin depths (4.5, 3.0, 1.5mm) creating heat.  Both technologies work by stimulating new collagen over time.  Both continue to improve over a 6 to 9 month period and both are thought to last about 5 years, though you will look better for the rest of your life compared to how you would have looked without having the treatment.  The downtime for Profound RF is 7 to 10 days due to bruising and swelling.  There is little to no downtime with Ultherapy.  In some patients, the two procedures may be combined for even better ultimate results. The results of each treatment are dependent upon the individual patient (age, health, skin damage, smoking, etc.), they are both effective, but in general Profound RF is a more aggressive treatment. The discomfort of both procedures is controlled in my practice with local anesthesia. As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Profound RF after having Infini RF; good idea or waste of money?

RealSelf actual patient comment:

I had an Infini RF treatment to full face and neck on Jan 7th. I’m seeing good results but am considering doing the Profound RF instead of a second Infini treatment. I’d rather not have to suffer the downtime repeatedly and Profound is supposed to be one and done. My goal is lift & tightening; neck, cheeks, mouth and brow. I am thin with prominent cheekbones and have maxed out on the potential for fillers. Is Profound the way to go? If so, how long should I wait before having Profound done?

 

A. Both Infini and Profound are excellent safe and effective non-surgical skin lifting and tightening procedures that use micro-needles and radiofrequency energy to heat the skin and induce new collagen production.  Infini may require multiple treatments with less down time for each treatment while Profound RF is a one time treatment with a longer downtime (7 to 10 days.)  You may have Profound RF about 4 weeks after recovering from your Infini treatment.  ​

As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!​

Q. Is it possible to have Profound RF done on the forehead and temple area?

RealSelf actual patient comment:

At 38 I am seeing the start of eyelid creepiness. I am reluctant to rely on Botox for this as it is costly and I’m not sure about the long term effects of using it. I am more interested in a procedure that will address the laxity and can be repeated over the years. Is this recommended and are there doctors near me who do it. I live in Northern California.

 

A. Yes, Profound RF can be used to treat the forehead and temple area for improvement of forehead lines, wrinkles, and skin tone/texture as well as slight brow lifting and improvement of “crows feet” lines around the eyes.  I routinely treat these areas with the face and neck as it is thought that there is a better overall result proportionate to the total surface area treated.  There is the possibility of increased bruising when the temple and crows feet areas are treated, and the forehead requires tumescent infiltration to avoid breaking the micro-needles.  ​In the NoCal bay area I believe that James Newman, MD is expert at the Profound RF treatment.

As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!​

Q. Profound RF for loose stomach skin?

RealSelf actual patient comment:

5’2″ 120 lbs, no kids. Lost 10 lbs in 2 weeks and it damaged my body. It was only 2 months ago, is recency of event in my favor? Can Profound RF help me? Can Profound combined with Ultherapy help more? I saw amazing before/after pics of an ab with “rolls” & crinkles looking 80% better on one doctor’s website but I’m skeptical…

 

A. Yes, Profound RF is a safe and effective non-surgical treatment to improve loose abdomenal skin.  The subdermal micro-needles emit radiofrequency energy deep below the skin to create tightening of the tissue as well as decreasing fat cells. As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!​

 

Q. Profound RF: What are the risks and side effects of this machine? How long does it last?

RealSelf actual patient comment:

HI doctors, can the heat from this machine melt facial fat? Does results look good initially but cause more laxity/saging down the road?

 

A. Profound RF is a safe and effective non-surgical treatment for tightening and lifting the skin of the face and neck, including the jawline and wrinkles.  The swelling is maximum about 48 hours after the treatment and resolves by 5 to 7 days.  You may apply concealer make-up by day 4 or 5 to hide bruising.  It is the bruising that takes from 7 to 14 days to resolve.  The treatment of the skin does  not remove fat.  In patients who do have excessive fat under the chin or in the neck, a separate handpiece is used that penetrates 6mm to purposely reduce fat cells.  I have not seen any patients appear older and gaunt after the treatment, only younger and tighter!!!  Profound RF stimulates the production of new collagen, elastin, and hyaluronic acid all of which add volume to the face.  It has been used since 2014 and there have not been any reports of more sagging or laxity “down the road”, just natural continued aging.  Patients will always look better than they would have had they not had Profound RF.  Fortunately, the risks and side effects are minimal for the degree of improvement.  The most common side effects are bruising (7-10 days), swelling (5-7 days), and dermal papules (days to a few weeks).  The complications of burns and scars are extremely rare, I have not seen any in my patients. As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!​

Q. Wait time for fat grafting after Profound RF?

RealSelf actual patient comment:

Hi Doctors, How long would I have to wait to get facial fat grafting after a full face profound RF treatment? I’m considering doing profound RF for some lifting and volume restoration. But if it isn’t enough, I’d like to do fat grafting. How long would I have to wait to be safe? Many Thanks

 

A. I would wait at least 6 months after Profound RF before having fat transfer to the face.  The facial improvement from Profound RF continues for 6 to 9 months.  There is usually improvement of the cheeks and jawline.  Fat transfer is a permanent filler therefore it is important to see the areas where fat is needed, as well as not over-doing an area where volume will increase over time from the Profound RF.  Good luck and be well.

Q. How long can the Profound procedure last long term?

 

A. The best answer to your question is that patients will look better for the rest of their lives compared to how they would have looked if they did not have the Profound RF procedure.  This is the same answer for facelifting and Ultherapy.  The results do vary depending on how individual patients respond and heal.  Most would say that you should continue to appreciate the benefits of Profound RF for about 5 years.  I just consulted with a single patient who had her treatment one year ago, she loves her results, has nice before and after photos, yet she is scheduling another treatment in about 3 months because of how much improvement she has seen.  These treatments are just “tools” that help with rejuvenation.  Many patients have just one treatment and are satisfied, others wish to have more.  Improvement after Profound RF continues for 6 to 9 months, therefore the earliest re-treatment is not before 6 to 12 months. As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Severe bruising and swelling post Profound treatment, is this normal?

RealSelf actual patient comment:

I had profound 6 weeks ago. My bruising and swelling were severe and took 2 weeks to heal. My festooning , which was to improve post procedure is now worse. I have dark circles under my eyes as well. I look worse then I did prior to the treatment. My doctor says that he has never had this result and there isn’t a fix except adding filler. This is quite honestly not an acceptable response. Does anyone have advise?

 

A. Sorry to hear about your experience.  Bruising and swelling are normal after Profound RF, swelling usually takes about 5 to 7 days to come down,  bruising usually resolves after 7 to 12 days.It is difficult to make recommendations without seeing photos or examining you.  It is best to discuss your concerns with your treating physician or another facial aesthetic expert in your area.  Dark circles and festoons are difficult problems to treat.  Fillers may help while the expected improvement from your Profound RF treatment occurs over the 6 to 9 months following your procedure.  Good luck and be well.

Q. Does Profound RF or Infini RF generate the most volume in facial folds?

RealSelf actual patient comment:

My nasolabial folds are deepening with age. I am developing marionette folds, too. Will treatment with Infini RF or Profound RF to these areas markedly reduce these folds given the fact that they both generate one or more of the components of facial volume (elastin, collagen, hyaluronic acid)? Can they increase volume (with enough treatment sessions) as effectively as Sculptra or fat grafting? Or are these two devices better suited to treating lipstick lines?

 

A. Both Profound RF and Infini are safe and effective non-surgical lifting and tightening treatments.  They both use micro-needles that emit radiofrequency energy creating heat that stimulate natural collagen production.  I find that the nasolabial folds improve in a natural fashion as the cheeks seem to have increased volume and lift. These devices are the best non-surgical lifting and tightening devices and do work on improvement of fine lines and wrinkles.  I often use them in combination with fillers when needed.  Sculptra, Voluma, and other fillers are used on an individualized basis depending upon the unique needs of each patient. As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Does Profound RF require multiple treatments?

