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Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology
8316 Arlington Blvd, Ste 401, Fairfax, Virginia
4.5 | 11 Reviews
26 Questions Answered
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QUESTIONS ANSWERED

How much for Botox in my lips?

Asked By:AnonymousANSWERS (1)
Hello. Sounds like you need a hyaluronic acid filler such as Juvederm, Belotero or Restylane, rather than Botox. For natural-looking results, you should have an expert facial analysis to determine whether it's just your lips that need injecting, or the surrounding area that supports your lips. The unnatural "duck lip" appearance that you sometimes see after filler happens when it's injected only into the lips without the lip support being restored. The choice of filler also depends on your facial structure and the structure of your lips. Sometimes a combination of fillers is best.

I recommend that you consult a Board certified dermatologist or plastic surgeon who is a filler expert. Prices range from around $500 to $700 for 1 syringe. It's worth paying a little more for really good treatment that looks completely natural.

Kind regards,

Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello, and thanks for your question. It depends how much Juvederm was injected, and where. If too much was injected, or you have a lot of swelling or bruising from the injection, this could cause some pain around your jaw.  

Hope this helps.

Kind regards,

Dr. Hema (Rockville, MD and Fairfax, VA)
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello, and thanks for your inquiry, If it is over 2 weeks since you had the Juvederm and you are still swollen, you may have been injected with too much. Another possibility is that your nasolabial folds were injected when the actual cause of the problem needed fixing by injection into another areas, such as your midface or the sides of your cheeks in front of your ears. The key to looking natural is to treat the actual cause of the problem rather than just what we see - in this case, your nasolabial folds. A third possibility is that you still have deep bruising which is causing prolonged swelling.

Fortunately, Juvederm can be easily removed if it has been misplaced or too much was injected, by injection of hyaluronidase to dissolve it. I recommend you consult a Board Certified dermatologist or plastic surgeon who is very experienced with fillers to figure out the best plan of action. If you're comfortable with the doctor who originally injected you, then go back and see him/her first.

Hope this helps.

Kind regards,
Dr. Hema (Rockville, MD and Fairfax, VA).
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello. The important issue is to determine why your right eyebrow is more arched, and to fix the cause rather than the effect. This the key to achieving natural-looking results and avoiding looking as if you've had plastic surgery. For this, you need an in-person consultation and full evaluation of your face. If the muscle overactivity is the primary cause, then it's ok to inject a little Botox, Xeomin or Dysport to relax the muscles. However, based on your photos, the underlying cause could be a decreased volume of skin, fat or bone on that side of your forehead, which is making the muscles overactive. I have seen and treated many patients like this with a hyaluronic acid filler. For safety and the best results, it should be injected with a blunt cannula, not a sharp needle. Sometimes a combination of filler with Botox is the best treatment. Based on logical understanding of the possible causes of your brow arching, a brow lift is not the solution.

I've included a reference to a book chapter I wrote for Clinics in Plastic Surgery (a textbook for plastic surgeons) that discusses this situation.

Hope this helps.

Kind regards,
Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello, Naz. It's a good idea to try a filler first even if you're considering a surgical implant. Injection with expert technique of a firm hyaluronic acid filler such as Perlane (Restylane Lyft) just over the bone will give precision sculpting and very good definition of your chin. If you were not considering surgery, Radiesse, which is calcium based, would also be a great option for precision sculpting and chin projection. You can also try Restylane Lyft to your nose. Based on your side profile picture, you should be able to achieve a nice result with the right technique. If you also have injection of a filler such as diluted Voluma or Juvederm to your forehead, it will balance your face even better and make your nose look more in proportion. For maximum safety and the best results, all these filler procedures should be performed with blunt cannulas rather than needles.

Many Middle Eastern and Asian women actually prefer fillers to implants because they give a less angular and more feminine look to faces of these ethnicities. Hope this helps. Kind regards, Dr. Hema.
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello, kmprg88. Botox can be used to weaken the muscles that depress your eyebows, and hence give them a lift. Another treatment that can help, and may be more appropriate given the shape of your brows, is to inject a hyaluronic acid filler to your brows and forehead, to increase their support and stop your brows hanging over your eyelids. This is an advanced level filler procedure that should be performed by an expert dermatologist or plastic surgeon, using blunt cannulas rather than needles. A third option is surgery if it's truly excess skin and not volume loss causing your brows to droop. I recommend you consult a board certified dermatologist or plastic surgeon to discuss all options. Hope this helps. Kind regards, Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews

Is Restylane silk good for tear through?

