Botox

Lip Fillers

Accutane

Dermal Fillers

Fraxel Laser

Hyaluronidase

Dysport

Latisse

You should not have any risk of the iris changing color if Latisse is applied to the eyebrows only. The side effect of iris color change is primarily reported when bimatoprost, the active ingredient in Latisse, is used as an eye drop. This medication, trade name Lumigan, is placed directly in the eye as a treatment for glaucoma. If Latisse is not entering your eye, it should not change the color of the iris. I recommend Latisse frequently for my patients with thin eyebrows and have not had any problems. Good luck!

One of the possible side effects of using Latisse is the potential of "brown darkening of the colored part of the eye (iris) which is likely permanent or eyelid skin darkening which may be reversible." I have blue eyes and would never want to risk possible color change. But, what if I only use it for my eyebrows (or lack of)? Would these side effects still be possible??

Are potential side effects still the same if used only on eyebrows?

Only a small amount of dysport is typically needed to lift the corners of the mouth (I usually start with 2.5-3 units per side). This should be injected into a specific location within the depressor anguli oris (DAO) muscle. I recommend going to an experienced board certified dermatologist or plastic surgeon for this injection because misplacement of dysport in this area can cause the mouth to become temporarily lopsided. It is a great treatment when done properly. Good luck!

How many units of Dysport are required on each side to lift the corners of the mouth?

It is a little bit difficult to tell with these photos, but it appears that there is extra volume or a bump just to the left of the nose above your nasolabial fold and possibly under the lateral aspect of the left eye.&nbsp; It is less apparent on the right.&nbsp; Regardless of where your bumps are,&nbsp;I would want to know more about the inflammation that occurred previously.&nbsp; Hyaluronidase injections most likely will&nbsp;be recommended to dissolve the remaining&nbsp;Voluma and&nbsp;fix the contour irregularity.&nbsp; If it seems that an inflammatory reaction is present&nbsp;or has previously occurred, I&nbsp;sometimes will also treat with antibiotics such as doxycycline or minocycline and consider steroid injections in appropriate situations.&nbsp; Many patients with misplaced or overdone&nbsp;filler do extremely well with hyaluronidase.&nbsp; Keep in mind that you will lose all or most of the product in the area, so after dissolving your filler, you may desire more filler in the future to restore the baseline volume loss.&nbsp; Adjustment in placement of the filler for future treatments&nbsp;can be discussed with your practitioner.&nbsp;&nbsp;If there was a true inflammatory reaction, further injections of filler&nbsp;should be also be&nbsp;discussed in the context of risk of recurrence of the inflammation, but can be attempted in many cases.&nbsp; As a first step,&nbsp;I would recommend reviewing your concerns with&nbsp;the physician who performed the procedure so that they may provide you with a plan of care.&nbsp; Good luck!&nbsp;

I got Voluma as a facial filler 20 months ago. Immediately after the procedure, 2 bumps appeared on my checks, much bigger on the left side. The doctor thought they were inflammations or potentially a reaction that will go away in a few weeks. Later he said it looked more like trauma and gave me medicine that didn’t help. Now that the filler is dissolving, they are becoming even more pronounced. Anything I can do now?

Are bumps after fillers fixable? (Photo)

Accutane does absorb best with fatty foods.&nbsp; I think a spoonful of a healthy oil would help if otherwise fasting, but may not be sufficient to achieve maximum absorption.&nbsp; Since patients are prescribed accutane twice daily, you can discuss this with your treating doctor and one option is to give a smaller dose in the morning to take with your spoonful of oil&nbsp;and a larger dose in the evening, to take with the larger meal.&nbsp;&nbsp;I&nbsp;would also consider something like a spoonful of peanut or almond&nbsp;butter in the morning.&nbsp;&nbsp;You should also look into a brand of&nbsp;accutane called Absorica, which also comes as Absorica LD (low dose), and&nbsp;is formulated with a lipid capsule to maximize absorption.&nbsp; You can try to get one of these options if this brand is affordable with your insurance.&nbsp; It should have better absorption than the generics regardless of the food intake.&nbsp; Best of luck!

I enjoy fasting and rarely eat breakfast and typically skip lunch. I’ve read a study that eating with accutane increases the absorption, specifically a fatty meal. Would it be sufficient to take my accutane with only a spoonful of a healthy oil such as coconut or mct oil?

