Paul Vitenas, Jr., MD

Thank you very much for your question and photographs. From your pictures, it does appear that you may be a candidate for CoolSculpting. The noninvasive technique uses Cryoplipolysis to ‘freeze’ fat cells, permanently damaging cells in the target area, which are then slowly eliminated by the body. CoolSculpting takes 35 minutes and can offer a 20-25% reduction in fatty tissue. When looking for a CoolSculpting provider, ensure they offer DualSculpting (two CoolSculpting machines) so that both arms can be treated in one session. It is important to keep in mind, however, that while CoolSculpting can eliminate fatty tissue, the procedure does not tighten stretched skin. For this reason, once the fat cells are gone, patients may be left with excess, sagging skin. I recommend scheduling a consultation with a board-certified plastic surgeon, experienced in body contouring procedures. At this time, he/she can discuss all of the options available for improving your upper arms, including CoolSculpting and a brachioplasty or surgical arm lift. 

Thank you for your question and photograph. CoolSculpting is an excellent option for eliminating stubborn bra rolls and arm fat without the need for surgery. Using Cryoplipolysis, CoolSculpting freezes fat cells in the target area. Over the next three months, these damaged fat cells are safely metabolized by the body. You can see a 20-25% reduction in fat after one session, and CoolSculpting can be safely repeated for additional results. From your picture, it appears you may make a good candidate for this procedure. I recommend scheduling an in-person consultation with a board-certified plastic surgeon, experienced in body contouring procedures. At this time, he/she can perform a physical assessment, determining if you are a good candidate for CoolSculpting. If so, a customized treatment plan will be created to achieve your desired results. 

Thank you for your question. At five days post-Botox treatment, you are just beginning to notice your initial results. The benefits from your Botox injections will continue to improve over the next two weeks. Give yourself a full two weeks to see how your Botox results appear. If you are not happy or have concerns at this time, contact your Botox administrator. However, if you have a sagging brow or eyelid, keep in mind the side-effects are temporary. Over the next three months, as the Botox results fade, the over-treated area will return to normal.

Thank you for your question and congratulations on your recent Botox session. After about four hours, the Botox will have sufficiently absorbed into the targeted muscles, meaning that migration is not an issue. Having your deep neck massage four days after your injections should not have any effect on your Botox results. If you have any further concerns or notice anything unusual, contact your Botox provider for his/her advice.  

Thank you for your question. Although it is not necessary to remove all of your makeup before your Botox injections, the site should be cleaned prior administration. However, the chance of this causing any problems or infection is very small. Do not worry, but If you have any problems such as unusual redness or discomfort, contact your provider. You may want to bring this up at your next Botox session, especially if you notice your dermatologist is again not prepping the injection site.

Thank you very much for your question. It sounds like your new Botox provider may have been using a conservative approach during the first appointment. As it takes one to two weeks for the results from your Botox procedure to become apparent, the best advice is to wait the full two weeks before getting a touch-up. This will give your provider a chance to assess the final results and apply the right amount during your touchup to reach your aesthetic goals.  

Thank you for your question. Although the fear of a ‘Spock brow’ is valid, keep in mind that these do not occur with Botox placed in the glabellar lines. A ‘Spock brow’ is the result of Botox placed along the outer portion of the brows, closer to the temples. However, to avoid any complication, it is imperative that you put your trust in a board-certified plastic surgeon and his team. An experienced provider will know the right amount of Botox and the correct placement to eliminate your Frown Lines without any risk. 

Thank you very much for your question and congratulations on your upcoming wedding. The results from Botox take about two weeks to look their best. That is a wonderful time to schedule your Botox injections so you’ll be ready your wedding, plus the results will continue to look good for up to three months. Remember to only see a trusted Botox provider or a board-certified plastic surgeon for the safest and most satisfying results. 

Thank you very much for your question as it is a common one. CoolSculpting is an excellent, noninvasive option for patients looking to eliminating isolated areas of stubborn fat. On average, patients will see between 20-25% of targeted fatty tissue melt away. However, the procedure is not a weight loss tool. The cool temperatures permanently damage fat cells along the treated areas by the body over three to four months. If you are interested in losing 20 pounds, your best option is to start with a weight loss plan, followed by CoolSculpting to smooth and flatten any remaining fatty tissue. To find out if and when you are a candidate for CoolSculpting, make a consultation appointment with a board-certified plastic surgeon with extensive body contouring experience.

Thank you very much for your question and photographs. From your pictures, you appear to have lax tissue and fat along your upper arms. CoolSculpting is an excellent choice for reducing isolated areas of body fat. A unique handpiece, designed for smaller areas of pinchable fat, can create trimmer, smoother upper arms by eliminating up to 25% of fatty tissue. However, CoolSculpting is not for everyone. While the treatment can permanently address stubborn fat, it does not tighten skin. Once the underlying fat cells are gone, the stretched skin may not bounce back, instead sagging on the arm. In this situation, a brachioplasty or arm lift may be required for optimal results. Using an incision from the armpit to the elbow, the fatty tissue is suctioned away using liposuction, and the stretched skin is excised, leaving the arms tighter and smoother. I recommend scheduling a consultation appointment with a board-certified plastic surgeon, experienced in surgical and noninvasive body contouring procedures. He or she will examine your trouble spots and reamed the best technique(s) to achieve your desired results.