Henry Lee, MD

Cosmetic Botox injections have not been studied in pregnant or breast-feeding women. It is not known how much Botox enters into breast milk. Similarly, it is not known how long it would take to leave your breast milk. 

Therefore, it is definitely not recommended to get Botox at this time. Congratulations on your baby!

Thank you for your question. Yes, a small amount of Botox into the frontalis muscle, which lifts your eyebrows, can be used to slightly lower a brow. There is a very small risk of eyelid drooping (aka ptosis) when Botox is injected to lower a brow. However, a more likely cosmetic effect you may notice when your brow is lowered is the appearance of more significant upper eyelid skin. Try this at home - look at your upper eyelids in the mirror while raising and lowering your brow. The higher your brow, the less skin there is resting on your eyelid. The lower your brow, the more skin there is. But again, actual eyelid ptosis is unlikely.

Good luck with your Botox injection! 

Yes, the knee area can be treated with CoolSculpting. The CoolMini applicator is used in this region. Of course, an in-person evaluation is necessary to determine if there is adequate pinchable subcutaneous fat.

Good luck with your treatment!

Thank you for your question. I would say that for most patients, the diamond configuration is the most appropriate placement of the CoolSculpting applicator. Of course, the best way to plan your treatments is via an in-person examination, where your abdomen is palpated and the best orientation of the applicator placement is determined by how pinchable your tissues are. I have also seen good results with vertical placement of the CoolFit applicator on the abdomen.

Everyone's abdomen is different, but if your CoolSculpting rep examined you and recommended the diamond configuration, that's most likely the best way to go!

Good luck! 

Thank you for your great question. Each office is different, and you will find many offices where a technician performs the CoolSculpting treatment, and others where the physician (MD) performs it. Technically, since it is a Class 2 device, a physician does not have to be the person to do it; however, there still needs to be medical supervision for the treatment.

In my office, I perform all of the CoolSculpting treatments, but this was due to my strong preference to be the providing physician for all procedures performed at my practice.

From your photos, I can appreciate what you see. There is some slight hollowing directly above your cheeks. A conservative amount of dermal filler, such as Restylane or Belotero, would be helpful to add volume in this area and improve the appearance of your eyelids. However, I will stress that you require a small amount of filler, and that you should avoid excess filling in this area, as you simply do not need it.Good luck!

Thank you for your question. From looking at your pictures, it seems that you have some hollowing, or loss of volume. This is what is causing the appearance of a circle around your lower eyelids. A dermal filler, such as Restylane or Belotero, could help to significantly improve the appearance of your lower eyelids by adding volume to the areas where your eyelids are hollow. In addition, to help with the appearance of your eyelids when you smile, targeted Botox injections could be helpful. Finally, in your pictures, you also have moderate upper eyelid ptosis (drooping). This can be corrected with surgery if desired.Good luck!

I will start by saying that an in-person consultation would be the best way to fully evaluate your needs. From looking at your photo, I noticed a few details. First, your right brow is slightly higher than your left brow. This may be due to underlying asymmetry with the bony structure of your face, slight ptosis (drooping) of your right upper eyelid, or another factor. It does appear that your right upper eyelid is a little ptotic, and when that occurs, the brow often elevates in order to try to lift the droopy eyelid. I do not see much excess skin in your upper eyelids, so it is difficult to recommend a blepharoplasty procedure based on your photograph. In addition, with a history of dry eyes, you should be aware that eyelid surgery can make dryness worse, and your dry eyes should be very well-controlled prior to undergoing eyelid surgery.
With regards to your lower eyelids, I notice a small bulge in your left lower eyelid. Your right lower eyelid appears normal if not a bit hollow. Instead of surgery, I would think that fillers would be a good option to improve the appearance of the lower eyelids. However, please note that fillers in the lower eyelids are not FDA approved and would be an off-label use.

Good luck! 

Again, the most important thing for you to do would be to get an in-person consultation with a surgeon who is experienced with cosmetic eyelid surgery.

There are three different products available in the US: Botox, Xeomin, and Dysport. Occasionally, there are patients who do not have a satisfactory result with Botox. When this happens, the dosage of Botox can be adjusted. Alternatively, you can also have one of the other products injected. Don't give up hope yet! Try following up with your original doctor or find a new one who has significant experience with injecting Botox.

I'm sorry to hear that you have developed PAH, or paradoxical adipose hyperplasia. This is an uncommon adverse event after CoolSculpting and appears to occur in one out of 4000-5000 people. I would follow-up with the provider who treated you with CoolSculpting and review your current photos along with the pre-treatment photos. Once a diagnosis of PAH is confirmed, then Zeltiq can help to provide assistance for you to find and have liposuction to treat the area of hyperplasia. Good luck!