 

A. Profound RF is thought to be a one time procedure.  Unlike many other facial aesthetic treatments, Profound RF does not require multiple treatments to see results.  Many patients are happy with their results and request a second or third treatment for further rejuvenation.  The results of the treatment continue to improve over a 6 to 9 month period.  For those patients requesting another Profound RF treatment it is advised to wait at least 6 to 12 months.  ​As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Is Profound the same treatment as Ultherapy?

 

A. Good question!  Profound RF and Ultherapy are different non-surgical device skin lifting and tightening treatments that are both safe and effective.  Profound RF uses paired micro-needles that emit radiofrequency energy while deployed 1 to 2 mm beneath the skin for 3 to 4 seconds creating a controlled temperature of 67 degrees C.  Ultherapy uses the topical application of micro-focused ultrasound energy at different skin depths (4.5, 3.0, 1.5mm) creating heat.  Both technologies work by stimulating new collagen over time.  Both continue to improve over a 6 to 9 month period and both are thought to last about 5 years, though you will look better for the rest of your life compared to how you would have looked without having the treatment.  The downtime for Profound RF is 7 to 10 days due to bruising and swelling.  There is little to no downtime with Ultherapy.  In some patients, the two procedures may be combined for even better ultimate results. ​As with any facial aesthetic treatment it is essential to make sure that you choose your treating physician carefully based upon their skill, knowledge, results, experience, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. I had a Profound treatment done almost three weeks ago. Is it normal for my jawline to be numb and sore?

RealSelf actual patient comment:

I also have soreness and numbness in my neck. Area under chin feels kind of jiggly and is still swollen. Does my healing fall within the normal time range for this procedure? The treatment focused on my lower face/jawline and neck.

 

A. It is always best to address questions and concerns about a procedure that you have had to your treating physician.  In general, patients may have some numbness and fullness for a few weeks after Profound RF treatment. If your “double chin” area was treated to reduce fat then it is common to have some “jiggly” for a few weeks. Please contact your treating physician for follow up.​  Good luck and be well.

Q. Profound treatment with broken needle

RealSelf actual patient comment:

One of the needles broke or bent during the treatment and they switched out the head. It happened again with the second head and they would just shut off the alarm and keep going. My question is if I received less treatment because of one or more less working needles?

 

A. Great question.  The Profound RF “heads” or tips that contain the paired micro-needles are complex state of the art technology.  There are 5 pairs of very delicate micro-needles​ in each tip.  They have intricate micro-chip technology that precisely controls the temperature and time of exposure.  If a micro-needle is damaged (usually by the needle striking bone), the needle withdraws back into the tip and no longer deploys.  If this should happen, then only 4 of the original 5 pairs of needles are working, giving only 80% of treatment per insertion into the skin.  The feedback of the broken needle sounds an alarm after 5 insertions with a compromised tip.  If the tip is detached from the handpiece and re-attached, 5 more insertions are allowed before the alarm sounds again.  By continuing with a damaged tip, you may still receive a full treatment as long as you receive 20% more insertions to make up for the broken needle pair. The tips cost hundreds of dollars.  If a needle breaks near the end of a treatment session,  a physician may choose to continue with the damaged tip, but should be giving more insertions to cover the same surface area, though it may take longer, patients should receive a full treatment.  Good luck and be well.

Q. What are the risks associated with Profound RF?

A. Profound is an excellent skin lifting and tightening non-surgical treatment that is both safe and effective.  Fortunately the risks, complications, and adverse events associated with Profound RF are rare.  The most common side effects to be expected with the treatment are swelling and bruising. The next most common occurrence is small raised bumps on the skin that called dermal papules.  Dermal papules usually disappear on their own within a few days, though they may persist for a few weeks.  I have personally not seen the extremely rare complications of burns or permanent scarring.

As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. Profound RF to lift jawline and treat wrinkles. How long does swelling last and can you apply makeup to cover bruising?

RealSelf actual patient comment:

I’m inquiring about the profound treatment to lift my jawline & treat some wrinkles & sagging on my face …doesn’t this treatment remove fat cells? Will it make your face appear older & guant? I’ve read to drink water to flush the “dead” fat cells out …but that not really what I want to happen .. also..can you apply makeup to cover bruising & how long does the swelling really last?

 

A. Profound RF is a safe and effective non-surgical treatment for tightening and lifting the skin of the face and neck, including the jawline and wrinkles.  The swelling is maximum about 48 hours after the treatment and resolves by 5 to 7 days.  You may apply concealer make-up by day 4 or 5 to hide bruising.  It is the bruising that takes from 7 to 14 days to resolve.  The treatment of the skin does  not remove fat.  In patients who do have excessive fat under the chin or in the neck, a separate handpiece is used that penetrates 6mm to purposely reduce fat cells.  I have not seen any patients appear older and gaunt after the treatment, only younger and tighter!!!  As with any aesthetic procedure, you must choose your treating cosmetic physician carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well!!!

Q. How long do the results from Profound RF last?

RealSelf actual patient comment:

I know the technically “correct” answer is that it takes off X number of years and that we continue to age afterward, but is this actually true? For Ultherapy, I basically returned back to baseline after one year even though I did look quite a few years younger right afterward. I was wondering if the results from Profound last longer, and how often we should repeat the procedure? Thank you!

 

A. The best answer to “How long will the results for Profound RF treatment?” is the same answer that I give to patients who ask how long a facelift or Ulthera will last.  Patients will look better for the rest of their lives compared to how they would have looked had they not had the procedure.  (Joan Rivers once said that she wished that she had an identical twin so that she could see what she would have looked like without all of her plastic surgical treatments!!!)  I believe that most experienced practitioners tell their patients that the treatment should last at least 5 years.​

As with any aesthetic treatment choosing your treating physician is essential for excellent results.  Choose your treating physician based on their judgement, skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. 1 month post Profound RF and I have more laxity. Is this due to all the residual swelling dissipating?

RealSelf actual patient comment:

I’m not expecting results yet but three weeks post profound my face looked and felt firmer. Within the past five days my face started to noticeably sag. I’m a good healer and according to the dr only had mild laxity. At a month post , I look worse than before I went in. My regular dr confirmed this today when I went in to see about fillers. The dr who did the profound is well respected. Is this part of the healing process for some? It definitely caused my filler to metabolize faster.

 

A. Depending on what kind of filler and where your filler was placed, it is possible that the heat from your Profound RF treatment may have caused some loss of the filler volume which would lead to the effect that you are noticing.  I do not believe that the skin “stretches” from the swelling.  Over the next 6 to 9 months after Profound RF your body should produce collagen, elastic, and natural hyaluronic acid adding​ volume to your face, especially to your cheeks.  In the meantime your treating physician may use Voluma and/or Sculptra to strategically add volume until the effects of your treatment take hold.  Good luck and be well.

Q. Skin Tightening? Any doctors have experience with “Profound RF” treatment?

RealSelf actual patient comment:

The Profound procedure looks very promising. Is any doctor doing it? What can one expect as far as down time? What is the typical pricing?

 

A. Profound RF is a safe and effective non-surgical device for lifting and tightening the skin of the face and neck.  Our patient’s experience has been positive.  The results do vary, but the overall patient satisfaction rate is very high (the “Worth It” rating here on RealSelf is 97%, and the one not worth it was based on a different technology.)  The cost is dependent on the extent of the treatment.  My philosophy is that if I am treating someone then they should get the absolute best treatment to maximize their chances for great results.  I treat the entire face and neck (twice the surface area) and recommend the concurrent use of platelet rich plasma (prp) which stimulates growth factors and stem cells, facilitating healing and ultimate results.  There is additional cost if the deeper subcutaneous micro-needles are used to melt fat.  The downtime also varies depending on the aggressiveness of the treating physician, my feeling is that if you are having the treatment, you might as well get the most bang for your buck.  Our patients are told to expect at least a 5 to 12 day downtime depending on their bruising.  Many patients can use concealer or tinted sunblock (in men) and be presentable within 5 to 7 days.

As with any aesthetic treatment choosing your treating physician is essential for excellent results.  Choose your treating physician based on their judgement, skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Is 30 years old too young for Profound RF if you’re dealing with facial skin laxity from weight loss?

