James D. Wethe, MD

Without examining you and photos from before your surgery it is difficult to make a determination of exactly how much improvement you have had. Despite this, I can see the residual skin/fullness in the area under the chin and understand how you would have wanted this to be "better'.  Ask your
surgeon what they see and what options they can come up with to make that area improve.  There are some new radio frequency devices that can tighten skin (Thermi RF, NeckTite) as well as the
option, perhaps, for something like Kybella.  Kybella could melt any residual fat and several physicians have reported skin tightening when using it. Hope this helps-

J. Wethe, MD

Looking at your photos and age I would have to suggest either non-surgical or minimally invasive types of treatment to consider initially.  There are a number of non-invasive methods such as Ultherapy that may help, or minimally invasive techniques such as radio frequency devices that can tighten skin (Neck Tite is one of them).  Best idea is to see a plastic surgeon who can go over all the options and then, having examined you, can help you with formulating a plan that works for you.  Hope this helps.

J. Wethe, MD

Hmmm..."sagging lower eyelids" are most commonly helped by surgery whether it
is tightening of the lower lid support structures or excision of excessive skin.  Removal of fat in the lower lid is also done on a conservative basis if that seems to be the problem.  Each of those answers
are, of course, surgical.  There ARE non-surgical options if the "sagging" is mild. Skin crinkling can be addressed by laser resurfacing.  Some of the non-invasive energy devices such as Ultherapy® can be used to provide some effect but the real answer is to see a physician who treats lower eyelids for a consultation and then go over both surgical and non-surgical alternatives.


Hope this helps

J. Wethe, MD

Hi...
Burning pain is not what I usually expect patients to report.  Commonly
there will be some tenderness to the lips and a bit of swelling but
don't hear "burning sensation" from these patients.  If you have a color
change, significant pain or even if you are a bit concerned the best
option is to contact and go see your provider so they can examine you
and make sure everything is OK... that is what I would
want my patients to do.  Hope this helps.

J. Wethe, MD

As unfortunate as your experience was, bruising is not related to which type of neurotoxin that was used.  It may be related to other factors such as recent aspirin, Advil, Motrin, ibuprofen, Aleve ingestion which can lead to more bruising and bleeding with any infection.  Some bruising is fairly common, but they are usually fairly small.  Occasionally every practitioner will have a larger bruise on a patient...which no one is happy about, patient or practitioner.  

J. Wethe, M.D.