Srdjan Ostric, MD

I think the details are important, and that is why a consultation and discussion with someone face to face is always better than the virtual world. Remember, a rhinoplasty is 3-D operation, and no matter how many pictures you take, they will always be 2-D. That being said, improvement is possible, and I think that would be the case with you as well. Of course, you have to be able to articulate the specifics, which is often hard to do outside of a consultation.

It should not last 2 days unless you bump it or something. The devil, so to speak, is in the details, and as a result, you should at least talk to your doctor about this. Are you keeping it moist, clean, and protected? Are you showering now? When is the bleeding occurring? Where was the surgery done? All these are important points.

Sometimes you need to perform excision, which has been a successful method to achieve results in my practice. However, they can come back if they are truly warts. I have also used a shave technique and thermal cautery to achieve good results as well. Once again, you have to be a little more aggressive in my opinion without being too aggressive, so you can achieve the result of wart removal. That being said, warts are sometimes tricky to get rid of.

Generally speaking, if you use deep sutures, and meticulous technique, the sutures can be removed with ease at about 5 days. They may be removed earlier in some cases, but I agree the 2 weeks in the face is simply way too long to keep stitches before they are removed.

If you have any doubt, then get it re-excised. That would be my advice to anyone who is concerned about the development of melanoma, in particular, especially if you have a family history of the disease. Since it has been 30 years, pathological techniques are available to see if all the cells in that area were completely removed. I am a plastic surgeon, and I perform these kinds of procedures, as well. Dermatologists can also perform this procedure.

The average amount of Botox used for the “11” lines between the eyebrows is around 20-25 units for a female, which translates into 5 units or so in 4 injections around the brow. You can also inject the midline with about 5 unit to correct that "bunny line" which occurs with the 11's quite often.

Men can require more units as their facial muscles are often thicker and stronger.

Likewise, if these are deep furroughs they may need to be filled with something like Juvederm, which is not uncommon.

The key point is communication with your doctor, and careful aesthetic judgement.

The manufacturer, Allergan, says it lasts 4 months. It can last up to 6 from what I have seen, and repeated injection can help make it last longer. This is an anecdotal observation. If you exercise a lot, this can shorten the time that Botox works as well, especially if you are into vigorous cardio.

I have heard this complaint before from patients, and it sounds like it may be a natural part of the muscle paralysis that occurs as a result of Botox injection. This may be causing the sensation you are describing. In regards to the rough skin complaint, I can't say for sure what may be causing this. It is always important to have a skilled and competent practitioner administer Botox, and it is important that you make sure it is good Botox from a certified manufacturer. All these points are very critical, and it does require you to do your due diligence, beccause this should be a given, but sadly, it is not always the case.

This is not an uncommon complication after fat transfer to the lower eyes, and can occur regardless of technique used. Laser treatment can be helpful to correct the pigmentation, although it is possible that if you wait, there will be some resorption of the pigment. I use fat quite frequently to help augment the cheeks and fill the naso-jugual folds, and it really is a powerful and effective technique that produces long lasting results, which patients really enjoy. 

Smoking will reduce the ability of newly transplanted fat cells to survive because of smoking's effect of blood vessels, especially small blood vessels that help keep a fat graft alive. The fact is that just about any procedure in plastic surgery will have a high risk of not working or result in a complication if you smoke, so the long and short is: Don't do it!