Ron Shelton, MD

The technology of Sofwave may be helpful to tighten skin on the body, not just the head and neck but for large areas I would wait for engineering to have a larger handpiece that the provider can use which will cover a larger surface area and be more efficient for big areas. It is not practical to work on an entire thigh but I have used it for creases above the elbows, creases above the knees and for crepy skin around the abdomen and upper inner arms.

Sofwave and Ultherapy are the most effective skin tightening non invasive devices of which I am aware of that are on the market. This is their only FDA indication. It is not a laser or device that has multiple uses. Their design involved much research and development to tighten lax, loose or sagging skin. I have had many satisfied patients who have demonstrated very good results after having Sofwave and/or Ultherapy on faces and necks.

Botox can be used off-label to treat nasal movement with smiling such as nostril widening and nasal tip being pulled downward towards the lip with mouth movement. It's best to see an experienced provider for this treatment who will discuss the risks. Start with low dose. It's best to return for more units if needed than putting in too many. Botox may drift or may be placed in unwanted muscle areas affecting mouth opening, smiling, eating, speech, asymmetric or unbalanced smiles, create difficulty brushing ones teeth, etc.

Many masks are not going to apply worrisome pressure to Botox insertion sites but it is best to avoid a strong strap that tends to be on N-95 masks and maybe some others, if the strap is putting so much pressure on the exact area of the Botox insertion, especially if it overlies a bony prominence. Those tight straps sometimes cause a temporary indentation of the skin for an hour or more after wearing the mask and that should be avoided.

Treating a gummy smile relaxes the muscle pull of the upper lip which lessens the exposed gum in those individuals who manifest this when smiling. I receive great results with this treatment. Your teeth however, are exposed at rest and Botox may not relax the muscles of the upper lip enough to reduce the opening of your mouth. I'm not certain why this occurred after your headgear treatment for your overbite. You may need to see a plastic surgeon or oral maxillofacial surgeon for an opinion.

Short term acne flares can occur after laser resurfacing and having done many Fraxel laser treatments in the last 20 years I have had patients who I have seen with short term acne breakouts but no one with long term acne in the treated areas. Fraxel laser resurfacing has been a significant  part of my practice along with other treatments for acne scarring such as punch grafts and microneedling.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

I prefer to do ultherapy first then follow it by the series of fillers or Sculptra.  Although sculptra is placed in the subcutaneous tissues it is possible that Ultherapy may reach that plane in certain areas of the face, especially with the 4.5 mm. transducer, and I question if the Ultherapy does heat up the sculptra particles if that might cause an undesired reaction. So if I were to do Ultherapy after Sculptra I would choose transducers that were expected not to reach the depth of the Sculptra placement.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

As Ultherapy can tighten and lift the skin it may help lift the skin and fat together raising it over the jawline from where it had sagged from the lower cheek. Despite some claims on the internet, the Ultherapy company doesn't claim that it can reduce fat. When I intend to reduce fat on a facial or neck area, I typically use either ThermiTight or Liposuction or both. Kybella is used on the submental neck below the chin. ThermiTight heats the fat cells to the point that is expected to cause the death of the cell which is much higher than the temperature that Ultherapy can cause.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

Ultherapy has been considered "color blind" and in fact performed safely on many patients. However, I will often not use the more shallow, 1.5mm. transducer, on patients who may be prone to post inflammatory hyperpigmentation or melasma skin darkening, as this superficial energy compared to the deeper 3 and 4.5mm. transducers, tends to leave temporary swellings or welts for a few  hours or days. I am concerned that although most patients won't develop any skin darkening with such reactions, there will be some who may if the 1.5 mm. transducer is used.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. 

Smile folds and the valleys between the cheeks and the nose are not made less apparent by pulling on the skin and in fact, facelifts don't usually make smile folds look less noticable. Pulling on the skin can make the jowls over the jawline improve. Ultherapy is avoided in the smile folds and directly over the marionette line with the 4.5 and 3 mm. transducers. I have used the 1.5mm. transducer with Ultherapy to improve dermal collagen in those areas.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.