I have a stomach pooch that just would not go away. I felt the coolsculpting helped it. Cons would be when the procedure is done it is a little painful but not bad.
I am a 39 y/o female who had the Fraxel Re:Pair procedure 3 days ago, and while I would not recommend it for those with low pain tolerance (like myself!), it already appears the results are worth the intense pain. When I first arrived for my appointment, I was given one 10mg Valium and one Lortab. My nurse applied a numbing gel (with an infuser), which stayed on for just over an hour, then my dermatologist applied approx. 20 shots of a local nerve block. He began the laser treatment on my upper eyelids (where no nerve block could be applied, of course), and the pain was incredibly intense. The lower eye area (also no nerve block here) was worse, but I was assured the areas which had received nerve block shots would be less painful. While they were indeed, the pain was still considerable, and I had to request a moment to 'catch my breath & grit my teeth' on several occasions. The doc made 4 passes (two horizontal and two vertical) over each facial area, and the pain seemed to intensify with each successive pass. By the time my face was finished, I told him I had changed my mind about the neck area, but he convinced me to at least let him make two passes over each neck area. He lowered the laser intensity setting for my neck (from 40 to 30; my eyes were at 20, I believe he said), and it was still barely tolerable, IMO. I was a bit shocked when they had me look in the mirror after they dried my face & applied the Aquaphor, but at least after seeing the immediate result (redness, swelling, oozing, bleeding, eyes swollen nearly shut), I felt I had justification for all my in-procedure whining. *g* For the first three days, I have applied the vinegar soaks every 2-3 hours (setting my alarm clock to do those during the night), followed by a thick coating of Aquaphor. I am also taking Arnica tablets to lessen swelling, and applying bags of frozen peas to my entire face a few times per day. I have, of course, experienced much discomfort, but no real "pain" to speak of. The vinegar soaks do sting like mad, but the stinging subsides quickly. I had numerous facial acne scars, a high-forehead (touching my hairline) scar from a forehead lift (5 years ago), an under-chin scar from a chin implant (6 years ago), the beginnings of crows feet at my outer eye corners, and crepey (not 'creepy'! *lol*) undereye skin from an overzealous lower bleph about 8 years ago. The forehead/hairline scar has already disappeared (though I did lose some hair in the front where he made contact with the laser), the chin implant scar is 100% gone, and all but 3 of my acne scars (the 3 deepes/largest ones) have filled in nicely. My upper and lower eyes are still considerably swollen, so it's difficult to say how those will turn out; based on the early results to my other areas of concern, though, I'm cautiously optimistic. Besides the eye-area swelling, my face is still a deep purplish-red, but given the ablation level of this procedure, I suppose that's to be expected. I was told I could expect things to 'tone down' to the equivalent of a 'bad sunburn' within 5-7 days. *fingers crossed* Updated on 24 Nov 2008: It has been more than six months since I had Fraxel Re:Pair, and my skin has now reverted - almost entirely - to its pre-FR state. The single exception is the improvement to the hairline scar I had from a previous brow lift; it has remained less noticeable than it was pre-FR. I followed the recommended post-procedural protocols, but after about 14 weeks, I began to notice my previously-improved areas looking more like they did before I had FR. I at first thought it may have been just because I had become accustomed to the "new & improved" version of my skin, but after taking photos and comparing them to both my pre-FR face and my 6 weeks post-FR face, it was glaringly obvious the favorable results were indeed diminishing. Unfortunately, they have continued to do so. While I'm not implying my skin is now worse than it was before I had FR, I am implying that $5,000 is a LOT to pay for less than 3 months worth of improvement. Even the doctor who performed my FR agreed there is very little visible difference at this point. Of course, he followed that by stating I should let him do another treatment (at a whopping $400 discount - LOL!) using higher settings. I am willing to bear my share of the responsibility for spending the money on the initial treatment without having known more about it; I am not, however, willing to do so again. Fool me once, shame on you... fool me twice, shame on me.
I would be very careful about having my eyelid microneedled because of potential complications during procedure and healing afterwards. Any invasive procedure over the globe would need an intraocular eye shield and I doubt that you could be aggressive enough to make a visual improvement. Without seeing the defect I would still council against this.
Wrinkles in motion need Botox or Dysport to relax the motion. Valleys that remain at rest can be filled with Bellafill once the motion has been addressed. This is a potential danger area for fillers as permanent blindness , while rare,and tissue death have been reported. unresponsiveness to Botox can sometimes be due to technique.
Bellafill is the most studied and has the longest continuous data of all the fillers. The 10 year safety profile was just published and it is still the safest filler on the market. Most filler studies stop at 2 years. Unfortunately it is often confused with other related fillers that never passed FDA clearance so are only legally used outside the US. It will not migrate and most of the side effects noted occur within the first few days (allergy) or the first year (nodules or localized infection or biofilms). These have also been reported with all the other fillers. It has been followed for 15 years and no problems with adverse aging are seen. Occasionally a nodule of scar tissue becomes visible and must be injected or excised.
From looking at your pictures I do not think a thread lift would be the primary procedure. The two prominent bands near the front of your throat should be addressed with Botox or Dysport as they appear to be two fibromuscular bands. Your skin could be tightened with Ulthera Ultrasound or ThermiSmooth Radiofrequency. A threadlift could tighten the area just under your jawline. An actual neck lift would give you the most dramatic results.
you will probably receive only modest improvement with only microneedling. You have mostly ice pick and crateriform scars. These are not the best type to do microneedling. Including 80% TCA on toothpick and punch grafting might improve you results and CO2 resurfacing would be a better choice because of the depth of your scars. Sublesional Bellafill injections would also improve your more shallow lesions. A combined modality is your best choice.
