Manchester Doctors

Will I Grow into my Nose? Nose is Bigger then All my Features (photo)

My family has pretty big noses, but the difference is for them, it works with there facial features. I'm 17 and my nose isn't bumpy, it's straight. The problem is it's very WIDE at the bottom and I don't think it goes with my features. My lips are small, my eyes are small, and im not a large kid. I don't understand why my nose is so unproportional. I want to be a actor someday and I don't think ill get to if my nose looks so bad. I feel if my nose was smaller i'd look good. Help? :(

I am afraid that I don't see everything that you see.   I see a nose that is balanced with your face, and small on profile.  The width could be a little less from the front, though it is perfectly acceptable and attractive as it is.

The problem that most men have is that their skin is not  very elastic, so that changes made to the skeleton may not be followed by desirable changes in the surface--you may just lose shape. 

If you decide to go ahead, be extremely careful as you select your surgeon, and ask to see photos of noses like yours with results that you like.  Not every surgeon will be able to give you what you hope for.

Good luck!

Mark B. Constantian, MD

Nashua Plastic Surgeon

How Will a Dental Appointment Before Juvederm Injection Affect the Bruising?

I am getting my first juvederm injection in my nasolabial folds in a week. I am extremely worried about the bruising, actually more than the results themselves! I have a dentist appointment a couple of days before to get some fillings; will that affect the bruising process when I get my juvederm, giving the fact that I will be put under anesthetics when I get my fillings? And what can I do to make sure the bruising is kept to a minimum?

You should be fine to have dental fillings done a week before you get Juverm.  Just be sure to avoid products such as ibuprofin (Motrin) and naproxyn (Aleve), which might increase your chances of bruising.  Use acetaminophen (Tylenol) if you need a pain reliever.  Also, be sure to use cold compresses intermittently throughout the rest of the day you get your Juvederm.

I actually tell my patients to avoid dental work for several weeks after they have fillers anywhere around the mouth.  I worry that excessive retraction on the cheeks may affect the placement or longevity of the filler.  This may sound overly cautious to some, but why take the risk in your investment?

James Bartels, MD

Manchester Facial Plastic Surgeon

I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

I have always love botox but my doctor stopped offering it and said xeomin would work better. I've waited three weeks with still no results, just some twitching near my right brow. Could I be resistant? I had the same amount/units as normal, if I switch back to botox will it still work. I have heard that it isn't recommended to go back and forth. I also take olive leaf extract and read that sometimes it is a natural antitoxin( use it for acne) Thanks!

Xeomin is the newest neuromodulator available in the U.S. and thus far, only experienced injectors are being given access to it for patient use.  Therefore, each physician who answers here has excellent credibility.  I have been using it in patients who have previously had Botox, as well as some who have never been treated, and I am diluting it exactly the same as Botox.  My results thus far have been equivalent between the two products for cosmetic purposes.  I am able to offer Xeomin at a slightly lower cost to the patient, which is attractive to many.

I have one long term patient who gets injections for essential blepharospasm (uncontrolled eyelid twitching), and when she switched to Xeomin she did not get nearly as good a result as with Botox.  Her spasms went away only for three weeks instead of the three months she gets with Botox.  In her case, we have gone back to Botox.

Provided that everything else is the same (injector, dilution, location of injections), I think that you are similar to my one patient in that, for unexplained reasons, Botox works better for you than Xeomin.  There should be no problem with going back to Botox and you should get the same good result you did before.

James Bartels, MD

Manchester Facial Plastic Surgeon