Elyse Rafal, MD

I agree the outcome does not as great as they can be - you might want to follow up with a cosmetic dermatologist to see if it can be dissolved or add more filler to even them out . hard massage can help too. 

Thank you for your question , Botox is very helpful injection for treatment . Botox, helps relax the jawline, reduce teeth grinding and clenching. cosmetically it slims the face and adds more definition  to the face. contact a plastic surgeon or cosmetic dermatologist . 

Thank you for submitting your concerns with photos.  There are different combinations of treatments you can look into.  One that I would suggest for you is micro needling with PRP and PRP injections.  Microneedling is a collagen induction therapy that promotes collagen and elasticity production in our skin.  As we age, the production and integrity of skin can change.  What results you can look forward to with micro needling is tightening of the skin, pore reduction, evening of skin pigmentation and overall prevents signs of aging.  The benefits from PRP facial injections are reducing the prominence of wrinkles, sun damage, dark circles, tightening skin.  The combination of the two treatments is a more radiant and youthful appearance.  For the best treatment plan and results schedule a consultation with a dermatologist in your area.  Good luck on your journey.

Hello and thank you for sharing your concern along with photos. First and foremost, good skin care starts with using the right skincare products.  Avoid using harsh anti-bacterial soaps (i.e. Dial), use gentle cleansers.  A good brand is vani-cream products and they are quite affordable.  Schedule an appointment with a dermatologist in your area that can recommend medical grade skincare products. In my office hand rejuvenation is quite popular.  It is done using the Aerolase Neo laser.  This is a collagen inducer and helps tighten the skin, reducing fine lines and wrinkles, also evening out skin pigmentation.  4-6 Treatments are needed, done about 3 weeks apart.  This is non-invasive and free from pain, there is NO downtime with this laser treatment. Good luck on your journey as there are many treatment options, get started by see a dermatologist.   

Hello, Thank you for submitting your concerning areas and picture.  A combination of treatments would be a good option for you.  Microneedling with PRP, done in a series of 3 treatments, 3-4 weeks apart along with incorporating aerolase neo facial rejuvenation treatments, done 1 week after your microneedling/prp treatments. Aerolase neo treatments should be done with a series of 6 treatments every 3-4 weeks for optimal results.  Both of these treatments are collagin induction therapies and will help correct and soften your areas where volume has been lost.  There are other great options for you, like HA fillers, but this is a great choice.  Good luck and schedule an appointment with a dermatologist in your area.

Thank you for submitting your inquiry and picture.   This is a simple fix, HA filler like Juvederm XC.  You have instant results and it does not require surgery.  There can be slight swelling for a couple of days.  Please, schedule a consultation with a board certified dermatologist near you.

Thank you for your submission with photos. You would be a great candidate for Kybella, a non surgical procedure for submental fat reduction, it is permanent reduction of fat.  Kybella is deoxycholic acid injected into the fat beneath your chin. That fat causes a fullness appearance to your face.  After the injections your body's natural metabolism then processes the fat cleared from your treatment area.  Once the fat cells are gone, you're left with a noticeable reduction in fullness under the chin, providing a more chiseled appearance to your jaw area and face.  You will get optimal results with a series of treatments spaced about 6 weeks apart. For skin tightening, Aerolase LightPod Neo laser skin tightening treatments done every 3 weeks, about 6 treatments will result in tightening of your facial skin.  There is no downtime with this laser.  It can be done the same day you have Kybella treatment done.  The LightPod Neo is a unique laser in the field of aesthetic medicine. It delivers 1064nm energy to the skin using a safe, gentle energy pulse, which virtually eliminates pain while providing the best clinical results for even the darkest skin tones. Schedule a consultation with a board certified dermatologist in your area.

Thank you for inquiring about tretinoin/retin-a.  Here are some tips on proper usage. If you have questions and concerns it is alwasy best to see your dermatologist. Apply the tretinoin to face at night at least 20 to 30 minutes after washing your face or 30 minutes after applying your last acne medication.  Use a gentle cleanser.  Do not spot treat, apply a thin layer (i.e. pea sized amount for entire face) and gently rub into area.  Moisturizers and sunscreens are applied in the morning.  Never apply any moisturizers, sunscreens or topical medications before, during or after applying the prescribed medication unless instructed otherwise.  Side effects: Sun sensitivity.  Apply a sunscreen with spf 15 or above at least 15 minutes before going outside.  During the early weeks your skin may become worse.  This means the tretinoin/retin-a is working.  It is normal for some people to experience some irritation (i.e. redness, peeling, stinging, burning and itching) If skin becomes very irritated, decrease usage to every other night or twice a week, gradually building up until you can tolerate every night. Avoid defoliants, scrubs, toners and astringents.  I hope this helps.  Remember, schedule appointments with your board certified dermatologist for proper skin regimans.

Thank you for your question and submitting pictures.  There are different options to treat your acne scar and melasma.  A combination of treatments would provide optimal results.  I would suggest microneedling in a medical office, with PRP, followed with a TCA peel.  You will have downtime, by day 7 to 10 you should be healed from peeling.  3 of these treatments spaced 4 weeks apart would bring your skin to a new, fresh level.  Schedule an appointment with a dermatologist in your area.

Thank you for your inquiry and photo.  Having tight skin skin, with a leathery appearance post tca is normal.  Around days 4-6 you should start peeling, by day 12, you should be clear from the peeling skin.  Do not hesitate to contact the dermatology office you received the treatment from.