Dr.McDaniel explained all aspects of the treatments I was interested in, allowing me to make an informed decision. I look refreshed and natural. I appreciate his conservative and safety conscious approach. A little certainly does go a long way!
Dr McDaniels is most certainly an artist. He comes in and sees your face as the canvas and has an incredibly light touch with all his injections. I’ve been going to him for 2 years now, Botox and restalyn for tear troughs and he has never let me down. I’m someone that bruises SOOO easily and was initially apprehensive about the potential for bruising with the injections. I continue to be amazed that I have yet to bruise in any of my experiences with dr McDaniels. He is one that prefers to be cautious when it comes to initial Injections, as he says it much easier to come back for more, vs look puffy or overly frozen. He also is extremely well priced for his work. Never has let me down—from restalyn under eye injections, to Botox brow lift.
Dr. McDaniel and his staff are excellent. Professional, knowledgeable and safety conscious are the reasons why they are my first choice for injectables. Wait times are a little longer than expected, but it is worth the wait for a provider who understands the impact of the muscles he is injecting and most importantly where not to inject!
Exceptional experience. I was given a fair and realistic prediction of what outcome to expect. I am more than satisfied with the results of his services. I am grateful to Dr. McDaniel and his entire professional and friendly staff.
I had always felt self conscious about the appearance of my vagina which ultimately affected how I felt in intimate situations which only got worse with age. I was looking for something that could improve the appearance and laxity of the skin and also improve my orgasmic ability. This procedure is amazing and has changed my life and the way I feel about my body and in intimate situations. There is no down time and results start immediately (orgasms are stronger and more frequent). I can't rave enough about this procedure.
After six previous laser treatments I decided to try the PicoSure laser. I heard that this laser was quicker in removing the ink than the other lasers. I asked the technician is she could give me an estimate on how many treatments I may need an it may be three or four. She also told me to schedule the second appointment within two months just to see how much this will fade. She was very thorough with everything that she was doing. She put some numbing cream on my hand and let it sit for about 20 minutes, which barely helped. It still HURT lol. Also she did my ENTIRE tattoo, where as the other places only did the black outline and it would take forever for me to see results, plus the laser had stopped pulling ink out. I think that this might actually work, I can already see some green fading and thats a great thing. But I will keep this updated every week until mu next appointment. Updated on 11 Aug 2015: Updated on 17 Aug 2015: The blisters have gone down and it just looks like a huge scab Updated on 23 Aug 2015: When will these blister/old ink come off? :(
Hello. I have had this birthmark all of my life and I am tired of it. It in on my chest so I cannot wear V Neck tops or scooped neck things. Also, I was told that my father had similar birth marks on his body. I don't want to be anything like him because he was a deadbeat who did not do his job. So, I am getting this removed. The first picture is after my first treatment. It got a bit darker after my first treatment as I was warned that it would. But, after that, it is supposed to fade. I had to pay a $97 consultation fee (which was way too high IMHO for a consultation) and $125 per treatment for the laser. The laser is the new state of the art Picosure laser. The equipment is very expensive and this is new technology so I can justify the price on the actual procedure. I am guessing I will need about 3 treatments. The doctor seems to think I will need less. But, when I was adding up the total cost, I just put $472 for Realself to accommodate the consultation charge and three treatments. We shall see. Updated on 10 Feb 2015: I haven't really seen any results yet. But, it could take up to six weeks to see results. So, we shall see. Updated on 18 Mar 2015: I had a second treatment about a week ago. The birthmark turned black and peeled. Now, a piece in the middle is gone and it looks like it is fading around the perimeter as well. The picture does not look as good as it looks in real life. I hope the improvement continues and I don't have to have too many more treatments. This session was a bit more painful even with the numbing cream. But, it was nothing I could not handle and it was such a small area that it was over fast. Updated on 7 Apr 2015: I recently had a third treatment. The birthmarked area turned into one big blister. It did not hurt but it looked weird. I freaked out and called the doctor. He said not to worry but to come in. They popped a hole in the blister to deflate it but left the blister skin in tact because the blister is "nature's bandaid" and it has growth factors and healing things in it to help skin heal better. They also used an LED treatment on it after they popped the blister. It is just like shining a light on the area of the skin to reduce inflammation. I was told to keep it covered and to keep ointment on it. I did it for a few days but I had to let it breath today because it was too itchy covered up. It looks as though the birthmark is gone! The area underneath is pink. There is a chance that some of the pigment cells could regenerate and I might need another treatment---but I might not :) We shall see. I am quite amazed. Dr. McDaniel definitely knows what he is doing and has the most up to date equipment in the Hampton Roads area. Updated on 30 Aug 2015: The birthmark is back though it is a bit lighter. :(
I have been going to this doctor for many years and am always delighted with my treatment and the results. He does all injections personally and takes his time to explain all options. Like me, he prefers a conservative approach that can be enhanced as needed. With fillers, I definitely did not want the celebrity "apple face" that I find so unattractive. Just tried the Volumna injections this week and the results are amazing! Will definitely go back for more as needed...