I enjoy fasting and almost never eat breakfast. If I take my Accutane with a spoon of coconut oil, would it still be effective?

I&nbsp;often will treat patients&nbsp;with accutane&nbsp;who are nonresponsive to standard topical therapies.&nbsp; It would likely be highly effective for your acne with lasting results.&nbsp;&nbsp;There are other options as well, such as stronger topicals, hormonal therapies, chemical peels, facials, etc.&nbsp; The benefit of accutane&nbsp;is the likelihood of durable long term results.&nbsp; It can cause an initial flare and possibility of temporary cystic acne.&nbsp; However, the majority of patients with milder acne do not have a severe flare, many patients do not flare at all.&nbsp; If a severe cystic flare does occur, oral steroids can be used for a short period to calm it down and it usually subsides by the second month of treatment.&nbsp; Accutane does have some potential risks and side effects and requires blood work monitoring, but the majority of my patients are very happy with their results and do well throughout the treatment period.&nbsp; It is often&nbsp;a great option.&nbsp; Good luck with your treatment plan!

I have been on tretinoin 0.025% and clindamycin for the last few months and I have not really seen improvement. Will accutane cause me to get cystic acne?

Can I use Accutane for mild acne/closed comedones?

It is not recommended to perform surgery on inflamed or swollen tissue. &nbsp;Therefore, if resurfacing treatments are performed before surgery, it is ideal to allow for redness, swelling, and exfoliation to resolve before the surgery date. &nbsp;With most procedures, such as Fraxel Dual,&nbsp;microneedling, and most standard chemical peels,&nbsp;2-3 weeks is adequate. &nbsp;The healing time does vary&nbsp;depending on factors such as&nbsp;the laser settings for Fraxel or the&nbsp;acid type and&nbsp;concentration for&nbsp;chemical&nbsp;peels, so&nbsp;this should be discussed with the practitioner who is administering the treatments.&nbsp;In some cases, additional cosmetic&nbsp;treatments are performed on the same day as a facelift, but they would be done directly after the surgery, not before. &nbsp;For any specifics regarding pre or post care for surgical procedures, it is always best to ask the surgeon,&nbsp;as there may be some variation based on physician preference and the specifics of their procedural technique. &nbsp;Best of luck!

Scheduled for Dual Fraxel 1550/1927 January 24, 2019 and face, neck and upper eye restoration on April 13, 2019. When should I stop to prepare for surgery?

How long before a face and neck lift should I stop dual Fraxel 1550/1927, microneeding and chemical peels?

I would recommend waiting the entire two weeks for full effect.&nbsp; After that time, if there is still persistent undesired movement or any unevenness or irregularity, your provider can address it.&nbsp; Nobody is completely symmetric, so sometimes one side is stronger than the other and additional Botox can be added to correct the asymmetry.&nbsp; Additionally, muscular anatomy varies slightly from patient to patient, and some patients have stronger muscles than others.&nbsp; It can be difficult to 100% predict how much Botox a given patient will need on the first treatment.&nbsp; Personally, I think less is more, and I would rather add additional Botox in two weeks than put in too much and over treat someone.&nbsp; After first time Botox, I always tell my patients to expect that we may need to add a little at two weeks to achieve the perfect desired effect.&nbsp; Once your provider learns what works best on your face, you can follow what has been done in the past and achieve the same consistent result in the future.&nbsp; Be patient, and see what your provider recommends at the follow up.&nbsp; The good news is that it is completely reversible, so if you are unhappy with your results, it will fade and you can start over!&nbsp; Good&nbsp;luck!

Plus uneven motion. I had Botox for the 1st time six days ago. 6 units in the forehead, 20 in the glabellar area and 2 on each side of the lateral brow. My forehead looks great, but I am noticing I can move my left brow up more than my right and there are indents forming between my brows that weren't there before. Is there a chance things will even out and the glabellar area Botox will kick in? I go back one one week for a follow up.

Why is my forehead better after six days but glabellar is worse?

