Upper lip fuller on one side versus the other?

July 5th, 2009

This is a question that I answered for a patient who had this procedure done by another doctor who had restylane injections to Lip Augmentation.

Unevenness may be due to differential swelling. One side may have received more manipulation than the other side and has become more swollen. You should wait at least 2 weeks before doing anything drastic.

The ways to correct it are to add more to the side that has less or is smaller. Or you can take some out of the side that has more by injecting an enzyme to digest the Restylane. You should go to someone that has experience in doing this to have a successful result. Knowing aesthetics is also the key to getting a great result.

Dr Young is located in Bellevue near Seattle, Washington

Negotiating price with your dermatologist?

July 5th, 2009

Negotiation could be okay to an extent. Pricing is usually carefully thought out and is set for a reason. Negotiation could get you somewhere but it could turn your doctor off and this could be a negative in your treatment in all honesty. You get what you pay for sometimes and this applies to everything. Choosing the right doctor is the most important thing. Even if you pay a little bit more, if the doctor takes care of you it will be worth it. He will bend over backwards for you if he feels he is being treated fairly.  In general though, I think most doctors though will always strive to do their very best for their customers ultimately.

Dr Young is located in Bellevue near Seattle, Washington

Restylane or Arcus Marginalis release for lower eyelid dark circles

July 5th, 2009

Both of those options can help. I think Restylane would be a better alternative to replace the volume that you have lost in the lower eyelid and cheek area. That is essentially what has happened — a loss of volume. The only thing is that restylane will last only 6-9 months. Fat repositioning can help the condition but there are limitations. It can leave you looking hollow and it can impact the position of your eyelids and can have complications.

I don’t prefer the fat repositioning procedure. I think volumizing the area is the best way to rejuvenate the face and the lower eyelid area. It can give you the most naturally looking results.  Fat transfer to this area is the best if done right.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  Dr Young employs the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington

Restylane for the dark circles under the eyes

July 5th, 2009

Restylane will last about 6-9 months but can improve this area. Fat injections can last 8-10 or more years if the fat survives after the first year. You are on the right track though. You need volume in this area and that’s the best way to improve this area. One thing to realize is that restylane will go away and can also be taken out earlier if you wish through enzyme injections. This can be reassuring.

Fat injections are more permanent and is a little harder to get rid of if you don’t like the volume but can be done through different special procedures. In my opinion, fat injections / transfer leads to the most natural results.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  Dr Young employs the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington

Restylane migrating to the bridge of the nose after injecting into the glabellar area

July 5th, 2009

This is a question that I answered for a patient who had restlylane injections by another doctor in the glabellar area:

It may be possible that the injection was placed over the area that you are concerned about. In my experience, with local anesthesia and swelling sometimes the landmarks that you have when it wasn’t swollen can be altered and you can get confused where you are injecting.

That is why I make it a guideline for myself to make accurate markings prior to any local anesthesia that can distort the area when I actually do the injections. Don’t worry though you can inject an enzyme that can make the bump go away if you want and these injections are really not as involved as the original injection of restylane. Things can be done for this!

In terms of migration, I think that it is less likely that it migrated. From the literature, this is not very likely to happen.  I think that the above explanation might be the answer.  Don’t worry if it is the restylane that migrated, this can be taken out if you would like.

Dr Young is located in Bellevue near Seattle, Washington

Hematoma and asymmetry after Radiesse Injections?

July 5th, 2009

This is a question that I answered for a patient who had Facial Fillersto the under eye area by another doctor who developed a large hematoma under the eye and what options she had to help the situation:

Bruising is a natural consequence that can happen after any procedure that enters the skin. This can be a procedure that involves injections or any surgical type procedure. Any doctor that tells you that he doesn’t get bruising is not telling the total truth. I think only God can assure no bruising.

The swelling and the difference will eventually get better. Your body does a lot to heal and make things better. Your doctor will help you through this and be there for you.

Some of the ways to avoid bruising and bleeding are to avoid blood thinners 2 weeks before and 2 weeks after your procedure, which include, but are not limited to:

  • High dose vit E
  • Aspirin
  • Anti inflammatories
  • Herbal medications or supplements

Local anesthesia with epinephrine can shrink the vessels in the area of injection and make less likely to manipulate blood vessels that can lead to bleeding. Genetics play a factor in how someone is likely to bleed, and this can be something that cannot be changed in a person many times.

