Blair Armstrong, MD

Hello Checkered Shoes!

Thank you for writing in. Your pictures look good, though it is different to appreciate subtle 3-D anatomy from a 2-D picture.  Fillers are becoming more widespread and from the thousands of perfect before and after photos posted online, it's easy to forget that every procedure carries a risk of complication, that it is necessary to allow time for healing, and that every patient may heal a little bit differently. 

The late term complications of filler include infection (biofilm), foreign body granuloma, pigmentary changes, scarring, etc. Almost everyone has natural facial symmetry and although filler can be used to improve symmetry, it often looks slightly different on one side of the face compared to the other.  If you are experiencing new or worsening pain / discomfort, this could be a sign of infection or inflammation.  I'd recommend that you see your injector.  If you are unhappy, the filler could be dissolved with hyaluronidase. This often takes several treatments to achieve full result and then you will be starting from square one.

You are blessed with naturally beautiful, full lips and thus nothing is necessary unless this is something that bothers you. There are age, race, gender variations in ideal lip volume, but generally the ratio of upper - lower lip of 1:1.6 is aesthetically pleasing.  Some filler placed in the upper lip could help to achieve this ratio and improve overall balance.  A small amount of the right type of filler provides a natural result without appearing duck-like.

These lines are formed by contraction of the frontalis muscle.  Over times these lines will deepen.  They probably have more to do with genetics, skin type, and sun exposure and can occur in even young individuals. Neurotoxins such as botox work well to soften these lines. A small amount can help to soften them without completely freezing your forehead.  

The great thing about consistent use of neurotoxins is that it can prevent these lines from deepening. Another good (and bad) thing is that the effect lasts 3-6 months.  If you don't like it, the results are temporary and will wear off.  Though, I usually find that patients love it and wish it lasted longer!

It is difficult to tell from your photos. However, neurotoxins, such as botox, are great for the glabella area or "11" lines.  The nice thing about botox is that since it temporarily freezes the muscles, consistent use can help prevent the formation of deeper static lines in the area. 

The muscles of the face exist in a balance. Some muscles are responsible for lifting the brow while others are responsible for depression.  By selectively inhibiting specific muscles, we can utilize this balance to reshape the brows, provide a non-surgical lift, or improve symmetry. Make sure to see an injector who has a comprehensive understanding of the facial anatomy. 

Most people, even some of the most beautiful celebrities, have some natural facial asymmetry.  Photos capture our faces in 2 dimensions only and can exaggerate this asymmetry depending on the angle, lighting, and distance from the camera lens.  If it is something that bothers you, then dermal fillers could be a good non-surgical option. 

Best, 

Blair Armstrong MD