He's the Best - Norfolk, VA
Dr. McDaniel will not give you a treatment if he feels it will not work for you. He will discuss all options and together you will come up with a plan.
This is a fairly common concern which can be due to a variety of issues (or combinations of these factors). Facial asymmetry is rather common - in particular there is typically more volume loss on the middle left cheek than the right due to the driver's side window effect. [Note if you are reading this in sunny Australia or other right-hand drive countries this effect occurs on your driver's side.] Underlying cheek bones may not be exactly the same height and fillers which are injected on top of the bone may not be uniform. There are other factors such as angle of needle, massage afterwards, and other technique issues. Tear trough areas are typically higher skill areas where small amounts of filler differences can create asymmetry. So it can be existing asymmetry which is not corrected with the first set of injections or it can be that the injections themselves create new asymmetry. Also for tear troughs it matters quite a bit which filler is used - and also whether the filler is very superficial (subdermal) or deep on the bone (supraperiosteal) and whether needles are used or blunt cannulas for the injections. Please be aware that this area is also one of the 'danger zones' and your doctor might have been being appropriately conservative in this area. I have to touch that area up sometimes to get optimal asymmetry so your doctor may appreciate a call from you so that he or she can give you a nice result in this area as it sounds like they did nice work on the rest of your areas.
This is an important question depending on the colors in your tattoo. GENERALLY speaking, the 755nm Alexandrite Picosec laser is superb for fading green and many blue colors that traditionally could not be removed with 1064nm Nd:YAG lasers in the past (the 1064nm laser fyi has been the workhorse laser in the past but it could not remove these colors well).Generally speaking the 532nm works 'best' for yellow, red and orange tattoo colors. The 1064nm and the 755nm both tend to work well for most black tattoos (thus the reason for having 532nm in both lasers).The picosecond pulses are much shorter/faster than the nanosecond pulses and this impacts how the tattoo particles react as well as how gentle the treatment is regarding pain. Please note that there are differences between the 1064 and 755 and 532 for treating skin of color patients and also tattoo pigments and the depth and technique used as well as the amount/density of ink and the presence of any scarring in the tattoo area as well as various other factors including the energy/power of the laser beam that may significantly influence results on individual patients - as well as create variation in results between different tattoos on the same patient. Sometimes all of these wavelengths are needed to produce optimal results, however the picosecond 755nm Alexandrite laser really is a star for green and blue tattoos.
Typically you might expect to see most of the results by 7-8 days although in some cases it may require a bit longer. You did not mention if this was your first injection or not. If you have been injected in the past and your response was very different than you current response then that is significant. You also did not mention which neuromodulator you were injected with: Botox, Dysport or Xeomin. There are some subtle differences but properly injected people typically have a nice result with any of these.If this was your first injection there are a variety of factors that could cause the response you described. It might also be that your injector was just being conservative if it was your first injection. However it is time to call and inform them of your situation. Clinical effects are not simply the result of the number of units injected but also a number of other factors are important including: the dilution when reconstituting neuromodulators, the location and depth of injection, your unique anatomy, and the muscle volume and distribution being injected. Also the size of needle, the pressure of injection and the spacing of injection sites all impact the diffusion or spread (think different sized raindrops) and thus the clinical result. The experience of the injector and their artistic/aesthetic sense is critical and often underappreciated when people are just shopping for neuromodulator or filler injections based solely on price (of course price is also important but the variation in results can be quite significant between injectors). In short, there is no way to discern with certainty from your photos and history why you have not seen more improvement. However the neuromodulators are so popular with people because the outcomes are typically very good so you likely just need a touch-up treatment. Best wishes for a successful touch-up and final result!
You were treated about 15 months ago - which unless you were on the FDA clinical trials is near the 'early days' of the approved injection of Juvederm Voluma in the USA. Based on the data from those studies a common answer is 'up to two years'. Based on European experience (where this has been in use for many years) the answer might be different ranging from a shorter time tolonger - perhaps 3 years (the techniques and volumes used in Europe are sometimes different than the typical injection protocols in the USA). I have seen quite a number of my patients returning in my practice who are 15 to nearly 18 months out who i injected using conservative volumes of 1-2 syringes who still are maintaining nearly 'full correction' and only a few who have begun to fade. So there is a difference between the Voluma material being metabolized by your body and decreasing in quantity and the 'visible correction' that you see in the mirror. You should probably ask your injector for advice on your specific case and technique and volume he or she injected. Typically however the timeline varies considerably based on the volume injected, the anatomic site, the depth/location the Voluma was placed, the overall technique used, whether you have had weight loss, and other factors. Injections of hylaronidase (an enzyme our bodies use to remove hylaronic acid) may be used to remove it sooner, but you should see someone experienced if doing this as the dose and brand of the hylaronidase that seems to be optimal for accomplishing this for Voluma is thought by some experts to differ from that used for other hyaluronic acid fillers.