RealSelf actual patient comment:

Although it’s been over a year since I lost weight, I’ve noticed that my face seems saggier than before. I’m only 30 and know that I would look better if it were slightly tighter. Am I too young for this type of procedure?

 

A. It is difficult to answer your question without a photo or better yet an in person examination.  For the most part, if you do have the “S” word skin (sagging) then either Profound or Ultherapy are great safe and effective device non-surgical treatments to address your concerns.  You should get a fantastic result since you are young and your healing response with be boosted.

As with any aesthetic treatment choosing your treating physician is essential for excellent results.  Choose your treating physician based on their judgement, skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Am I a candidate for profound RF skin tightening procedures/fillers even with the metal wires in my face? (photos)

RealSelf actual patient comment:

I had cheekbone reduction surgery to make the upper face less wide. There are tiny wires stabilizing the new bones. Am I still a candidate for profound RF skin tightening procedures as well as fillers to add a little volume in my cheeks even with the metal wires in my face?

 

A. I would likely treat you with Profound RF after a consultation and examination.  You should bring your x-rays to your consultation.  The Profound RF micro-needles are deployed 1 to 2 mm beneath the skin.  I would avoid insertions directly above the wires to be extra cautious. Good luck and be well.

Q. Injectable laser” for tightening?? Profound?? Has anyone used it on legs yet?

RealSelf actual patient comment:

I recently read about a new laser that is supposed to be “injectable” for tightening?? I think that it is called Profound? I think they have been using it on the face but going to be getting a new way to use it on the legs for loose skin? Has anyone heard of this and what kind of results it is having? I’m curious about it. I would love to have tighter skin on my legs.

 

A. Profound Lift is a micro-needling device with radiofrequency heating of the undersurface of the skin that is a safe and effective non-surgical facial and neck lifting and tightening treatment.  It is not a laser.  It is not an “injectable”, though the paired tiny needles apply the radiofrequency energy 1 to 2 mm beneath the skin surface (6 mm beneath when fat is being dissolved.)  In my practice it is an excellent procedure for face and neck rejuvenation.  There are some practices that promote the treatment of the entire body, usually under general anesthesia in an operating room that takes hours to complete.  I have not seen any impressive photos of the treatment on body areas other than the face, though if you have the time, money, and patience, it should work to tighten any skin.  In our practice we have found that Venus Freeze, a non-invasive topical radiofrequency application has been effective at helping the loose leg skin above the knees as well as helping with thighs.  Good luck and be well.

Q. What is the recovery from Profound RF like?

 

A. Profound Lift is a wonderful lifting and tightening treatment of the face and neck, it stimulates your own collagen, elastin, and hyaluronic acids resulting in a natural rested, healthy, and rejuvenated appearance.  It is safe and effective.  The recovery is predictable and involves some downtime that varies among patients.  All patients are swollen and bruised for the first few days, maximizing at about 2 to 3 days after the treatment.  The swelling resolves by day 5, and sometime bruising may as well, but I inform my patients that there is a good possibility that they will have some residual bruises for 8 to 14 days. After discussing the treatment with my patient, I will usually treat them with an aggressive treatment for best results (this includes treating the forehead, the entire neck, and using PRP as well, areas not included in the standard Profound protocol.)   Bruises can usually be hidden with appropriate cover-up concealer.  My wife said that the weird thing about the recovery was that after the first 24 hours she felt completely normal except when passing by a mirror, at which time she looked as if she had lost a boxing match.  The good news is that there is no pain during the recovery.  It is an excellent time to catch up with things on the “to do” list around your home, and catch up on those binge watching Netflix shows.  Patients may return to full physical activities and working out after 5 days. Results can be noticed as early as a week or two, in other patients it may take up to

As with any aesthetic treatment choosing your treating physician is essential for excellent results.  Choose your treating physician based on their judgement, skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. How Does Uthera Differ from E Prime?

 

A. We are fortunate to live in age when non-surgical skin lifting and tightening devices are available to treat patient who wish facial and neck rejuvenation without having to go to undergo “the knife.”  Both Ulthera and Profound stimulate new collagen formation.  Dr. Cho and other physicians have given excellent answers here regarding the differences between these two safe and effective technologies. I agree with them.  In my practice, the main difference in my recommending one treatment over the other is the time that a patient has for recovery.  For those patients who can afford 7 to 10 days for bruising and swelling to resolve while they catch up with reading, Netflix, housework, etc. I recommend Profound lift with PRP (plasma rich platelets).  For those patients who request little to no downtime, Ulthera is their treatment of choice.  As with any aesthetic treatment choosing your treating physician is essential for excellent results.  Choose your treating physician based on their judgement, skill, experience, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Looking for a doctor to do facial sculpting with injectables. Is saline preview a good idea?

RealSelf actual patient comment:

Someone told me to look for a doctor who will help me see what the result will look like by injecting saline into the areas where I’ll be getting fillers. Do you do this? Is it a good idea? I am looking to erase/ flatten out deep nasal labial folds and lines to bring out my youth. Soften a sharp jawline. And also looking to balance out symmetry. I want to make sure the doctor and I are on the same page before I get the real injectables. So I am looking for the best way to do that.

 

A. The most important aspect of any facial aesthetic treatment is making certain that you have chosen your physician most carefully based on their experience, skill, knowledge, and natural artistic vision.  You may have a “preview” of what to expect with facial fillers by having normal saline solution injected.  I am happy to do this for selected patients.  At your consultation, before and after photos of patients with similar facial rejuvenation treatments are reviewed.  Most patients at that time decide to go ahead with treatment, but if you still desire a saline preview, then that is performed.  It sounds as if you are an excellent candidate for facial rejuvenation with volume replacement.  Good luck and be well.

 

Q. How can I make my face look less round and flat? (Photos)

RealSelf actual patient comment:

I feel like my face is so flat on my side profile how do I bring out my features more? Would fillers help that? Is there something I can do to make my face look less round? Thanks

A. Yes, fillers properly placed should add to your natural beauty.  I would treat your with Voluma on your cheek bones.  There are other treatments that can be done after Voluma treatment depending on how you respond.  ​Your job to choose your injecting physician most carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  You should look great, but your treatment results should not look obviously plastic.  Good luck and be well.

Q. Good candidate for nasolabial fillers? (Photo)

RealSelf actual patient comment:

Hello! I’m a late-20s female who is starting to notice pronounced nasolabial folds, primarily on the left side of my face. I think this might be due to having “flat” anterior cheekbones and fairly low body fat or some other anatomical thing that has to do with my smile (I included an image in case that’s helpful). I’d like to have a career in front of the camera so I’m trying to age as gracefully as possible. Any thoughts on whether I should look into fillers? Thanks!

A. Your request is a common complaint that we see in our facial plastic surgery office.  Beginning at about age 25 there is loss of bone in the cheeks.  This results in the formation of early nasolabial folds (NLFs).  Rather that treating the result of the bone loss (the NLFs), today we treat the cause of NLFs, the volume loss in the cheeks.  For a patient such as yourself, one syringe of properly placed Voluma should correct the slight aging that you are experiencing.  We like to call it going from “Hotty to Oh My G-ddy!!!”  Your job to choose your injecting physician most carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  You should look great, but your treatment results should not look obviously plastic.  Good luck and be well.

Q. Is volume the only way to eliminate smoker lines?

RealSelf actual patient comment:

Dr. has used Juvaderm UP for smoker lines on my lips however he’s doing this by adding volume I believe is creating a puffy look on my upper lip ,According to him it’s the only way to erase those lines.Any suggestions? Can the little lines be addressed one by one?I don’t want to look over done should I look for other options? Also I want to get rid of my puppet lines what you recommend? Also is there anyway to get rid of the very fine lines in the middle of my cheeks? Thank you

A. There is more than one way to skin a cat and there are more ways than inflating lips to treat “lip lines.”  The best treatment for these lines is a fractionated CO2 laser with PRP (platelet rich plasma) which requires some downtime.  The lip lines can be individually filled using a thin hyaluronic acid filler such as Restylane Refyne or Vobella without adding volume to the lips. Another treatment is Profound Lift with PRP.  Lastly, microneedling with PRP can be helpful.  Most importantly always choose your treating physician carefully based on their knowledge, skill, experience, and natural artistic vision.  Good luck and be well.

