Betty Troutman, DO

Halo can definitely cause hyperpigmentation to the chest.  The chest is not as forgiving as the face when it comes to healing.  In addition, it takes longer for the chest to heal from a Halo procedure than does the face.  Having said this, it is important that your medical history and skin assessment be done by a skilled professional/provider who has worked with the Halo procedure.  In general, the Halo is safe and effective when in skilled hands.

I love both of these products.  However, it really depends on how much volume needs to be replaced.  I look at Sculptra as replacing the baseline.  I then use Voluma and other filler products for enhancement.  My recommendation would be to seek advice from someone who is not only an expert in the field of aesthetics but also carries multiple products.  This can give the assurance that there is less bias in their recommendations.  

Best of luck on your decision.

Dr. Troutman 

Thank you for the opportunity to assist you with some possible solutions to your concerns.  I have been injecting for the past 15 years.  While I agree that the most important and first step for you would be a consultation, I would like to contribute that Kybella is not FDA cleared for treatment of buccal fat.  The photos that you provided are somewhat limiting in that when I do an in-person consultation I evaluate your concerns from several directions.  In other words, your evaluation is from a front, side, oblique, and tilted view of your face.  This gives us a much clearer view of your personal profile.  During the consultation, I listen to your concerns and together we discuss the possible approaches to these concerns. From the limited photo, the model has very high cheek bones and a long, triangular face.  In your photo, you do have slight lower and middle face heaviness.  While a plastic surgeon may be able to help you, it may be that you would achieve best results from building up your cheeks and mid face a bit with fillers.  The important thing is that you seek consultation from an experienced injector and someone who knows facial anatomy.  Fillers would be the least aggressive approach to a possible solution.  

I hope this helps and I wish you the best of luck on your journey. 

Thank you for your great question.  This concern comes up commonly with patients.  I think it depends on your downtime, how quickly you would like to see results, cost, benefits and risks, and of course the exact nature of the volume loss.  Both modalities are good options.  Just based on the question (I did not see photos), I favor Sculptra.  If you are not yet in need of a surgical procedure such as a mini face lift then you can temporize for a few years with Sculptra.  Sculptra does not require any sedation so this in and of itself will decrease some risk.  Most of all, I would recommend a consultation with a provider who is well skilled in this area.

You absolutely can have your Halo treatment over your thyroid scar.  In fact, this is likely to help your scar especially if you have repeated Halo treatments.  In skilled hands, there are safe levels of treatments that can promote collagen production thus improving the looks of the scar.  In my opinion, the Profractional is probably the best option if your target is to improve the scar.  The Profractional, however, will require increased time for healing.  

Good luck on your treatment decision.

Thank you for your question regarding the subject of fillers.  I am an Aesthetic Physician from the midwest.  Being from the midwest, most of our patients request subtle changes when they are seeking treatment with fillers.  Subtle changes can be obtained in the cheeks with Voluma or Restylane Lyft.  However, you may not get the longevity from the Restylane Lyft as you would get from the Voluma.  In most places the Restylane Lyft is somewhat cheaper than the Voluma.  For you lips, subtle changes and longevity can be obtained from Restylane Silk, or Volbella.  I enjoy both of these products and the cost is about the same.  You might keep in mind that often how subtle a treatment is depends upon your communication with your injecting physician.  It is important that you choose a physician that listens and understands what your desired goals are.  Remember that longevity not only depends upon the product you choose but also upon whether or not you smoke, the tissue in which the product is be placed, how much you exercise, and the injector.

Yes, Halo can address both superficial and deep pigment.  Your results can depend upon your skin type, depth of your procedure, and the number of procedures you have.  You may be able to achieve better results with a combination treatment of a BBL (Broad Band Light) and Halo.  Some types of pigment can be very difficult to treat.  While some pigment may respond to treatment with permanent loss of the pigment other pigment may require ongoing treatments to maintain control.   Regardless of the the treatment recommendations, follow-up care should include avoidance of sun exposure and tanning beds.  In addition, most patients will benefit from a good line of skin care products that offer sun screens with a physical barrier.  Pigment regulators in your skin care products can also be of help. 

This is a very common question.  From viewing your photographs this appears to be what is called lentigines.  Lentigines are benign lesions that occur on sun-exposed areas of the body.  The most common areas are the face and back of hands.  The lesions tend to increase in number with age.  They will often vary in size, are flat tan, brown or black spots.  These benign spots can be treated with bleaching agents and lasers.  The best source of treatment is prevention with sunscreen and avoidance of the sun.

From what I can tell with this particular photograph and without a history, I do not believe that this is rosacea.  I would recommend that you see your Family Physician or Dermatologist.  This could be a reaction to some product you may be applying to your face, acne, or a number of other diagnosis.  Your physician should be able to help you diagnose this and help you with treatment.  

Thank you for submitting this question and I hope you the best of success with getting this diagnosed and treated.

Dr. Betty Troutman

The diVa technology is produced by the Sciton company.  During my consultation with patients I let them know that the manufacturer recommends three treatments one month apart.  It is then typically recommended that you have one treatment yearly.  However, there are women who achieve their desired results in less than three initial treatments.  It is always best that you meet in consultation with your treating physician so that they can obtain an in-depth history and do a physical exam.