Aaron Capuano, MD, FACS

Hello and thank you for the question. It appears that your wounds are still pink and your upper lip is still swollen and in an early stage of remodeling which if I was to guess puts you somewhere between 6 weeks and 3 months post op.  As your wounds are remodeling and the edema is leaving your upper lip you will see changes that may continue for six months or more.  At that time if you still are having an issue with the amount of upper tooth show, botulinum toxin can be injected into your upper lip elevators to improve the appearance of upper tooth show.  Once the edema resolves, selective injection of hyaluronic acid filler can also slightly lengthen your vermillion and improve the amount of tooth show present.  In the meantime, I would speak with your surgeon about post operative scar regimens like silicone, sunscreen and gentle massage.  Good luck, I hope this helps.  

Hello and thank you for the question.  Having 10 injections of hyaluronidase is more than I have typically seen done in practice.  Maybe your injector was using tiny aliquots of HA to avoid overcorrecting.  On the other hand, it may have been used to correct severe overfilling or persistent nodules, in which case, you may still have inflammation or fibrosis present from the soft tissue trauma or displacement which can affect your subsequent fill results.  I usually recommend patients wait at least 6 weeks after treatment of nodules to re-inject with more filler.  This allows the tissue to soften and heal.  If hyaluronidase is used to simply treat an area where filler migrated or was poorly placed, patients can have filler reinjected after two weeks.  Hyaluronidase has a half-life of about 2 days following intra-dermal or sub-dermal injection.  Hope this helps.

Microneedling with radio frequency is a good non-surgical method for tightening skin with minimal downtime. Results are usually seen after three months.  Tightening occurs as your tissue remodels after it is selectively damaged by the Microneedling with RF.  The amount of tightening you will get is relative to the amount of elasticity you have where the treatment is to be performed.  As you lose weight, the amount of skin laxity you have may increase, and this may improve slightly once your weight is stabilized.  Having a Microneedling procedure as you are losing weight will centainly not hurt you, But you might be disappointed that the result you see are not quite as robust as you expect.   The procedure can however be repeated to improve the outcome.  It is important that your expectations for Microneedling with RF are in line with what the procedures can provide to you.  Large amount and of skin laxity are not going to be corrected with this type of procedure.  Typically, relative to surgery, Microneedling with RF should give you about 20 to 25 percent of the tightening that you could expect from the surgical thigh lift.  For people with minimal laxity, this can be a great solution.  The best first step towards successful rejuvenation of your inner thighs are to have an in person evaluation by a board certified plastic surgeon.  Hope This helps.

Hello and thank you for the question.There are many non-surgical ways to address concerns with drooping of the skin of the upper eyelids and eyebrows.   One way to elevate your eyebrows and the skin of your upper eyelids is to inject the superior and superior lateral aspect of your orbicularis oculi muscle with botulinum toxin. When injected in the proper plane, this can raise your brows, improve symmetry, and make your periorbital region look more open and well rested. Another method for elevating the forehead including the Eyebrows  and upper eyelid skin is with the use of a hyaluronic acid filler, placed under the superior lateral brows,  A third type of treatment includes use of one of many methods of delivering heat into the skin to cause collagen denaturation and temporary skin tightening.  The energy can be applied to the forehead and upper eyelids to raise the brows.  I prefer methods that deliver energy directly to the skin like Microneedling with radiofrequency or erbium lasers.  Results from each method are subtle, but can provide a result that most younger patients are happy with when used in the right combination. And yes, an upper eyelid surgery is an option.  Please be sure to make an appointment with a board certified plastic surgeon for an in person evaluation.  Good luck. 

Hello and thank you for the question. Your blister may be the result of filler or it may be from another cause.  Knowing more about the symptoms associated with the blister and the onset and duration relative to your last injection may help shed some light on a diagnosis.  There is no contraindication to using hyaluronidase on your lips to dissolve the excess filler.  I would proceed very slowly and carefully though, because removing a large volume of filler in your lips may leave them looking hollow and wrinkled, because they are used to accommodating the larger volume.  An in person evaluation by a board certified plastic surgeon I’d a good place to start.  I hope this helps. Good luck.