Q. Would a Silhouette lift or Juvederm Voluma in the upper and mid cheeks be best?

RealSelf actual patient comment:

I’m looking for a natural looking lift for my sunken lower face.My jawline is not smooth and the orbital bones are showing. I just don’t want to look inflated but I want the lower jowls to be lifted. Would 1 syringe of Juvederm voluma for each cheek be enough to lift the minor sagging? I am considering a sillouet lift but i hear negative reviews….and I don’t want too many syringes of Juvederm. Recommendations?

A. You are not alone, one of the most common requests for facial rejuvenation is improvement of the jawline, jowls, and the area under the eyes.  These are the most common early signs of facial aging and are related to volume loss.  I would treat you with 2 syringes of Voluma and then wait, letting you live with your new rejuvenated naturally volumized face. After a few weeks, we would re-evaluate your face.  At that time you may be fine or we may decide that more rejuvenation would benefit your very pretty face.  Whether that would involve more hyaluronic acid filler, or Sculptra, or even Silhouette thread lifting would then be determined.  There are excellent safe and effective non-invasive lifting and tightening devices ​that are great for your goals, including Profound Lift (micro-needles with radiofrequency heat energy) combined with PRP (platelet rich plasma), or if you do not have the 7 to 10 day “downtime” Ultherapy would be a good alternative choice.

The most important aspect of your treatment is making sure that you take the time to choose your treating physician most carefully based on their experience, skill, knowledge, and natural artistic vision.  Good luck and be well!!!

Q. Is Sculptra okay for smile, loss of volume, and lips? (Photos)

RealSelf actual patient comment:

Can scultpra be used for all areas where I’ve lost volume or have fine lines? If not, what the risk of getting it in my smile line or lips? I’m concerned about using juvaderm in my cheeks again because I smile so much- it looked unnatural last time.Last of all, how would I find a facial sculpting expert in my area?

A. Sculptra is a great natural facial volume replenisher.​  It can be used everywhere on the other except the lips.  Based on your photos, I would treat you with a combination of Sculptra, Voluma (for your cheeks), and Volbella (for your lips.)  The best way to find an expert injecting physician in your area is by word of mouth.  Visit multiple offices, look at their before and after photos, check out the appearance of the physician’s staff, and ask to speak or meet with their past patients.  Choose your injecting physician based on their experience, skill, knowledge, and natural artistic vision.  Good luck and be well.

Q. Does Sculptra treat smile lines?

RealSelf actual patient comment:

I am in my late 20s and I am interested in Sculpta. Does it treat nasolabial folds? Does the treatment hurt? Do I get a local anesthetic? Does sculptra come with lodocaine?

A. Sculptra is a biostimulating injectable filler that helps with the nasolabial folds (smile lines).  The treatment involves multiple injections, but the discomfort can be minimized by having topical anesthetic ointment for 30 to 60 minutes before treatment.  There is lidocaine local anesthesia in the Sculptra mix.  In patients in their 20’s often times we prefer the use of a little Voluma to lift the nasolabial folds (nlfs form because of loss of volume in the cheek bones.  By replacing that, the nlfs lift in a naturally beautiful way.)  The most important aspect of your treatment is making sure that you choose the best physician injector based on their experience, knowledge, skill , and natural artistic vision.  ​Good luck and be well.

Q. Is Juvederm Voluma filler good for cheekbone enhancement?

RealSelf actual patient comment:

I’m 27 and want to get cheekbone enhancement with Juvederm Voluma but I”m terrified. Although it pretty much says no real serious side effects because this product hasn’t been used for long I cant trust that it’s a good idea. I ‘m thinking it will cause changes in elasticity of my skin, the serious side effects that can come on later that no one has seen yet such as tissue scar formation/firmness and discoloration. Getting filler at such a young age and continue to do so, how will this fare?

A. Facial fillers are not tissue expanders.  Voluma is an excellent filler, especially for eloquently enhancing the cheeks, under eyes, nasolabial folds, and generally lifting the face in a naturally beautiful manner.  Fortunately you are young enough that a very small amount of Voluma (1 ml or 1 syringe) will give you results that take you “from hotty to oh my goddy!”  The most important aspect of having a Voluma treatment is making sure that you take the time to select your injecting physician most carefully.  You should base that decision on the physicians experience, skill, knowledge, and most importantly their natural artistic vision.  I treat patients in the mid to late 20’s frequently and they are among our most happy and satisfied patients.  Good luck and be well!

Q. What to do about a huge bump on the side of my nose that appeared 1 year post-op. It’s is still there a year later? (Photos)

RealSelf actual patient comment:

Post surgery I noticed a huge bump on the side of my nose, which feels like hard bone so there is nothing to do to fix it. Its more vissable in certain lightings&makes the front of my nose look crooked. I know to fix it would require me to go under the knife again, but I’m happy with my side profile, it’s just the front which now looks crooked post surgery. Been over one yr all my swellings gone down so I know the bump won’t either. It’s permanent unless I do something.What are my best options?

A. It appears that your nasal bone moved laterally after your osteotomies (breakage of nasal bones.)  Depending upon your physical examination, a one sided lateral osteotomy may correct your deformity.  Speak with your rhinoplasty surgeon, or consult with a rhinoplasty expert.  Good luck and be well!

Q. Fillers or fat transfer when yet to have babies? 28 y/o suffering from upper cheek hollowness.

RealSelf actual patient comment:

I’m yet to have babies. I’ve been contemplating to get either filler or fat transfer. In my case the doctor said i will need 2 cc of filler. I cant decide between fat transfer or filler. I am afraid that if i get fillers done then i will have to stop when I get pregnant and I will again be seeing hollowness and if i get a fat transfer done, the grafted fat might increase in size as many doctors say. Please help me in reaching some decision.

A. I would strongly recommend that you consult with an expert in facial injectables.  If you were my patient, I would likely use a little Voluma to restore your early loss of facial volume.  It results in a beautiful, natural transformation that let’s you look like yourself, just a younger and more rested appearing you.  As many of my patients say immediately after their treatment, and their initial, “Wow!”, they say, “I love the treatment, Voluma takes me from hotty to oh my goddy!”  Please be sure to take your time and choose your injecting physician most carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  It is not the filler that will give you great results, it is the injecting physician whom you choose.  Good luck and be well.

Q. Can years of under eye Botox create Malar Mounds? (Photo)

RealSelf actual patient comment:

For the last two years I have been getting Botox under my eyes. I was starting to get deep creases under my eyes not cried feet. The last 2 times that I went for Botox it was with a new doctor. She injected 10 units and 6 of them were directly below my lower lid. I now how lower eye bags that are almost unbearable and they are worse in the am. I am only 29. Is this a result of Botox? Will it get better when the Botox wears off or is it permanent since I have been getting Botox for two years?

 

A. The relatively high dose of Botox for your lower eyelids is preventing your muscles from contracting and squeezing accumulated fluid from your malar area.  This should resolve when the Botox wears off, avoid injecting this area in the future and look to other ways to treat what bothers you.  Good luck and be well.

Q. I want to have my upper eyelids done and originally was going to go under anesthesia but now I don’t know?

RealSelf actual patient comment:

The 1st quote i was givin was including anesthesia but then they gave me a different price all together which added 1000 $. How “awake” are you under local only and which do most people do? I have extreme anxiety so i dont know if i could sit still during the procedure.

