Dermatologic Surgeon, Board Certified in Dermatology
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I provide aesthetic dermatology care for patients in the Upper East Side of New York City. My primary goal is giving personalized attention with the highest quality of professional care using the latest proven therapeutic advances, techniques, and methods.
Asked By: anetinkak
ANSWER
The short answer is that a robust HA Contouring Filler injected properly from the region of angle of jaw along the jawline can help to straighten and define the jawline and diminish jowls along the jawline.Traatment takes about ten minutes to perform, provides immediate results, and typically engenders little to no significant post-treatment downtime. I have personally had very gratifying results with my patients using this technique for precisely the kind of jawline laxity seen in the photos provided. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injection expert and best of luck.
Asked By: Johnshoe118
ANSWER
I stopped using Sculptra several years ago after adopting it quite early on when it first got its approval. It's main benefit then was that its results lasted about two years (as opposed to HA fillers of the time lasting only about four to six months). Its downsides were that it was expensive, and required multiple treatment sessions to achieve results. However, when robust HA fillers that lasted up to two years were finally approved, and that could give results after one treatment session, I could no longer see the value of using Sculptra. As to most of the current "bells and whistles" light and energy-based devices. the fact is that the hard science to back of the use of these expensive, often "here-today-gone-tomorrow" gizmos lags well behind the heavy marketing hype and social media buzz to promote them. So, "buyer beware" when it comes to these is worthwhile advice. What have stood the test of decades of time for safety and efficacy are Botox (and its relative neuromodulators), superficial peels using high concentrations of glycolic acid, salicylic acid or low concentrations of TCA; manual, mechanical microneedling (again, here no need for the expense or risks of RF microneedling). Hope this helps to clarify things
Asked By: Bonnie678
ANSWER
The upper cheeks are a major support for the under-eyes, so when there is volume deficit, as seems to be the case her from the photos, the use of a robust HA volumizing filler, properly injected in the appropriate locations, can result in a significant improvement of infraorbital hollows and tear troughs. As an aside, I was not surprised by the lack of success of the PRF. The fact is that the hard science to back of the use of PRF and PRP, for that matter, lags well behind the social media buzz and marketing hype to promote these treatments. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injection expert and best of luck.
Asked By: WabbitJr
ANSWER
I have been performing subcisions for over thirty years for elevating and smoothing Indented scars of all types with gratifying results. It is best reserved for deeper and wider scars, such as boxcar and rolling scars following severe acne or for chickenpox scars. That being said, there are some very important points that must be made in order to establish realistic expectations for treatment outcomes. First, and very importantly, there is no treatment (or combination of treatments, including subcision) currently available that can realistically offer more than a 60-80 percent overall improvement in the appearance of any scar older than three months (I.e for a so-called "mature" scar). I have learned from experience that no matter how much I emphasize this fact to people before initiating treatment, their mindset hears 100percent improvement. Secondly, to realize the 60-80 percent overall improvement can take anywhere from two to six treatment sessions (on average three to four). Thirdly, the success of subcision depends primarily on creating a temporary blood pocket under the skin (blood contains wound healing and growth factors that stimulate new collagen synthesis, and it is this new collagen synthesis--not the breaking of the tethers--that is responsible for the improvement). Fourth, an HA filler can be injected at the time of the subcision--not to act as a filler--but because the filler is able to stretch fiber making cells (fibroblasts) under the skin that are on the periphery of the scar, and this stretching helps them to produce more collagen in response to the blood components. (So, the filler is not acting as a filler, but as a collagen production stimulator). So, assuming the subcision was performed properly and appropriately aggressively by an experienced, board certified cosmetic dermatologist scar treatment specialist, possible explanations for the lack of success may be that further treatment sessions were required to achieve your sixty to eighty percent improvement, and/or no filler was used to further enhance the results. I hope this helps you to better understand and evaluate your subcision results, especially since it has proven an effective treatment over the decades with an impressive safety and efficacy record. Hope this helps and best of luck going forward.