Asked By:AnonymousANSWERS (1)
Dear September, Restylane Slk can be injected to the tear trough. It is likely to cause swelling for at least a few days after, as it absorbs quite a bit of water. Neither Belotero nor Restylane Silk should cause the Tyndall Effect if injected correctly. Both are scientifically designed for superficial placement. Hope this helps. Kind regards, Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Dear af.06, it is important for your injector to assess your whole face before injecting your nasolabial folds. This, together with correct injection technique, can help avoid this type of problem. While I cannot tell definitely from looking at such a closely cropped photo, it looks as if the Juvederm may have been placed a bit too superficially, and also as if you may need filler to also support the surrounding areas, rather than only to the nasolabial folds. Your anatomy on each side of your face can vary considerably, and each side must be treated with an individualized strategy. Since you're referring to Juvederm by the overseas names, I wonder if you were injected outside the US? I recommend you return to your injector and discuss removal of the misplaced filler with hyaluronidase. The area can then be reinjected. You need an in-person assessment to determine if Juvederm or another product is the appropriate choice for reinjection. Hope this helps. Kind regards, Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Dear Kristi, Don't worry - you'll be fine! Although it was previously recommended not to lie down after Botox, there is no evidence that even this causes problems - let alone just bending down to pick up your child. A new global publication on Botox is coming out soon, with recommendations from top experts from throughout the world. You'll be glad to know that in this publication, for which I am the first author, all the experts concluded that there is no basis for post-Botox instructions such as not lying down or avoiding air travel. Hope this helps! Kind regards, Dr. Hema
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews
Hello gemmassage. Ask your doctor if a small amount of hyaluronidase can be injected into the top right side of your lip to dissolve out the unwanted Juvederm. By the way, you may get much better results if the support is restored to your lips by injecting the area around them. It gives a more natural look than injecting into the lips when the area around them is volume-depleted. Hope this helps. Kind regards, Dr. Hema.
provider-Hema Sundaram, MD-photo

Hema Sundaram, MD

Dermatologic Surgeon, Board Certified in Dermatology

4.5 | 11 reviews

Hema Sundaram, MD reviews

Hema Sundaram, MD

RATING DETAILS

4.5
11 reviews

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Hema Sundaram, MD
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10 Results
Dermal Fillers

ekurz33

Great experience

Had a great experience. She knew what she was doing and came up with a solid plan for dealing with the sagging skin and wrinkles on my face. Much better than the previous doctors I had seen. Not cheap, but worth it when I look in the mirror every morning. My only complaint is that everything has to be paid up front.

$2,300Radiesse

Keroni

dr. hema is the best cosmetic physican in rickville,, md

I would recommend Dr. Hema Sundaram as being an amazing cosnetic PHYSICAN in the Rockville, Bethesda area. She is so knowledgeable in her field. She made me as a patient 100% confident in her knowledge of all procedures. I had every confidence in her and knew anything I chose to do would turn out perfect. She is so very caring to each and every patient. I was so confident that I chose the right office .

Botox

thrillhill

Turning Back the Hands of Times!!! - Fairfax, VA

I want to turn back the hands of time and had botox injections in my forehead. Dr Sundaram was very knowledgeable,polite and professional. Very easy to talk with and seem to truly care. She listen and was very friendly and pleasant to talk with. The injections were painless and I noticed results within days. I was quite pleased with the outcome.

$400Botox

Kathy Miller

Botox Injections to Forehead Wrinkles - Fairfax, VA

wanted to see if it would erase age lines between my eyes. I decided to try it and discovered it was not as painful as I had anticipated. I was very happy with the result and plan to continue to get regular treatments for the troublesome area. The office was clean and the staff very nice. I have referred friends to this office.

$300Botox

michaelp54

Excellent Injector - Kensington, MD

Dr.Sundaram actually takes the time to get to know her patients and listens to what they have to say. She has steady hand and makes an excellent injector. I hardly felt anything at all afterwords - no bruises or bumps. Is very attentive and she asked me all the right questions demonstrating a high level of intellect and overall knowledge of health and well being.