A. We perform upper eyelid Blepharoplasty under local anesthesia all of the time.  With proper pre-medication the surgery is very well tolerated.  We give Xanax 30 minutes before to help with anxiety and then give weight appropriate Demerol injection about 15 minutes prior to the surgery.  Most of our patients are in and out of sleep during the 1 hour procedure.  Love Austin! Good luck and be well.​

Q. Nose and neck nightmares! What procedures are available to correct these unflattering features? (Photo)

RealSelf actual patient comment:

As I age what used to be the “tip” of my nose is turning into the ” ball” of my nose. When I first noticed it I thought no biggie however the ball is GROWING! And my neck no doubt the formation of a turkey neck has began this is NOT something I am comfortable with! What procedures if any are available to correct these very unflattering facial features???

A. If those are your nightmares, I would like to see your sweet dreams!  The tip of your nose can be refined with a conservative rhinoplasty while there are a number of treatments both surgical and non-surgical that will address your neck concerns.  The most important aspect of your prospective treatment is to make sure that you choose your treating aesthetic physician/surgeon most carefully based on their skill, knowledge, experience, and natural artistic vision.  Boomer Sooner.  Good luck and be well.

Q. Could both Rhinoplasty and Septoplasty be done together? (Photo)

RealSelf actual patient comment:

When i consulted an ENT SURGEON, he suggested me to undergo septoplasty, to rectify the curve in my nose since birth. I asked him whether Rhinoplasty be done together, although i want to change my nose shape because it doesn’t suites me. He answered me with a no. Can it be done together?? Thank you

A. Unfortunately your ENT gave you bum advice.  Rhinoplasty and septoplasty are performed at the same time more often than not.  It sounds as if your particular ENT surgeon is not comfortable performing the aesthetic rhinoplasty portion of a septo-rhinoplasty.  Most ENT surgeons are very well trained in both septoplasty and rhinoplasty.  As long as you are going under anesthesia to correct your septum, you might as well consult with surgeons who are facile at doing both procedures at the same time.  Make sure to choose your nose surgeon most carefully.  Good luck and be well.

 

Q. The swelling is out of control after lip filler. Is this normal? (photo)

RealSelf actual patient comment:

I had lip injections yesterday, they were really painful after but not so much any more. The attached photos show before and after then what they look like now.

A. Sorry to hear about your adverse reaction to filler in your lip.  You must return to your injecting physician for evaluation.  Most likely you are one of the extremely rare patients who may be allergic to filler.  Make sure that you know what type of filler was injected.  You should inquire about a steroid shot and taking antihistamine for immediate relief.  In the future you should have a forearm skin test prior to any filler injections.  Good luck and be well.

Q. How often for maintenance Sculptra? Can’t go by looks since you see yourself everyday.

RealSelf actual patient comment:

I know a good rule of thumb is one vial per decade, but that’s at first? I’m 35 and although I noticed fine lines and signs of aging, I didn’t realize it was volume loss. During a botox visit, I was offered a free Sculptra treatment to be a demo. They said I was a perfect candidate as I had volume loss around cheeks, temple and jaws. After a total of three vials spaced out accordingly, I couldn’t be happier. It was a mini face lift! So if I want to maintain, how often should I get a vial?

A. Great to hear that you are happy with your Sculptra treatment.  It is thought that once a patient reaches “full correction” after their injections they may benefit from “maintenance” treatment about 2 to 4 years later.  We are all unique so it is best to return to your physician for re-evaluation whenever you notice that you may be looking a little tired or that dreaded five letter word, saggy.  Good luck and be well.

Q. Will a closed rhinoplasty accomplish my desired effect? (photo)

RealSelf actual patient comment:

The hump needs to be shaved a bit. I don’t want a curve. The overprotection of my tip is the biggest issue I have and I’m afraid of the tip appearing more bulbous and projected by bringing in the bridge. Can the desired effect be accomplished with subtle alterations made via a closed rhinoplasty?

A. Yes, a properly performed closed rhinoplasty procedure can accomplish your nasal aesthetic goals.  The closed approach rhinoplasty is becoming somewhat of a lost art as the last generation of rhinoplasty surgeons have learning rhinoplasty from their professors under the “open” or “external” approach.  The closed approach avoids any external incisions or scars, but is much more difficult to teach or observe the intricacies, thus most teaching centers use the open approach.  Subtle results can be achieved without leaving you with an obvious “done-look” nose.  Go Bears!  Good luck and be well.

 

Q. I have a dip at the tip of my nose and would like it gone. Was wondering about approx. cost, time to heal, bandage time? (Photo)

RealSelf actual patient comment:

 

A. The tip of your nose can​ be shaped to your liking with a properly performed rhinoplasty.  The cost of the surgery varies depending on the surgeon. Costs will include the surgeon fees, operating room and anesthesiologist fees ranging anywhere from $7 to $25K.     It is and will be your nose for the rest of your life, so as they say about sushi, going for the cheapest is not always best. The most important aspect of your rhinoplasty is making sure that you choose your surgeon based on their skill, experience, knowledge, and natural artistic vision.  The time line for healing is about 5 days until the tape and splint are removed, one week for walking around the block or out and about, one week for work, 3 weeks for aerobic exercise, and 6 months before diving head first into the water.  Good luck and be well.

Q. I want a smaller, youthful, more feminine nose not an upturned pig nose – could I get closed surgery?

RealSelf actual patient comment:

I also don’t want the standard nose that is often given to everyone. Not too sure about a chin implant, was suggested to me, I may consider it if I am 100% satisfied with my nose. below are my pictures, & a nose style I like. I am also worried about my nostrils being uneven. Will they show up more asymmetrical if I remove the tip and the hump? I am willing to travel a bit to find the right doctor, but I am terrified my appearance will cause me to not look like “me”.

A. The most important aspect of your​ prospective rhinoplasty is making sure that you choose your surgeon most carefully.  You can achieve a smaller, youthful feminine nose with a “closed” approach rhinoplasty, all incisions are inside of your nose without any external incisions or scars.  The closed approach has become somewhat of a lost art as a generation of rhinoplasty surgeons have been trained with the “open” approach as it is much easier to see the anatomy and techniques in a teaching environment.  Your nostrils should have a symmetric result and should not be affected by hump removal and tip refinement.  A “pig” nose should not even be a consideration in a properly performed rhinoplasty on your nose.  I agree that a conservative chin implant will improve the proportions of your nose and other facial features.  Choose your rhinoplasty surgeon carefully based on their experience, skill, knowledge, and most importantly their natural artistic vision.  Good luck and be well.

Q. Will half a syringe of Voluma make a difference in the cheeks?

RealSelf actual patient comment:

“Hello, I purchased 2 syringes of voluma, but my doctor ended up only using 1.5 of it. I now have half a syringe left and I don’t want it to go to waste I know voluma is most commonly used for the cheeks…I have good cheeks but a bit of a lift and/or some more volume/definition would probably be nice since I am quite thin. Can half a syringe actually make a noticeable difference? Also, what does brushing/swelling look like this little amount injected? I always bruise with injections by this DR”

A. Voluma is a great filler when used by expert injecting physicians.  A small amount can make a big difference.  I can always find room for a bit more to make a face look more beautiful in a natural manner.  Though patients may bruise with any injection, it is certainly not normal that you should always bruise when injected.  The most important aspect of any aesthetic treatment is that you choose your injecting physician most carefully based on their skill, experience,knowledge, and natural artistic vision.  Good luck and be well.

Q. Am I a good candidate for Rhinoplasty?

RealSelf actual patient comment:

“I know I’ll ultimately need an in person evaluation, but can my nose be fixed with rhinoplasty? It’s very downward facing and long and my gap between nose/lip is large (I don’t want to lengthen the nose more though as is already quite long) also, I have a small bump and possibly overall narrowing of bridge for my face? Should I keep it as is or can I gain some overall aesthetic improvement? Thank you!!”

A. Your areas of concern about your nose can be addressed with rhinoplasty.  I would advise a subtle, very conservative rhinoplasty plan in your case.  Your small bump can be taken down and your tip can be refined.  The lines from your brows to the tip of your nose can be smoothed.  It is essential that your choose your rhinoplasty surgeon most carefully based on their skill, experience, knowledge, and most importantly their natural artistic vision. Good luck and be well!

