Red Bank Plastic Surgeons

Does Botox Interfere with Juvederm Dissolving?

I had Botox injections to my crows feet, bunny lines and "11's" and in the same appointment had Juvederm Ultra to fill in tear troughs. Too much filler was injected and also injected in the wrong plane and I now have bags under both eyes. My doctor wants to use vitrase to dissolve filler, however I've been reading some cases where Botox may interfere with lymphatic drainage due to the lack of muscle contraction, resulting in a worse situation. What is your advice?

Botox and Juvederm can be used together without concern. In fact, in some cases it is preferable to use Botox to relax the muscle to prolong the volume effect from Juvederm. If Vitrase, an enzyme to dissolve Juvederm or Retylane for that matter, is needed to get rid of unwanted filler, its use will not affect the Botox effect. 

Asaad H. Samra, MD

Red Bank Plastic Surgeon

What is the Safest Resurfacing Technique For Uneven Skin Tone? (photo)

I've been considering skin resurfacing, but there are too many choices. What is the best method? Laser? Chemical peel? Facial? I have relatively good skin, except for a couple of indented scars and uneven tone. I'm nervous about any treatment. I don't want to damage my skin to fix a few irregularities. (Same question, but I've added photos!)

A combination of treatment methods is going to yield the best results.  As you can see from some of the answers, the basic starting point is a medically supervised skin care program to optimize the condition of the skin.  No matter what additional steps you take, that is the most cost effective starting point.  Where you go from there depends on your tolerance for down time, etc...Realize that no scar can be completely removed this will save you much disappointment down the road.  The broad area of indentation may require injectable filler to achieve better elevation.  In some cases good old low tech surgical excision yields a significantly improved appearance.  Beware some selling you on the latest greatest machine to fix all your problems...with no downtime to boot!

Robert Herbstman, MD

Red Bank Plastic Surgeon

Mini Tummy Tuck Straight After C-section?

I've had slack skin since giving birth ten years ago, I'm due to give birth again in January. I haven't gained any extra weight, but I'm thinking of asking my doctor for a mini tummy tuck straight after having a C section. My slack skin has depressed me for years. What do you think? I live in Scotland, and was told another local lady had this done after giving birth.

As you can see by the responses it is NOT advisable to combine any type of tummy tuck at the time of the C Section. Just because someone in the community may have rolled the dice and gotten away with it doesn't mean the odds for uneventful healing are good.  Play it safe and recover from the pregnancy/delivery then concentrate on the rebuilding process.

Robert Herbstman, MD

Red Bank Plastic Surgeon