Anna Chacon, MD, FAAD

Both oral and topical minoxidil have their own advantages and considerations, and the choice between them often depends on individual preferences, tolerability, and specific medical conditions. Topical Minoxidil is commonly used for treating hair loss and is applied directly to the scalp. It is widely available and tends to have fewer systemic side effects since it is not absorbed into the bloodstream as significantly as oral formulations. Common side effects are usually localized, such as scalp irritation or itching. Oral Minoxidil is sometimes used off-label for hair loss and may be considered when patients do not respond to topical treatment. However, oral minoxidil can have more systemic side effects, including potential cardiovascular effects such as changes in blood pressure or edema. The study you referenced suggests that oral minoxidil at 5mg may not be superior to topical applications in terms of efficacy. Given your preference for topical treatments and the concern about systemic side effects, it may be reasonable to start with topical minoxidil. This approach allows you to assess your response to treatment with a potentially lower risk of systemic side effects. Always consider monitoring for any side effects and evaluating treatment efficacy over time.

AirSculpt and CoolSculpting are not the same procedure; they are distinct body contouring treatments with different techniques and mechanisms. AirSculpt is a minimally invasive liposuction procedure that uses a patented technology to remove fat through a small incision. It involves a device that gently plucks fat cells out of the body, aiming to provide precise fat removal with minimal downtime and scarring. CoolSculpting, on the other hand, is a non-invasive procedure that utilizes cryolipolysis, a process that freezes and destroys fat cells. The body then naturally eliminates these dead fat cells over time. CoolSculpting involves no incisions and is often used for individuals looking for a non-surgical option for fat reduction. Both procedures are designed to reduce unwanted fat, but they differ significantly in terms of invasiveness, technique, and recovery time. It is essential to consider your goals, preferences, and medical history when choosing between these treatments.

Juvederm is a hyaluronic acid-based dermal filler primarily used to add volume and smooth out static wrinkles, such as nasolabial folds and marionette lines. It is not typically used for dynamic wrinkles, which are caused by muscle movement and are best treated with neuromodulators like Dysport or Botox. For dynamic wrinkles, especially in areas like the "11's" (glabellar lines), forehead, and crow's feet, Dysport or Botox are more appropriate as they temporarily relax the muscles responsible for these wrinkles, reducing their appearance. Using Juvederm for dynamic wrinkles might not provide the desired effect and could potentially lead to overfilling or an unnatural look. It is essential to use the appropriate treatment for the specific type of wrinkles you wish to address. If you have concerns or questions about the recommended treatment, discussing them with a qualified professional who can tailor the approach to your needs would be beneficial.

Deciding between tear trough filler and lower blepharoplasty involves considering both the extent of your concerns and your comfort with potential risks and outcomes. Here are some factors to consider for each option: Tear Trough Filler: Benefits: Non-surgical, minimal downtime, and immediate results. Filler can effectively address minor volume loss and provide a subtle improvement. Risks: Although generally safe, fillers can cause temporary side effects such as swelling, bruising, or, in rare cases, vascular complications. Longevity: Results are temporary, typically lasting 6-18 months, depending on the type of filler used. Lower Blepharoplasty: Benefits: Offers a more permanent solution for both volume loss and fat pad protrusion. Surgery can provide a more dramatic and long-lasting improvement. Risks: As with any surgery, there are risks, including lid retraction, scarring, and infection. Recovery time is longer compared to fillers. Suitability: Given your concerns about minor volume loss and tight under-eye skin, it's crucial to weigh the potential benefits against the risks. The second opinion suggesting you are a good candidate indicates that surgical intervention could address both volume loss and fat pad issues effectively. Considering your situation, if your primary concern is minor volume loss and you're wary of surgical risks, starting with fillers might be a prudent approach. They allow you to evaluate the aesthetic improvements without committing to surgery. However, if you desire a more comprehensive and lasting solution and are comfortable with the surgical risks, a lower blepharoplasty could be appropriate. Ultimately, the decision should be based on your personal comfort with the risks, desired outcomes, and discussions with trusted medical professionals who have evaluated your specific case.

It sounds like you're dealing with an uneven result from your recent Smartlipo procedure, which can be understandably frustrating. Based on your description, it appears that your concerns about remaining volume in the untreated upper flank area are valid, especially if there is a noticeable difference between the treated and untreated sections. Here are a few considerations and potential next steps: Assessment of Remaining Volume: It’s important to have a comprehensive evaluation of the untreated area. A second opinion from another experienced cosmetic surgeon or dermatologist can provide insight into whether additional treatment is necessary to achieve a more balanced appearance. Treatment Options: If there is indeed significant volume left in the untreated area, options may include another session of Smartlipo or alternative liposuction techniques to address the discrepancy. Non-invasive body contouring treatments could also be considered, depending on the specific circumstances. Skin Laxity Considerations: Your original doctor’s comment about it being "just skin" might point to an issue with skin laxity rather than fat volume alone. If skin laxity is a concern, skin tightening procedures might be recommended to improve the overall contour. Documentation and Communication: Ensure that you have clear documentation of what was agreed upon initially and any deviations from that plan. This can be helpful in discussions with both your current and any new doctors. Consultation Preparation: When you go for your second opinion, bring all relevant information, including photos and any previous consultation notes. This will help the new physician understand your case thoroughly and provide a well-informed recommendation. Seeking a second opinion is a prudent step, as it can offer a fresh perspective and reinforce your understanding of the best course of action moving forward.