Q. Would Alar base reduction be enough?

RealSelf actual patient comment:

“Or would I benefit more from doing some work on nose bridge as well? What can you tell by just this one picture”

A. Based on your photo, alar base reduction only on your nose would alter the natural proportions of your nose, causing your nose to be an unwanted attention getter.  A great nose does not draw attention, rather it gets out of the way of other facial features, particularly your eyes (which should be the central focus of your face.)  Consult with rhinoplasty experts to address your nasal aesthetic concerns.  Be sure to choose your rhinoplasty surgeon most carefully.  Good luck and be well.

Q. What kind of rhinoplasty would be the best option for me?

RealSelf actual patient comment:

“I’m 20 years old considering a rhinoplasty i feel like the tip of my nose keeps getting bigger every year and also I’m wondering if i have a deviated septum, I would like to know what kind of rhinoplasty would be the best for me and the pricing in my area. it’s the thing that makes me the most insecure should i do it now or just wait and do it all at the same time with FFS. i posted a picture of my nose and the desire nose i would want, are those results achievable ?thank you.?”

A. You have a nice nose and realistic aesthetic goals.  I love operating on noses like yours using a closed approach (no external incisions or stitches).  I would “sand down” your bump and refine your tip cartilages.  No packing is used.  Noses such as yours respond very well to subtle rhinoplasty where “less is more.”  You should still look like yourself, just your nose will not be stealing attention away from your eyes and other facial features.  Make sure to choose your rhinoplasty surgeon most carefully based on their skill, experience, knowledge, and their natural artistic vision.

Q. Would Sculptra be the appropriate filler to treat my nasolabial folds? Which areas would you inject?

RealSelf actual patient comment:

“I am a 37 years old male with pronounced nasolobial folds. I always had a bit of nasolobial folds and to be honest never liked them, but they just start to look really pronounced and the line is getting more vertical which really creates a very tired look. Please let me know your professional opinion about the best treatment. I am also adding some photos to give you a clearer view of the issue. Thanks in advance for your help”

A. Yes, Sculptra would be an excellent treatment to treat the volume loss in your face that has resulted in prominent nasolabial folds.  Make sure to choose your treating physician most carefully based on their experience, skill, knowledge and natural artistic vision.

Q. What is the best treatment for nasolabial folds?

RealSelf actual patient comment:

“I am a young patient 24 and I was wondering what is the longest lasting and best treatment for my nasolabial folds, around the mouth area, corners of my mouth , cheeks? I have read good reviews about sculptra but not sure if that is going to be the best alternative for me. Thanks”

A. Nothing beats being 23 years old for nasolabial folds.  Unfortunately from age 25 on we all begin the process of losing volume (bone, fat, and muscle) from our face.  When there is volume loss from the maxilla (cheeks), the soft tissue above the nasolabial folds loses its scaffolding support and begins to head south.  The best treatment to correct nasolabial folds is actually to avoid treating the fold itself (which is the result of volume loss in the cheek) and to instead treat the cause of the fold using either Voluma or Sculptra to replace (not augment) the lost cheek volume in a natural way.  So many patients are concerned and share that they do not wish to look unnatural or have “bigger cheeks”.  I do not make your cheeks bigger, rather just restore them to their previous more youthful volume.  Make sure to choose your treating aesthetic physician most carefully.

 

Q. How much is the average lines of Ultherapy for face and neck, or the most frequent/common number of lines used?

RealSelf actual patient comment:

“I know individual treatment may vary. But I would like to know as doctors that perform ultherapy what the most common number of lines you use is.”

A. The average number of Ultherapy lines for the cheeks is 240 lines deep, 190 lines superficial;  for the eye and forehead area, usually about 70 deep, 100 superficial;  for the neck 110 deep and 120 superficial.  If an extended neck is included (down to the clavicles) then an additional 150 deep and 150 superficial lines are used. Make sure to choose your Ultherapy physician most carefully.

 

Q. Could my nose use surgery? Is the bump bad/ugly?

RealSelf actual patient comment:

“I’ve always been self conscious about my nose. I have a dorsal bump, and I hate it very much. My parents say I’m overreacting, and that it’s nothing, but I would like a professional answer as to if it would look better with surgery, and if my nose currently has bad form. Am I overreacting? Or is it truly ugly?”

A. You have a very nice nose with a small bump on the profile.  If it bothers you a lot then it is worth investigating rhinoplasty.  I love operating on noses like yours as it is possible with just a few small internal incisions (closed approach rhinoplasty) to take down the bump with minimal other changes to the nose resulting in a beautifully natural nose.  In your case it is most important to choose a rhinoplasty surgeon who will listen and understand what your aesthetic goals are, and who will honor your request without drastically changing your nose with an “obviously done” appearing rhinoplasty.

Q. Should I be more direct to the doctor when being treated with Botox?

RealSelf actual patient comment:

“I am 59. I’ve had Dysport and Botox and experienced the droop. I believe only the central glabella area should be treated not above my eyebrows. Last time I asked the doc not to do above my brows but she went ahead and did a couple injections just above the tail of my stronger side, hence droop. To get positive results, should I suggest she only do the glabella and possibly under (rather than over) the tail of my eyebrow to get a slight lift? Thank you for any help you can offer.”

A. Yes, you should definitely discuss what works and what doesn’t work for you with Botox.  Everyone’s anatomy is unique, every injecting physician should assess the patient’s anatomy prior to treatment.  If you are dissatisfied with your injector, make sure to choose your next doctor most carefully.

 

Q. Have you ever seen swelling this bad 8 days post-op?

RealSelf actual patient comment:

“I had septorhinoplasty (closed) with work done to my tip. I’ve never seen a photo like this…. all of the cast removal day photos of noses look so nice and mine just looks completely deformed. I had surgery exactly one week ago. I am so depressed.”

A. Sorry to hear about your post-rhinoplasty swelling.  You should have your rhinoplasty surgeon examine your nose to make sure that all of the “packing” has been removed and that you do not have an early infection.  I personally have not seen your amount of swelling one week post rhinoplasty.

Q. I had 1 cc of Juvederm injected into my lips yesterday and absolutely hate how they look….

RealSelf actual patient comment:

“Where should I ask for the dissolver to be placed so that I can have a more natural shape but still keep filler in my lips? Can I just partially dissolve it? How long should I wait? I’m very upset because I had put the money aside for it and cannot afford to pay for another syringe at the moment. Would wydase etc dissolve everything? I still want the filler but a more natural look! It also caused weird lines around my mouth.”

A. Sorry to hear about your lip injection dissatisfaction.  It appears that your lips were large and pretty to begin with, and then on top of that too much Juvederm was injected.  At this point it is best to wait a few days and then consult with someone whose artistic vision can be trusted.  Most likely you will have some of the recent filler dissolved with hyaluronidase.  I would begin with your upper lip because the natural ratio of beautiful lips is the lower lip being about 1.6 times larger than the upper.  As with all aesthetic treatments, the most important aspect of your treatment is making sure that you choose your physician most carefully based on their skill, experience, knowledge, and natural artistic vision.

Q. I had Ulthera on my neck November 2016…

RealSelf actual patient comment:

“5 months later I look just awful, what should I do to fix it?”

Ulthera Patient

A. The excess skin on you neck can be reduced by either surgery or minimally invasive non-surgical procedure called Profound. Profound uses radio frequency energy emitted through micro-needles below the skin to tighten lax skin of the neck, jowls, cheeks and forehead. As always, be sure to choose your treating physician most carefully.

Q. Bulbous nose reshaping – can it be done without redoing whole nose?

RealSelf actual patient comment:

“Can it be done without redoing whole nose? Not looking to have full reshape, but just the tip.”

A. Your question is a common one and is best answered in person after examination and evaluation by an expert rhinoplasty surgeon. ​Shaping a nose is like sculpting, once one part is changed it is essential to be sure that the rest of the nose is in harmony. Rhinoplasty has evolved over the years to where the surgery is more conservative, we consciously attempt to preserve more of your underlying bone, cartilage, and soft tissue. When I consult with a patient with your goals, we share a computer image of before and after, and then decide on the plan. Sometimes thinning and refining the tip is all that is needed, in other cases, small refinements of the rest of the nose is required for the best aesthetic outcome. The most important aspect of your rhinoplasty is making sure that you choose your rhinoplasty surgeon very carefully based on their experience, skill, knowledge, and natural artistic vision.