There are some medications that can help certain bleeding disorders. But there are a lot of factors that can affect bleeding in ones genes that still need to be discovered and not likely can be changed through medicine.

In terms of the swelling that is asymmetric, this will eventually go down things that could help it include oral steroids for general swelling, pressure in that particular area (which could be done by a full facial compression garment with more gauze in the area of swelling the other side, or localized injections of steroids. You can also improve the swelling from the bruising through limited exercise that will bring blood flow to the area and help remove some of the residual inflammation and swelling.

Dr Young is located in Bellevue near Seattle, Washington

Bulky radiesse results and what should be done? Steroids?

July 5th, 2009

This was a patient that had a procedure done by another physician and wondered what could be done about some bulky results  after Facial Fillersinjections only 7 days after the procedure:

Seven days is too early to make a decision about steroids or other intervention. You should wait at least 2 weeks to a month before considering some type of treatment for the radiesse. During the first 2 weeks to a month, you are going to have a considerable amount of swelling from the inflammation that is undergoing around the radiesse. Your body is fighting and adjusting to the new tissue that has been injected. Doing something this early would be a mistake.

There are several risks with steroids that should be considered before using them. You have the risks of high blood pressure, high blood sugars, muscle and bone loss, poor wound healing, immunosuppression (you could be more susceptible to infections), hip damage, adrenal suppression, hormonal changes, acne, weight gain, mood changes, psychosis, changes in your appearance and more.

These are systemic effects that can happen if you are on a lot of injections over a long period of time, which is unlikely to happen with 1 or 2 injections but these risks need to be considered by anyone getting steroids. Locally at the site of injection, the effects could be thinning of the skin, you can develop vessels and increase vascularity that can change the appearance at the area, fat can be metabolized and cause depressions, your chances of infection and rejection of your radiesse could also be increased.

Dr Young is located in Bellevue near Seattle, Washington

Radiesse good for lip augmentation?

July 5th, 2009

Facial Fillers is generally avoided in the lips due to the bumps and nodules that it can create. Restylane is the best in the lips. Juvederm can also be used in the lips as well. Both of these products have a limited longevity and can last from 6 months to a year.  Fat injections are an option in the lips but take a lot of experience and knowledge of lip anatomy and dynamics to create the best result.

Lip Augmentation, when done well, can last years. But you want to go to a surgeon that has experience doing these in the lips. The length of time fat lasts is tightly related to the technique that is being used. You have to traumatize the fat as little as possible and when you place the fat it has to be layered in small amounts so that the fat can survive and find its own blood supply and environment.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  Dr Young employs the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington

How Long does Radiesse Last?

July 5th, 2009

It slowly goes down with time but can last for longer than a year. In fact biopsies of areas that have hadFacial Fillersinjections have shown that it can last up to 3 years or more.  But the volume that remains later on is no more than 30% of the original volume that was injected. The area that is injected also determines how long it lasts.  In more mobile areas, the effect is less and goes away faster.

Dr Young is located in Bellevue near Seattle, Washington

Neck pain and swollen stitch in the neck area

July 5th, 2009

This is a question that I answered for a patient who had something done from another doctor.

Pains and aches after any procedure including a null is a natural process and sometimes the cost of being beautiful. It is almost impossible to not have these after any procedure. The question is how painful it is and if it is causing you to be in a state where you can’t function well on a daily basis. The stitch might need to be removed if it continues to cause you problems and can be done very easily.

The headaches are due to sutures pulling on your facial muscles and will get better. You might need some different medications to help you with your pain and transition.  Sometimes the pain is due to nerves being caught and is rarely indicated to have a procedure to alleviate this nerve impingment.  Muscle relaxants, anti inflammatories, Nerve relaxants can all help your situation and can be discussed with your doctor.  Don’t worry this will get better. Just be patient.  Your doctor will hold your hand, so to speak, through this whole process.

Dr Young is located in Bellevue near Seattle, Washington