$2,240Collagen Injection

Mindshift1955

60 Year Old with Two Grown Sons - Falls Church, VA

I am a little happy but not totally because the out come of the fillers is not what I expected.During my evaluation, I will request more filler for my under eye bags. I am not fully satisfied with what was done on July 13, 2015. I did express my concern about the under eye once the procedure was completed.

$2,000Chin Liposuction
TheresePower

TheresePower

Thrilled with Liposuction for Jowls - Fairfax, VA

My jowls were really ageing me. Finally decided to really do something about it. Non invasive procedure had not shown measurable results, for me. Had a liposuction procedure 6 days ago, and from the day after could see immediate improvement, when I removed the compression garment and dressing to clean the area. I had been very anxious leading up to the procedure, and worried that I might not be pleased with the outcome, and then might be "stuck" with it. I have to say the procedure itself was very tolerable, and done under local anesthetic. Dr. Sundaram made sure I was comfortable throughout. There has been some expected and relatively light bruising which is already fading. There was very little drainage post op, literally drops of fluid. I have not had a pain pill at any time. The procedure will be followed up with skin tightening laser treatments, but already it looks 100% better and much firmer. My understanding is that the tissues will tighten and remodel further over the next six months. I thought the procedure would have more downtime, and pain attached, but I am more than ready to go back to work, already. For me this is a highly effective procedure, and Dr. Sundaram is a master, with an artistic aesthetic eye, and top notch medical skills. Her staff were also very attentive and kind, and fully answered my every question, making me feel supported and educated. I am thrilled that I finally went ahead and did this for myself, and am so happy that I put my trust in the expert, and gifted hands of Dr. Sundaram.

$1,200Restylane Lyft
Mel4466

Mel4466

Perlane and Boelotero - Rockville, MD

I have seen Dr Sundaram for fillers in the past and was happy with the results. Last fall they were having phone problems and I went to a plastic surgeon for filler...big mistake. I was ok but not pleased. I recently had an appointment with Dr. Sundaram and she removed the filler and did her magic! Was I there a long time ? Yes, however she made sure I was numb and took her time. I am amazed with the results and how great it makes me feel.

$5,000Fraxel Laser
Veronica62

Veronica62

I Had Fraxel Repair Done 8 Days Ago

I had this done in Norther VA, prices are generally high here. My doc had done about 50 of these types of procedures, I'm 46, at the bottom end of the recommended age range. Fair skin, which I was told has the best results. The procedure itself, with numbing mask, then numbing cream was excrutiatingly painful. It was pretty short though, about 10 minutes. Afterwards, even though it looked really horrible, it wasn't really painful, just uncomfortable. The first two days, like everyone else, my face looked like hamburger. My skin actually blackened too. Ick. Hard to sleep b/c of the every 2 hour vinegar and water rinses, which hurt the most the first day. I kept them in the fridge, which started to be soothing after day one. I got different creams from the derm, Aquaphor being the main one I used the first two/three/four days. I took a shower and washed my face and hair after 24 hours. No probs. I had a swollen face, so when I went back on the 4 day appt, the derm gave me a four day course of Prednisone. Very helpful. No Ibuprophen etc. though. I ended up not liking any of the creams (including Pyratine 6, very expensive and not worth it) the derm gave me. I started experimenting with my own creams on day 5, the Origins Doctor's line. I used up the whole jar of the Night Health cream, it was very effective in emulsifying the skin, getting rid of the dead stuff. I just put masses of it on, and it would get absorbed, the dead skin could just be washed off. Day 6, I was still very red, but I wasn't scary looking, and could go out with makeup. I used the green Smashbox Primer, which tones down red skin, also is very moisturizing. I hear Eucerin has a green conditioner, same principle. I'm at day 8, and my skin is still quite red (like a moderate sunburn) and slightly burning feeling, but really looks good. Age spots are pretty much gone. I had a bunch on the side of my cheeks. I just have to keep an eye on the makeup, b/c it doesn't last too long. Maybe 3 hours. But, I'm amazed at how the makeup is in fixing the redness. My neck is still swollen, but most of my skin has lost the super scaly look that characterized the last few days. Still some superficial peeling, but not much. No scarring, not pigmentation, nada. I was told my derms other procedures went the same way. Can't say what the long term results are going to be, but the procedure's not too terrible, and I am seeing some improvement in my skin even at this point. Maybe too expensive for the results, I'll have to wait and see to make that decision.