Brandy Segura, MD

It looks like you are lacking support around the lips. When you fill your lips, the valley between your lips and cheeks gets larger and creates that crease. I would suggest cheek filler to help lift the cheek a bit and decrease the amount of nasolabial fold and tissue in that area. You can also fan filler above the lip to support that area and fill in the crease.

All fillers have different properties, G prime, cohesivity, moldability, etc. The tear trough (under eye) also comes with it's own set of difficulties when using filler such as, tyndalling (blue haze under the eye from filler), lymphatic draining issues. A great filler for under the eyes is classic restylane. That is probably the most commonly used filler for that area.

Refraining from bending down is only for the first 24 hours as your provider is wanting to keep the Xeomin where it was injected. After that, you are free to bend down and kiss your dogs!

Longevity of toxins and fillers vary from person to person. You may simply be a fast metabolizer. Patients who work out or simply have a quick baseline metabolism tend to see this.

Xeomin takes the longest to see full results out of all of the toxins. I recommend waiting the full 2 weeks to see how you will respond.

The minimum dose to the glabella region which causes the 11's should be 20 units. It's my opinion that your injector under dosed you. With that being said, Xeomin takes 2 weeks to take full efficacy. You should wait for 2 weeks and then be seen for a touch up and to reach the minimum 20 unit dose.

Xeomin lacks the accessory protein that leads to antibody formation. It is worth a try to see if you respond to Xeomin.

Hi,
Yes, filler can be used to treat fat atrophy and to restore lost volume. I would recommend a collagen stimulating filler like Radiesse, which stimulates your body to keep creating collagen for 6 months to a year after injection.

Hi Jim,
Botox (a neuromodulator) consistently can help lessen the depth of the forehead wrinkles and prevent worsening. If you don't inhibit the muscle from moving, the creases will get worse. If someone were to use filler to fill in the creases, but did not "freeze" the muscle with a neuromodulator, the muscle would likely cause the filler to move over time and still create the creases, now with filler causing plumper areas above and below the creases.
Filler is often NOT placed in the forehead because it is considered a "danger zone" for vascular occlusions leading to skin necrosis and blindness. For patient safety, neuromodulators are the first and only choice for forehead lines.

Hi Tammy, it looks like you are experiencing malar edema. This is not an uncommon side effect and is more likely to happen when an injector places the filler too superficially, too much filler, or places filler in a patient who had visible eye bags prior to the procedure. I would recommend visiting the injector who placed the filler and ask them for a course of steroids to help with the inflammation, and inquire about dissolving some of the filler. Malar edema can be tricky to treat and does not resolve with massage. Often, dissolving is the best practice. I hope that answer helps.