Juvederm Voluma XC was recently approved in the USA by the FDA. It is the first (and only) filler FDA-approved for deep injection in the cheek area to correct age-related volume loss. It gives you a subtle lift, helping restore contour and a more youthful profile for up to 2 years. It becomes more widely available in December and the pricing comparisons should be more easily obtained at that time.Other fillers are commonly used in this area but their use is considered ‘off-label’ by the FDA since they werenot designed and tested specifically for this anatomic area. Radiesse is one example. Unlike Juvederm which is composed of hylaluronic acid, Radiesse is composed of calcium hydroxylapatite - which is a substance identical in composition to the mineral portion of teeth and bones. It functions as a collagen stimulator and can produce long lasting correction and is a popular product, but it was not designed nor approved for cheek volume loss but rather is approved for moderate to deep wrinkles and furrows. Juvederm Voluma is a very unique filler.Juvederm Voluma XC has been used in Europe since 2005 and in many other countries around the world and in Canada. It has been proven to be a very safe and highly effective filler for restoring lost volume in the cheek and it typically provides a bit of a ‘lift’ for the facial area as well. The correction or improvement is long-lasting – typically two years with optimal correction. The techniqueused for Juvederm Voluma is somewhat different and the manufacturer (Allergan) is providing and requiring special training in order to use Juvederm Voluma XC.On a more technical note, Juvederm Voluma XC has two physical characteristics which are very important and understanding the basics of these properties will assist in understanding the differences in various fillers and Juvederm Voluma. One characteristic is the ‘lifting’ effect (called G’ or G Prime in the medical technical literature) and the other is ‘cohesiveness’. This allows Juvederm Voluma to create an uplifting effect often termed ‘tentpole’ effect. This sets Voluma apart and it is why itis so highly effective for cheek volume loss. While the amount of Voluma needed will vary for each person's situation, generally speaking 'less is more' with Juvederm Voluma and you should not compare the number of syringes or vials with other products, but rather look at 'optimal correction'. For patients who are younger with early cheek volume loss and mild sagging a little Voluma can make a big difference in appearance. So discuss with your injector what you need as you cannot directly compare to what you may have used with other fillers in the past. Importantly, the 'lift' from correctly injecting Voluma into your cheek may well produce enough lifting of the skin around your mouth that smile lines and marionette lines may be significanly reduced - or not even need injections like you have had in the past. So while Voluma may be more expensive per syringe, this lifting effect may require less filler in other areas than you have used in the past and also it may last as much as twice as long. So compare with caution as these are not 'apples and apples' type comparisons. Juvederm Voluma is about to open a whole new world of facial rejuvenation options for patients in America. There are limitations too, so current fillers including the existing forms of Juvederm Ultra as well as Restylane, Belotero and others will still have important roles in facial skin rejuvenation. Juvederm Voluma XC can be injected just above the surface of the cheekbone – unlike other fillers which typically are injected within the skin (intradermally) – and it helps create the filling and lifting effect. This is due to the special cross-linking of the molecules (calledVycross technology) and also helps account for is very long-lasting effects. If it is injected over areas of the cheek that do not haveunderlying cheekbone then it is injected differently (sometimes called ‘putting the canopy over the tentpoles’). By the way the XC means it contains some lidocaine local anesthetic which makes the injections more comfortable.This is new technology for most American cosmetic surgeons and it is better to undercorrect initially and go back and touch-up a bit after a few weeks than to overcorrect. Sometimes even with very experienced cosmetic surgeons Voluma is going to need some shaping…I have to do this and I just tell patients in advance they might need to return. There is a sculpting artistic component as well as important technical skills for optimally correcting a patient with Juvederm Voluma and most people have somefacial asymmetry as well – so don’t necessarily think of this as ‘one stop shopping’. This is an investment for beauty for the next two years and you want to get itright….just like custom fitting an outfit…you might need a bit of adjustment.In summary Juvederm Voluma is a remarkable and very unique addition to our treatment options in the USA. It is going to (literally)change the way many people are treated in this country (just as it has overseas) and the results should provide a very natural, youthful appearance.I believe it is always important to choose a cosmetic injector who is experienced with whatever product you are about to be injected with. I would suggest asking to see a few before and after photos of patients who were injected by the hands of the specific person you are going to receive your injections from.That is I believe that this is particularly true for Juvederm Voluma due to the special skills needed both technically for injecting this, but also for the artistic side of recreating the ‘cheek of your youth’ that has natural contours and which is not overcorrected. It also helps to see photos of someone with similar volume loss severity as your particular case. Once you have found your expert injector, talk to him or her about your concerns and what treatment will give you the most natural, youthful appearance that fits your lifestyle and budget.