Swelling in the first 24 hours post filler can be quite dramatic and is not representative of the final result.&nbsp; Although the swelling may be worse in one area, the underlying product may be just fine because lips tend to swell unevenly.&nbsp; I would give it at least a week for the swelling to calm down, and if you are still unhappy with the results, make an appointment to follow up with your provider.&nbsp; If your final result is not to your liking, you can either dissolve the product in the upper lip or add more product to the lower lip even it out.&nbsp; I think you will find that your lips are not nearly as full as you think they are once the swelling goes down.&nbsp; Good luck!&nbsp;

So I just got lip filler about 8 hours ago...extremely bruised lips and I feel they look extremely uneven. Extremely disappointed with the results as I've gotten lip fillers before but they've never looked like this! Comments or opinions greatly appreciated.

Just got lip filler. I feel the top is a lot more swollen compared to the bottom. Would I need to dissolve? (photo)

It is not recommended to get Botox in pregnancy.&nbsp; However, your baby is most likely going to be fine.&nbsp; Cosmetic treatments are generally avoided and not studied in pregnant patients because the general thinking is that if you don’t have to do something, don’t do it while pregnant.&nbsp; That being said, there have been many cases of patients injected early in pregnancy who did not know they were pregnant and had&nbsp;no negative outcome for their baby.&nbsp; It has also been done for non-cosmetic reasons such as migraine or muscle spasticity while pregnant with no known adverse effects to the fetus.&nbsp; One study from 2016 looked at the charts of 232 patients who were given Botox while pregnant (majority in first trimester) or just prior to pregnancy.&nbsp; They found that the prevalence of birth defects was not increased as compared to the general population.&nbsp; That being said, much larger numbers of patients would need to be studied to truly test for&nbsp;safety.&nbsp; You should inform your OB that you received Botox while pregnant.&nbsp; But try not to worry!&nbsp; What is done is done, and negative effects are unlikely.&nbsp; Take care and congratulations!!&nbsp; Enjoy that baby!&nbsp;

Botox in 2 areas and 16 weeks pregnant. Will this harm my baby?

Absolutely!&nbsp; Botox takes two weeks for full effect, so I would not recommend injecting the SAME area within a 2 week time period, otherwise you risk over treatment.&nbsp; Any NEW area can be injected at any time, and after 2 weeks additional units can also be added to the original area if more is needed.&nbsp; It is ok to alternate between providers, however I would be honest with them about what you are doing and when in order for them to provide you with the best care.&nbsp; Generally, once I have been seeing a patient for Botox over time, I have a detailed map and plan for what works best on that patient.&nbsp; It would be best for your various providers to be aware of what each other are doing.&nbsp; Nobody will be offended if you tell them you have seen someone else, and as much information you can provide about what was done previously will help.&nbsp; Bring in your records or treatment map from other providers if possible!&nbsp; This will be the best way to ensure consistent results from one provider to the next.&nbsp;&nbsp;

I got baby Botox for the first time today, 16 units. I went because I was interested in finding another reliable aesthetic doctor in my area as my regular is hard to book with so I have two reliable options. Is it ok to still see my normal doctor in 3 weeks for my eyes, 5 units per eye? Then go back to having my forehead/eyes done at the same time, every 3-4 months? Is it ok to switch between doctors every so often as needed? I travel from another state so it’s hard to rely on one.

If I got my forehead injected today with Botox, can I do crows feet in 3 weeks?

Heather M. Richmond, MD, FAAD

Clear + Brilliant Badge

Reviews

Photos

Locations

Laser Resurfacing

Dermatologists are board-certified doctors who have the training and expertise to diagnose and treat diseases of the skin, hair, nails, and mucous membranes.