Asked By: requiredgenericusername
ANSWER
As my subject line states, HA fillers can work well for softening smile lines and droopy angles of the mouth and have a several decades' long safety and efficacy for doing so. An additional profile view photo would have been very helpful to assess your problem. Generally speaking, however, treating volume loss with an appropriately robust HA filler in the upper and/or mid-cheek area in many cases can provide the necessary lift and cheek contouring that diminishes the smile folds below. Similarly, treating volume deficit in the area of the angle of the jawline can help to straighten and define the jawline and diminish jowls along the jawline. However, if there is little in the way of volume loss in the above areas, then a low viscosity, malleable, cohesive HA Filler can be directly injected (by an expert injector) more superficially into the smile lines and angles of the mouth to address these problems. In experienced hands, treatment should take no more than twenty minutes and typically engenders little to no significant downtime. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist filler injector expert and best of luck.
Asked By: Dchiaramonte
ANSWER
I'm sorry this has happened. You would be wise to consult with an experienced, board certified cosmetic dermatologist to discuss the manual, mechanical microneedling (no need for the added expense and risks for RF microneedling) accompanied by the application of Rx pigment promoting agents, such as topical tyrosine or latanoprost, to help promote repigmentation. Hope this helps and best of luck.
Asked By: b4sil250
ANSWER
I have been performing subcisions for over thirty years with gratifying results for elevating all kinds of indented scars, whether post-surgical (as in this case), acne, and chickenpox. However, there are some very important pieces of information that are critical for achieving satisfaction with this technique. For one thing, for treating any scar from any cause (with any method or combination of techniques) that is over three months of age (I.e. a "mature" scar), one can only realistically expect a 60-80 percent overall improvement in appearance. What's more, for the vast majority of scars, in order to achieve this, it may take anywhere from two to six treatment sessions (on average three or four sessions). So, you may wish to reconsider continuing with subcision treatments. All this of course assumes that the two prior treatments were performed by an experienced scar treatment physician with extensive experience in performing subcisions. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist and best of luck. Surgical excision runs the risk for the development of stretch scars and stitch tracks.
Asked By: rgp620
ANSWER
From the photos provided, there appears to considerable volume loss in the cheek regions. Since the cheeks provide support for the under-eyes and lift for the midface below, it is likely that the use of a robust HA volumizing filler, properly injected in the hands of an experienced, board certified cosmetic dermatologist filler expert would not only address the hollows under the eyes, but provide a more youthful contour to the cheeks and diminish the smile folds below. Before jumping to expensive, aggressive surgery or even to minimally invasive fat injections, you would be wise to consult with an expert filler injector who would be able to manually manipulate your cheeks to simulate filler treatment to give you a better, real-world idea of the potential outcomes of this nonsurigical approach. Treatment typically should take no more than ten to fifteen minutes to perform and usually engenders little to no significant post-treatment downtime. Hope this helps and best of luck.
Asked By: t8055
ANSWER
I'm sorry this has happened to you. If the scar is elevated, it can be flattened with intralesional injections of an anti-inflammatory agent, such as triamcinolone. Once flattened, manual, mechanical microneedling (no need for the added expense and risks of RF microneedling) can be used to better blend, in both color and texture, the surface of the (now flattened ) scar with the surrounding normal skin. If hyperpigmented, prescription skin bleaching agents can be applied to accompany the Microneedling; if there is hypopigmentation, prescription pigment enhancing topicals, such as topical tyrosine and latanoprost, can be applied to promote repigmentation. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment expert and best of luck.
Asked By: Cute858844
ANSWER
I have personally been treating papular acne scars with low intensity electrocautery for over thirty years with gratifying results--something that cannot be said for so many of the here-today-gone-tomorrow, expensive "bells and whistles" laser and energy-based treatments being so heavily hawked out there in social media. The treatment is quick and simple, performed under local anesthesia, and engenders little to no significant post-treatment downtime. You would be wise to consult with an experienced, board certified cosmetic dermatologist scar treatment specialist and best of luck.
dr. nelson lee novic is highly praised for his expertise in nonsurgical cosmetic procedures, particularly in , , and . patients commend his skill in delivering natural-looking results with minimal downtime. his professionalism, thorough explanations, and personalized care are frequently highlighted. dr. novic's exceptional bedside manner and genuine concern for patient outcomes are consistently noted.
