Every visit is more and more pleasant. With amazing results. Dr. Mandal is a facial artist. Great location. Lovely office. Friendly staff. She takes the time to explain different options for you. Love!
Ellacor left me terribly scarred, as in Crater Like Scars, and with Coring Scars, from the Coring Device, as well as with severe Post Inflammatory Pigmentation/Melasma, and Broken Capillaries I will now.have to spend Considerable money, in the hopes I can at least lessen these effects. It also did not produce any noticable Anti-Aging effects, such as tightening, etc. For me, this was personally one of the worst decisions I have ever made, cosmetically, and financially. Updated on 16 May 2024: Time will tell, after I have completed my Scar Revision treatments, but I should have mentioned Ellacor also resulted in extreme Textural Changes in my skin, as well as Hypopigmentation in some areas, and the "Core Marks", are actually Track Marks.
I am 49 and just had my first Artefill cosult today but I've been researching/watching Artefill since 2004. A brief history: The original product, Arteplast, had a high rate of granuloma formation due to irregularies in size, smoothness and electrical charge. The product was refined and became Artecoll in 1994 (perfectly smooth round poylmerized microspheres resist holding electrical charges) and has been used in Europe and Canada since 1997. Artefill is the US version approved in 2006. Please refer to JAMA Facial Plastic Surgery for details. Two important points I've learned for all to consider: 1) the product is like any other, there WILL be a wide range of reactions, an 2) this product is EXTREMELY TECHNIQUE SENSITVE, which means it is ALL about who is doing the injecting. The product isn't a filler, it's an actual implant, and it is ideally placed between the subdermal and subcutaneous tissues - for us consumers this means this is not for superficial lines/wrinkles or areas you move with regularity (like the neck). What is troubling is that many people don't seem to be given that whole range of possible complications AS WE EXPECT WE SHOULD, so this is where we have to do our own research, unfortunately. It's very confusing, especially when we feel the pull of wanting to look and feel better NOW. I am still researching it - I'm not satisfied about the immune response facts (or lack thereof) and though it appears there is a small % of inital adverse reactions reported (and my heart just breaks for every one I've read) there also appears a trend of adverse reactions reported years after the procedure-the data is sketchy. It isn't a brand new-baby product, but only being around since 1994 still makes this a toddler in the world of medicine in my humble opinion. Thank you all for sharing your own experiences here. Updated on 25 Aug 2014: After additional research and consultation, I've come to the conclusion that I am NOT ready to make a commitment to Artefill for the following two reasons: 1. Immune Response Unclear/Unknown: They can't (legally) say Artefill is permanent, but it APPEARS to be permanent by all accounts from Europe/Canada since 1997, so that IS important to consider: the immune response (to the PMMAs that remain in the skin and are designed to stimulate one's own collagen) is simply unknown - NO PHYSICIAN CAN ANSWER THIS QUESTION DEFINITIVELY AS OF TODAY, SO IF ONE MAKES THE CHOICE TO DO IT, ONE HAS TO OWN THE ENTIRE DECISION BY ACCEPTING THE UNKNOWN RISKS - THERE'S NO BLAMING ANYONE ELSE. I personally can’t make peace with that risk. 2. Unclear How to Correct an Adverse Reaction: The incidence of adverse reaction appears to be low but a consumer/patient has to know it IS POTENTIAL. Accepting the knowledge of that potential risk (no matter how slight), leads to the next logical question: what does one do if they experience an adverse reaction immediately/in the future? It is not clear what the options are (i.e., protocols to follow to correct) if one finds themselves one of the few unlucky people who do suffer an adverse reaction to Artefill. This is again, is something I find hard to make peace with. I hope Artefill only gets better with more use/study. I’m going to sit this this one out for now and wait for more research to be compiled. But if/when I choose to have Artefill, I would request the services of the physician I consulted with. I thank all of you who have respectfully shared your own experiences with honesty and integrity. Thank you!
You can try to massage the area to see if it will soften somewhat. However, the bump appears prominent enough to warrant the need for Hyaluronidase which can dissolve hyaluronic acid fillers. Hyaluronidase is injected into the area of previously placed filler and tends to work better on the Restylane family of HA fillers compared to Juvederm products. Hyaluronidase is designed to treat HA-based fillers and not other fillers such a Radiesse, Sculptra or Bellafill, so you want to verify that you did, in fact, receive an HA filler this time. Evaluation and treatment by a skilled and experienced expert is the first step in assuring the most optimal results.
There is no specific upper limit to the the total number of facelifts one can have. At least half of the patients I perform facelifts on have had some type of facelift in the past and are having a second one due to the aging that occurs with time or an unsatisfactory result from the first facelift. I have also performed tertiary facelifts on some patients. As you get into your 60’s, 70’s and 80’s, the skin loses elasticity, thus increasing your chances of a facelift not lasting as long as expected and/or a “pulled” or “wind blown” look. Also, with age, the face loses volume from bone and fat loss which can result in sagging. In such cases, a facelift won’t solve the problem. Rather, one needs facial volumization treatments with injectable fillers. The best way to determine the most suitable combination of procedures you are an optimal candidate for is through a detailed consultation with a Board Certified Facial Plastic Surgeon who is skilled in both surgical as well as non-surgical facial rejuvenation treatments.
Based on your photos, you may have submental fat under your chin. If this is the case, Kybella can permanently destroy fat simply with an injection. I commonly use Kybella in combination with Infini RF which lifts and tightens sagging in the neck and jowls in patients with mild to moderate aging such as yours. It is difficult to properly assess your facial asymmetry as more photos are needed but if you have more hollowing on one side compared to the other, as a result of your buccal fat procedure, a long-term injectable filler such as Bellafill may be able to correct the asymmetry. Bellafill is highly safe and can last 5 years or longer as shown by the FDA study which followed over 1000 patients for 5 years. I would not necessarily recommend a facelift at this early stage.
I perform Infini RF to non-surgically lift and tighten sagging jowl and neck skin in several types of patients. Patients who have never had a facelift can benefit from RF treatments prior to surgery since the skin elasticity is improved and can result in a better facelift result. Those patients who have already had a facelift can maintain their facelift result longer by having annual Infini RF maintenance treatments following surgery. I have not come across any scarring issues with RF when it is performed correctly. In fact, the Infini RF has successfully been used to improve acne scars as well as post-surgical scars.
Your photos show two distinct anatomical areas that can be corrected. The red arrows pointing to the lower “lines” are malar creases which can worsen with age. Treatment can be successful with injectable fillers. However, it is important to rule out other causes first such as environmental allergies and lymphatic blockage. If the malar creases change over the course of the day and get better or worse during certain times, then placement of filler may cause the swelling to be more pronounced. However, if your malar creases do not get worse or better, then injectable fillers may be a good option. You also have hollowing immediately under your lower eyelids which bring more attention to your malar creases and can also be corrected with an injectable filler such as Restylane.
