Doris Day, MD

I'm guessing that you've also been using a retinoid or having other rejuvenation treatments because the fact that you're not hearing the "crunch" sound means that either the doctor changed the needles they were using and these are of a better quality, that they're changing the needles as they go along with the injections since it's a dull needle that can make that sound, or that your skin is healthier due to rejuvenation treatments and the needle is passing through healthier collagen as it goes through the skin to the muscle. All of these are good outcomes and you may notice that you have less pain and bruising from the treatments as well.

Botox in the masseters can be very helpful for reducing the strength and size of this muscle which can soften the jawline and achieve a beautful contour in that area. Typically 5 units is a small dose for this area but more can be added, usually 20 to up to 50 units per side depending on how large the muscle is and how much of an effect you're looking for. 

The Light Sheer Duet Diode laser can treat very large areas quickly, no gel or mess, and with very little discomfort even in olive skin tones. It's important to shave the area prior to treatment and to not have a suntan in the area being treated. It usually takes 5-7 treatments for optimal results and occasional maintenance visits for any stubborn areas.

The light sheer duet is a diode laser that has a very large spot size and does not use gel. It is fast and virtually painless, not messy or sticky and great for larger surface areas like legs and back. It takes about 5-8 treatments, only works on dark hair. You should shave the area to be treated so the hair is present but short. Treatments should be done at 1 month intervals. You should not have a suntan when doing the treatments. They should be done by or under the supervision of a dermatologist.

Ematrix can be very effective in skin of color. Everything depends on the settings used and how the treatment is done, along with post-treatment care. You should not have had recent sun exposure and should use sunscreen after. There are two different tips, I prefer the standard sublative for my skin of color patients over the deep sublative.  I do have my patients wear makeup as desired the next day. Sometimes the redness and small brown dots can persist for about 5 days. A series of treatments are usually needed at about 3-5 week intervals.

Permanent makeup is a form of tatooing that can beautifully camouflage your scar. A qualified artist can actually create mini hair strokes that will look like natural hair. This would be the fastest, easiest and least costly of the treatment options. Hair transplant is another option and can be done over the permanent makeup if you choose to do that at a later date.

There is a board certification for this process and it is important that it be done properly for best results.

Because of the muscle weakness on the side of the face that had the stroke the two sides of your face will age differently. This will become more apparent over time and as you naturally age. Neuromodulators such as Botox, Xeomin and Dysport, often along with appropriate soft tissue fillers, properly placed, can dramatically improve the symmetry and balance of the face, looking natural and beautiful.  This is an advanced injection technique and, especially in this case, needs to be done by a properly trained aesthetic physician.

After a medium depth TCA peel your skin is especially sensitive for 1- 4 weeks or more depending on your skin type. You should ask the physician who did the peel if it's safe or recommended to have a facial and how long you should wait. You skin should be fully healed and no longer red from the peel before you even consider a facial.

Properly placed Botox Cosmetic can help lift corners of the mouth and soften marionette lines and even smooth the jawline. The effects are even more beautiful and very natural when combined with fillers. The combination also has a synergistic effect and can last longer than either treatment alone.  This is an advanced technique and should only be done by properly trained aesthetic physicians.