Dianne Quibell, MD

To remove filler we first need to be sure that the filler is a hyaluronic acid filler (Restylane, Juvederm, Belotero family). There are two types of hyaluronidase: Vitrase is from a sheep source and is more likely to cause allergic reactions. Hylenex is a human recombinant form and is less likely to cause hypersensitivity. Your test spots indicate that you had one of the two forms of hyaluronidase. If Hylenex, the least allergenic form was used, I would still feel comfortable using this under your eye but I would pre-treat you with a steroid such as oral Prednisone and an antihistamine such as Zyrtec or Xyzal. I would also keep an eye on you for an hour or two after the injection but I am certain this would remove the filler without causing much untoward reaction to the removal process and it will ultimately achieve your goal.

All hyaluronic acid fillers are "cross-linked" by the manufacturer so they don't metabolize after injection and have a lasting effect. The Juvederm fillers that start with a "V" such as Volbella are linked with propietary "Vycross technology". Unfortunately, these fillers have about a 4% risk of delayed onset lumps/nodules. Your physician can treat them by injecting an enzyme called "hyaluronidase" (Hylenex or Vitrase) and some patients require antibiotics. We see this side effect more rarely in other hyaluronic acid fillers such as Restylane and Belotero. I suggest Restylane Silk next time 

Hair loss at any age can be devastating but at age 20 it concerns me that there may be condition causing this alopecia (hair loss). There are many causes of alopecia including autoimmune diseases and nutritional deficiencies (and I don't mean biotin-which has never been proven to help hair loss). Be sure your physician checks iron (ferritin), vitamin D and zinc. If you are still without an answer Dr. Jerry Shapiro in at NYU Langone Medical Center is the worlds leading expert in hair loss. He has special equipment  (trichoscopy) to diagnose and treat this debilitating condition.

As we use our facial muscles to express our self, the skin can leave a crease called a "dynamic wrinkle". Many of these dynamic skin changes can be treated with a neuromoulator (Botox, Dysport, Xeomin) alone. The average patients require re-treatment every 4 months or 3 times per year! It's worth it because not only will the line improve, you appear relaxed and refreshed. When you are treated by an experienced physician, you will get a lovely "chemical brow lift". If the line does not completely resolve with neuromodulator, a filler can be used but be sure you have an experienced injector, because the area between the brows is high risk for a vascular occlusion. Fillers in this area typically last a year, but it is important to keep up with Botox so the filler does not migrate.

Radiesse is a filler that volumizes the face and hands. It is composed of 2 substances; a gel and some crystals. The gel can disappear within 3-4 weeks and this is NORMAL. When the gel disappears, the crystals should be stimulating the body to make new collagen. This process is called biostimulation. It is possible that by using only 1/2 syringe on each side of the face, not enough crystals were deposited and your "stimulation of new collagen" may not be noticeable. I'm sure you're disappointed, but consider getting injected with Restylane Lyft or Voluma, a hyaluronic acid that does rely on the body's biostimulation for volume correction.