Q. If I decide on a tip rhinoplasty and then want a full rhinoplasty, is that bad?

RealSelf actual patient comment:

“What is your advice? I’m just a little too worried about actually having them hammer and break the nasal bone. I’m also terrified about anesthesia going wrong and being awake during.”

A. Rhinoplasty is an artistic procedure. Everyone’s nose is different. Some noses may lend themselves to just having the tip refined, and the majority of noses benefit from having the entire nose shaped to create nice harmony that does not attract attention to aspects that may be out of proportion. Fortunately, anesthesia today is much improved over years past. When my patient is undergoing anesthesia prior to rhinoplasty, I tell them just before the IV medication that lets them “go to sleep” to think of their favorite people, places, things to do (i.e. paddle boarding in Hawaii, etc.). Our patients experience what seems like a one minute dream and the next thing that they know is they are in the recovery room comfortably awake from the 2 to 3 hour rhinoplasty. There is no need to worry about “waking up” during the rhinoplasty surgery. You should not be aware that the nasal bones are being cut (“hammer and breaking”). I would not limit your rhinoplasty because of this fear, whether to address your nasal bones or not should be based on the goals of the surgery, your anatomy, and your shared artistic vision with your rhinoplasty surgeon. Choose your rhinoplasty surgeon based on their experience, skill, knowledge, and most importantly, their natural artistic vision.

Q. Skin Tightening? Any doctors have experience with “Profound RF” treatment?

RealSelf actual patient comment:

“The Profound procedure looks very promising. Is any doctor doing it? What can one expect as far as down time? What is the typical pricing?”

A. Profound uses paired micro-needles that emit radio frequency energy in a precise temperature controlled manner that maximizes the production of new elastin, collagen, and hyaluronic acid in the treated skin. I have used Profound on the face and neck (including the forehead to lift tired brows) resulting in impressive lifting, tightening, and natural rejuvenation. We have also treated cellulite of the thighs with Profound. Patients are quite swollen after the treatment, usually lasting 5 to 7 days. Bruising varies and also resolves within 5 to 7 days. Our pricing varies depending on the areas treated, anywhere from $4,500 to $8,000. I personally perform all Profound treatments on my patients. Make sure to choose your treating aesthetic physician most carefully based on their experience, skill, knowledge, and natural artistic vision.

Q. “Injectable laser” for tightening? Profound? Has anyone used it on legs yet?

RealSelf actual patient comment:

“I recently read about a new laser that is supposed to be “injectable” for tightening?? I think that it is called Profound? I think they have been using it on the face but going to be getting a new way to use it on the legs for loose skin? Has anyone heard of this and what kind of results it is having? I’m curious about it. I would love to have tighter skin on my legs.”

A. Yes, we have used Profound on the thighs to treat cellulite with nice results and no downtime. There are certain areas on the legs where if the skin is thick enough Profound can tighten loose skin. It does work very well on the face and neck to tighten and lift, rejuvenating the face in a natural rested fashion.

Q. Can you suddenly develop an allergy to Juvederm? What are the chances that the same thing will happen again?

RealSelf actual patient comment:

“I had a horrific and traumatizing experience with Juvederm Summer 2015, which has lead me to fear any type of lip fillers or fillers in general. I got a hematoma, which lead to an infection, which lead to a huge bump on my lip, which had to be drained at the ER. Before this happened, I had no problems with Juvederm, and had it done regularly over the Aquamid which I’ve had in my lips for over 8 years. I want to do Juvederm again, but I’m so afraid that the same thing will happen again!?”

A. Sorry to hear about your bad experience with lip filler injection. What you experienced was not an allergy to the Juvederm injected into your lips, rather you had a vascular (blood vessel) event, either there was too much bleeding from a deep needle puncture, or you may even have had filler injected into a blood vessel which can cause overlying skin to break down. Aquamid has been known to have severe delayed response infections and that may have played a role in your complication. It is most important for you to consult with and be treated by only an experienced, skilled, and knowledgeable physician injector in the future. I believe that you may be able to have lip injections again, but only with precautions taken.

Q. How do I choose my rhinoplasty surgeon?

A. The absolute most important aspect of your rhinoplasty is your choice of rhinoplasty surgeon. Rhinoplasty is considered the most difficult of all facial plastic surgeries combining art and science. You should consult with at least 3 or more rhinoplasty surgeons prior to making your decision. Your decision should be based on the surgeon’s experience, skill, knowledge, and most importantly their natural artistic vision. Make sure that your rhinoplasty surgeon listens to your concerns about what bothers you about your nose as well as appreciating your aesthetic rhinoplasty goals. It is important to be on the same wavelength prior to surgery so that you are not left to be surprised by unwanted results. Look at before and after photos, ask to meet or speak with the surgeons rhinoplasty patients, ask if anyone in the office has been operated on by the surgeon. Computer imaging is helpful to communicate your goals for rhinoplasty, make sure that the imaging is realistic and not just a nice photo-shopping job. Should you have any further questions about selecting your rhinoplasty surgeon, feel free to contact me. Good luck and be well. ~Dr. P

Q. Can Sculptra Be Injected Into the Lips?

A. Sculptra is an excellent facial volumizer. It works by stimulating your body to make new natural collagen where it has been injected. There are areas where Sculptra should never be injected and the lips are one of those areas. Sculptra is injected deep to muscle and over bone in most facial areas. When injected in areas without underlying bone, Sculptra is injected beneath the skin. Sculptra is not injected in the lips or superficially around the eyes because unwanted lumps and bumps can form. We prefer to inject lips with Juvederm, Restylane, and Restylane Silk, all of which in our hands results in natural beautiful lips. Always make sure to choose your injecting physician most carefully to ensure safe, effective, and long lasting results. Good luck and be well. ~Dr. P

Q. Is Ultherapy permanent?

A. Patients often ask, “How long does Ultherapy last?”  The best answer is that when performed properly, a patient who has received Ultherapy will look better than they would have for the rest of their life had they not had the treatment.   I have personally performed Ultherapy for the past 6 years, and can only answer this question from my personal perspective.    The treatment is the best non-surgical lifting and tightening procedure available and is thought to be a onetime treatment.  I have seen many patients five years after their Ultherapy still looking better than they did before their treatment.  Other patients return after one year and are very happy with their results and wish to have more with another treatment.  Unfortunately the aging process continues with time, fortunately we have wonderful safe and effective treatments to help you keep looking your best.  Good luck and be well.

Q. Why does Ultherapy cost vary so much?

A. Ultherapy costs vary depending on the area(s) treated as well as on who is performing the treatment. In my practice, I perform all Ultherapy treatments because as a facial plastic surgeon I believe that my knowledge of anatomy and my ability to keep my patients as comfortable as possible leads to the best possible results safely while minimizing any adverse reactions or complications. My charges are slightly higher than the charges in a practice where the treatment is delegated to an assistant with little or no knowledge of vital facial structures and anatomy, and minimal experience in the treatment. The three main areas of Ultherapy treatment are the face, neck, and brows. The cost of the treatment varies depending on whether all three areas, or one or two areas are treated. Good luck and be well. ~Dr. P

Q. What constitutes of a thorough facial analysis?

A. Patients come to my practice not for a syringe of filler or a certain number of units of Botox. My patients benefit from my technique of full facial analysis using natural artistic vision to create the best naturally beautiful version of themselves. Over years of experience as a facial plastic surgeon treating thousands of patients, teaching others how to perform treatments, and staying up to date on the latest safe and effective facial rejuvenation treatments, I have developed the ability to thoroughly analysis your face and recommend the best individual plan to keep you looking your best. Leonardo da Vinci, hundreds of years ago described the “devine” or golden ratio that is found in nature as well as in beautiful faces. I use those natural ratios to create beauty on your face after careful analysis. At your consult, we will discuss the analysis of your face and give you a beauty plan for years to come. Good luck and be well. ~Dr. P

