Buffalo Doctors

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!

Marion Moers-Carpi, MD et al recently presented the results of an experiment comparing 20 units of BOTOX®  to 30 units of XEOMIN® for forehead lines. It was a large, double blind study, with 112 patients in each treatment group.

Multicentre, Randomised, Double-Blind Study to Evaluate the Efficacy of OnabotulinumtoxinA (20 units -- BOTOX®) in the Treatment of Glabellar Lines, When Compared to IncobotulinumtoxinA (30 units XEOMIN®)

Bottom line: This clinical study found that 20 units of onabotulinumtoxinA [BOTOX®] are as effective as 30 units of incobotulinumtoxinA [XEOMIN®] in reducing the severity of glabellar lines 28 days post injection, and demonstrated a trend in favour of onabotulinumtoxinA at days 84, 98 and 112. These results were obtained despite a 50% higher dose of incobotulinumtoxinA than onabotulinumtoxinA.

Kevin C. Smith, MD

Niagara Falls Dermatologic Surgeon

I Cant Decide Between 300-350cc Silicone, Or Which Profile to Get. I Want Natural Looking (photo)

I am 29 years old. I have a 32B currently. My rib is 28". I wanted to get teardrop but my dr only does round. I want them to look natural. I dont want them to be too round up top giving the "fake" look. Because im quite small I was going to go 300-350 but I dont know which profile is better for my size I think my chest size across is 11.2. I have breast fed one child and one breast seems larger and sags a bit more. I was also wondering if I would have to get a different size in one? THX!

At 11.2cm you have a narrow frame. Since you are not going too large either a high prfile or moderate profile implant would be fine.  It depends on whether you want more cleavage or more projection.  I would try on the different sizes and profiles during your next visit to your surgeon to help you decide. You should achieve a very nice result.

Todd B. Koch, MD

Buffalo Plastic Surgeon

Am I a Candidate For Fat Transfer in One Breast Only? I Have Uneven Breasts and Already Had Encapsulated Implants Removed.

I am 42 5'2" & about 130 pounds. I had breast implants 20 yrs ago. They encapsulated and caused me lots of complications. I got them replaced & removed 4 years later. I now have uneven breast - 1 A cup & 1 AA cup & they are different shapes now. My question is -since Im not a candidate for implants, would you recommend fat grafting for me if I only want to inject fat into the smaller breast (AA) so that it can be the same size & shape as the (A) cup? How much fat would I need? thanks!

It sounds like you may be a candidate for fat graft breast augmentation.  You have reasonable desires.  Photos would be helpful.  I would seek a consultation with a Board Certified Plastic Surgeon familiar with this approach.

Todd B. Koch, MD

Buffalo Plastic Surgeon