Omaha Doctors

Normal To Have Severe Pain Post CoolSculpt? How Long Will It Last?

I had Cool Sculpt of abdomen, 5 months post lipo, as well as flanks. My flanks was mildly sore. I am two weeks post Cool Sculpt and am wearing Lidoderm patches for severe nerve pain in the ab area. Seems to be radiating out from near the belly button. I have tried Steroid Shot, 3 days neurotin 300mg 3x day, Toradol - on day 3/5. I have a rx to pick up in the am for Dose Pack steroids. Any idea how long to resolve? My dr has not seen this in other patients. Will this resolve?

Most people experience some mild discomfort after CoolSculpting to the abdomen, it may last several weeks, but it is always temporary and will eventually resolve.  I have found topical anesthetic cream spread over the area of discomfort several times a day to help control the pain. 

CoolSculpting is still considered a new and novel method to non-surgically reduce fat deposits and tighten the skin.  Therefore, we don't know how each person will react to the freezing.  I have had several people complain of rather severe pain that you have described, always in the abdomen and in fairly thin patients with loose skin.  What I believe is happening is that some abdominal muscles are pulled into the applicator head and bruised or "beat up" during the treatment.  The pain is similar to a muscle strain or sprain and it takes several weeks for the muscle to heal itself.  It is self limiting and in the long term, the muscles are fine. 

I have experienced this discomfort after my second treatment on my abdomen and it did resovle.  By the way, my tummy looks great now, so it was well worth it!!!!

David Finkle, MD

Omaha Plastic Surgeon

Would Restylane Work For Blackness in Tear Trough Area? (photo)

I have what seems like thin skin in the tear trough area on the inner most part of the lower lid, which extends a few cm's down the tear trough area. There is also no flesh under the skin there. Would having restylane injections in this area help with the blackness by giving some volume or would it just lift the whole area and remain transparent with the muscle colour reflecting through the skin? Help I constantly look worn out....

Having performed thousands of injections in this area over 9 years of using Restylane, my experience is that most of the time Restylane is more useful UNDER the area you want treated than IN the area you want treated.  Additionally, there are many more problems with treating that area than you might imagine.

Generally speaking, I love the results that Restylane can produce for under the eyes, but if you have little or no 'substance' under the eyes, you are flirting with disaster.  That means that the Restylane might look odd (bluish) or it might be lumpy. 

Also, the MOST important point is that not many injectors have the skill to pull this one off right.  It is exceedingly hard to do it the right way and very easy to mess up, so if you do decide to try it, you better go to someone who is A++++ in their skillset or your next visit will be to have hyaluronidase to reverse it.  Good luck!

Joel Schlessinger, MD

Omaha Dermatologist

Why Are Restylane Injections (Undereye Hollows) So Expensive?

It's usually recommended that 2 syringes are used per eye; $1000 per syringe. Why is restylane so expensive? Is appears cheaper and more convienent to get an under eye implant atleast the results will be permanent where as with restylane you'll have to come back approximately every 6 months to 1 year for injections. Someone please help, I need undereye hollows filled but I can't afford $3000-4000 for restylane injections.

While we charge more on the line of $450 to $550 a syringe, I rarely use two syringes per eye area.  Generally, one will suffice and overdoing it will only lead to issues if you aren't satisfied.

My recommendation is to go slowly initially and see how you like it.  You can always do more in the future.  Now, if four syringes were tackling the face areas that might be understandable, but to just do the under eye hollows, that could even be too much unless you need quite a bit of correction. 

As for the implants, they have a pretty awful track record.  They don't stay in place very often and when your facial structure ages they can look odd as they have no ability to be redone as with fillers like Restylane, Juvederm or Perlane.  That makes them a challenge if you change over time (which everyone does!). 

Good luck!

Joel Schlessinger, MD

Omaha Dermatologist