Q. When can a patient shoot a gun after otoplasty and rhinoplasty?

A. It is always best to consult with your surgeon when you have questions after surgery. We ask our patients to avoid strenuous activities for about 3 weeks after rhinoplasty at which time they may resume all physical activity other than boxing and diving head first into swimming pools, lakes, or the ocean. After otoplasty it is important to not traumatize the ears again for about 3 weeks. Good luck and be well. ~Dr. P

Q. Can all dermal fillers be dissolved?

A. Not all facial fillers can be dissolved. We prefer to use fillers in the face that can be dissolved, especially in areas of the face where there are significant blood vessels. Permanent fillers such as Bellafil and Silicone cannot be dissolved at all. Radiesse, though not a permanent filler, cannot be dissolved. The fillers that are made up of hyaluronic acid (Restylane, Juvederm, Voluma, Belotero) can be dissolved with an injection of hyaluronidase, an enzyme that rapidly breaks down the filler. The advantages of fillers that can be dissolved are that any lumps, bumps, or filling that is not good can be quickly corrected, and in the rare case of filler being injected into a blood vessel with vascular compromise, impending vascular necrosis can be avoided. Sculptra is a biological collagen stimulating filler that cannot be dissolved, yet is very safe as the fine Sculptra particles are dissolved in water and local anesthetic solution. My philosophy is to avoid the use of permanent fillers in the face because if there is a problem it can be very difficult to take care of….”Permanent filler, permanent problems.” Good luck and be well. ~Dr. P

Q. How long do dermal fillers last?

A. There are long lasting dermal fillers, short lasting dermal fillers, and those in between. The longest lasting dermal fillers are permanent fillers that include Bellafill, Silicone, and the patient’s own fat. The advantage of these fillers is that they last forever, the disadvantage is that they last forever and are very difficult to remove. The next longest lasting dermal filler is Voluma which is said to last up to 2 years. Sculptra is a bio-stimulating product that stimulates natural collagen production. Once patients have reached their “full correction” point with Sculptra, the results last for 2 to 4 years before additional treatment. Radiesse, Juvederm, Restylane may last from 9 to 12 months. Belotero is the shortest lasting dermal filler, lasting about 3 to 4 months. Make sure to choose your injecting physician most carefully to ensure that your treatment is safe and effective. Good luck and be well. ~Dr. P

Q. What is the difference between Fraxel restore and dual?

A. Fraxel restore laser was the first laser to use “fractionated” technology. Fractionated lasers treat a percentage or fraction of the skin surface area which is different from how older lasers treated the entire skin surface. The advantage of fractionated lasers is that normal skin aids in a more rapid and natural healing without the lines of treatment demarcation between treated and untreated areas. Fraxel restore laser is considered a non-ablative laser which means that it leaves the surface of the skin intact without removing any skin. Restore sends columns of heat through the skin which stimulates new collagen production and improves brown spot pigmentation. Restore treatment involves a 20 minute treatment, usually repeated 2 to 4 times every two to three weeks. Restore results in improvement of fine lines and wrinkles, better skin tone, texture, and color. The treated area is red and slightly swollen for 1-2 days, followed by a bronzing appearance that leads to a powdery flaking on days 3-5. By one week the skin looks beautiful.

A second type of laser was added to the Fraxel restore platform, this second laser is Thulium laser which specifically targets brown spots. The combination of the two laser systems is called Fraxel Dual. The Thulium laser is the best treatment for brown spots. The two lasers may be combined at the same treatment session to give patients a true “dual” treatment that results in beautiful skin. Good luck and be well. ~Dr. P

Q. What is the typical recovery after fillers?

A. Fortunately most of my patients are able to return to their normal activities immediately after their injectable filler treatment. In rare cases, there can be a small bruise which I minimize by using special advanced injection techniques. In the event of a small bruise, our patients are given arnica gel skin patches which have been proven to minimize bruises within 24 hours. We ask our patients to discontinue any medications that thin their blood for one week prior to treatment, and they can be resumed the day after treatment. We have found that not working out strenuously for one day after injections helps to decrease any late bruising or swelling. We like to see our patients back for follow up examination 10-14 days after their initial treatment to make sure that they have an excellent naturally beautiful result. As with any aesthetic procedure, be sure to choose your injecting physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P

Q. What is the best way to get rid of this “tired, saggy” look on my face?

A. Many of our 35 to 50 year old patients complain of looking tired and noticing that their face is sagging for the first time in their life. Fortunately there are some great choices of treatments that address the problem quickly, safely, and effectively. I particularly love to immediately correct “tiredness” with strategically placed injection of Voluma using The Master Injector Technique. With a 10 minute comfortable treatment, properly placed Voluma helps to rejuvenate the under eye area, the cheeks, the nasolabial folds, the corners of the mouth, and even the jawline. Ultherapy is the best lifting, tightening non-surgical treatment for the face, neck, and brows. Depending on the patient, Botox and/or Sculptra are used to complete their natural beauty rejuvenation. As with any aesthetic procedure, be sure to choose your treating board certified cosmetic physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P

Q. What makes Voluma different from other facial volume fillers?

A. Voluma has been a God send in my ability to rejuvenate patient’s face within 10 to 20 minutes. A small amount of Voluma is able to lift the face unlike any other facial filler. It is also the longest lasting non-permanent facial filler, lasting for up to two years. Voluma injection experts such as Dr. Persky are able to inject the product strategically to maximize the lifting effect while using the minimum amount of product to give you your best naturally beautiful results at the most economical cost…the biggest bang for your buck! More than any other aesthetic treatment that we perform, when patients are handed a mirror after their Voluma treatment, they respond with a spontaneous, “Wow!” As with any aesthetic procedure, be sure to choose your treating board certified cosmetic physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P

Q. How Often Do I Need to Repeat My Voluma Treatment?

A. The nice thing about Voluma treatment is that the effects are additive and cumulative. The first time that I treat a patient I like to remain conservative, usually using only 1 or 2 cc syringe(s) for a naturally beautiful result. I re-evaluate our Voluma patients about 10 to 14 days after their treatment to make sure that their results are maximized. Though Voluma lasts for a long time (when Voluma is injected properly, the results are very natural and long lasting, up to 2 years), I can usually find somewhere to place another little bit of Voluma to make you look even better. I recommend that patients consider a little more Voluma whenever they wish to look better, refreshed, rested, and beautiful. That can coincide with holidays, special occaisions, birthdays, etc. It is best to have your treatment 10 to 14 days before your special occasion. As with any aesthetic procedure, be sure to choose your treating board certified cosmetic physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P

Q. Why Do Many Voluma Patients Say That It Helps Them to “Go From Hottie to Oh My Goddie!”?

A. Recently while speaking to a new patient I asked whether she had ever had Voluma injected. She responded that she loves Voluma more than any of the other facial fillers that she has experienced and added, “In 5 minutes Voluma made me go from Hottie to Oh My Goddie!” Voluma results are immediate and long lasting. The injections are less uncomfortable than Botox injections according to our patients experience. As with any aesthetic procedure, be sure to choose your treating board certified cosmetic physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P

Q. What is The Dr. Persky Facial Beauty Plan?

A. Dr. Persky believes that each of his patients deserve an individualized beauty plan, not just for their immediate treatment but for the long term over many years. At your initial consultation with Dr. Persky, he will discuss what your goals and motivations are for your aesthetic needs. Next, Dr. Persky will perform a complete facial analysis discussing your unique rejuvenation. There will be recommendations made for immediate treatment, treatments for maintenance, and then long term treatment plans. Dr. Persky is conservative and usually proceeds with moderate improvement at a time. Included will be a discussion and recommendation of the best skin care products that will compliment and maximize your rejuvenation. As with any aesthetic procedure, be sure to choose your treating board certified cosmetic physician very carefully based on their experience, care, knowledge, skill, and most importantly their natural artistic vision. Good luck and be well. ~Dr. P