Dermatologist

Spring Lake

Barton Sterling, MD

Cheek Augmentation

Cheek Lift

Chemical Peel

CO2 Laser

Cosmelan

Glycolic Peel

Juvederm

Kybella

Laser Hair Removal

Liquid Facelift

Microneedling

Microneedling RF

Mole Removal

Phenol Peel

Retin-A

Scar Removal

Silikon 1000

Tattoo Removal

TCA Peel

Voluma

critical risk

Vancouver

Eric Pugash, MD

Arm Lift

Body Lift

Breast Augmentation

Breast Implant Removal

Breast Implant Revision

Breast Implants

Breast Lift

Breast Lift with Implants

Breast Reduction

Brow Lift

Butt Lift

Chin Implant

Chin Liposuction

Diastasis Recti Repair

Double Eyelid Surgery

Ear Surgery

Eyelid Surgery

Facelift

Facelift Revision

Facial Fat Transfer

Genioplasty

Inspira Breast Implants

Lip Surgery

Lower Facelift

Mentor Breast Implants

Mini Facelift

Mini Tummy Tuck

Mommy Makeover

Natrelle Breast Implants

Neck Lift

Restylane

Restylane Defyne

Restylane Lyft

Restylane Refyne

Restylane Silk

Skin Lightening

Skin Rejuvenation

SMAS Facelift

Tummy Tuck

Tummy Tuck Revision

Volbella

Xeomin

Hanif Ukani, MD

Breast Reconstruction

CoolSculpting

Gynecomastia Surgery

Liposuction

Male Tummy Tuck

Nipple Surgery

Ottawa

Trefor Nodwell, MD

AlloDerm

Belly Button Surgery

Botox for Gummy Smile

Brazilian Butt Lift

Brazilian Butt Lift Revision

Breast Fat Transfer

Breast Reconstruction Revision

Breast Reconstruction with Latissimus Flap

Buccal Fat Removal

Butt Augmentation

Butt Implants

Calf Implant

Chin Filler

CoolMini

Earlobe Repair

Facial

Facial Reconstructive Surgery

Forehead Reduction

Fractional Laser

Fraxel Repair

Ideal Implant

Labia Puffing

Labiaplasty

Laser Liposuction

Laser Peel

Lip Implants

Lip Lift

Lip Reduction

Liposuction Revision

Nonsurgical Facelift

Nonsurgical Neck Lift

Nonsurgical Nose Job

Pec Implants

Power-Assisted Liposuction (PAL)

ProFractional Laser

Ptosis Surgery

Punch Excision

Skin Tightening

SkinMedica

Thermage

Thigh Lift

Tumescent Liposuction

Sydney

Jack Zoumaras, MBBS, FRACS (Plast)

African American Rhinoplasty

Asian Rhinoplasty

Cheekbone Reduction

Deep Plane Facelift

Dermabrasion

Eyelid Retraction Repair

Revision Rhinoplasty

Rhinoplasty

Sinus Surgery

Marotta MedSpa

Hair Loss Treatment

Hair Transplant

PRP for Hair Loss

Renuvion

SculpSure

FamWellMD - Jacksonville

FamWellMD

Etre Cosmetic Dermatology &amp; Laser Center - New Orleans

Etre Cosmetic Dermatology & Laser Center

Medical Rejuvenation Centre - Vancouver

Medical Rejuvenation Centre

Quintessa Aesthetic Center - Middleton

Quintessa Aesthetic Center

Halo Laser

Skin Boss Med Spa

Skin Boss

Aquagold

BroadBand Light (BBL)

Clear and Brilliant

Dermaplaning

NovaThreads

truFlex

truSculpt

Dr. Richmond is incredible! She is very thorough and takes her time. She is extremely knowledgeable and confidant. She has done multiple procedures on me, ranging from medical biopsies (she found a very early melanoma) to cosmetic procedures such as fillers, botox and laser treatments. I trust her fully and have referred several friends and family to her!

Dr. Richmond is incredible

M_causey

17 Answers from Board Certified Dermatologist Heather M. Richmond, MD, FAAD See Education, Board Certification, and Treatments Offered.

Heather M. Richmond, MD, FAAD

CONNECT WITH TRUSTED DOCTORS

MAKE SURE YOUR DOCTOR IS REALSELF VERIFIED

Before and After Photos

CONNECT WITH TRUSTED DOCTORS

HEATHER M. RICHMOND, MD, FAAD REVIEWS

RATING DETAILS

Dr. Richmond is incredible

Doctor Directory

Atlanta

Boston

Washington DC

Los Angeles

New York

Chicago

San Francisco

Houston

Seattle

Dallas

WE SEND PRETTY
EMAILS

Heather M. Richmond, MD, FAAD

CONNECT WITH TRUSTED DOCTORS

MAKE SURE YOUR DOCTOR IS REALSELF VERIFIED

CONNECT WITH TRUSTED DOCTORS

HEATHER M. RICHMOND, MD, FAAD REVIEWS

RATING DETAILS

Dr. Richmond is incredible

Atlanta

Boston

Washington DC

Los Angeles

New York

Chicago

San Francisco

Houston

Seattle

Dallas

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS