Jennifer Guthrie, MD

There is a short list of things you shouldn't do after Botox/Fillers, your provider will usually give you post treatments instructions and have you sign them making sure you understand the liability.

Excessive heat, sweating, strenuous activity, saunas/jacuzzis, alcohol based facial products, pressure on the face such as getting a massage, and sleeping on either side of the face is to be avoided for the first few days. Don't try to mold or move the filler as it needs time to settle. Refer to your practitioners post care instructions. 

The answer to this is more complicated because each persons anatomy and genetics are different. 

"Smokers lines" or vertical lip lines are in fact genetic, so when treating them thats what you have to keep in mind. You cannot treat them with a one size fits all approach. Some of my patients do well with a thin filler, but the problem lies in the "location" of the lines, they usually split down the vermilion border, and when HA fillers are injected here it usually creates a certain look some would call the "duck effect", some people like this look and some people hate it so it's very specific. Some of my patients do better with threading in this area though you don't get the instant gratification of fillers, you get a more natural look later on after a few treatments. It is all preference really. 

Since you are so young it wouldn't be cost effective or reasonable to start you on dermal fillers for the rest of your life. I would say get a Vampire Facial 2-3 times per year and that is all the anti-aging maintenance you will need for a long while, you can of course couple this with Botox if wrinkles bother you, but at 18 years old you probably don't have an issue with skin laxity or wrinkles. Enjoy your youth while you have it. 

Unfortunateley Botox will only treat the crows feet, the wrinkles under the eye are caused by a two edged sword of skin laxity and loss of volume under the eye and in the cheek area. It is a good idea to keep up your regular Botox treatments but you can add in a little filler in the cheeks and PRP/Micro Needling or some laser to resurface the skin under the eyes. Its not an overnight process but after a few treatments you should start seeing a difference. 

This is an area I never use fillers due to the sensitivity of the ocular nerve, and its surroundings. I usually do PRP injections coupled with micro-needling. To remove excess skin from the under eye region surgery is the most effective by far. You can dissolve the filler with hyaluronidase but if it has been multiple years than what you are seeing probably is not a hyaluronic acid based filler and needs to be addressed differently. 

You have a few options in this realm, H.A. filler, semi-permenent fillers, and permenant fillers that bond with the bone to create new shape. I would start with H.A. fillers such as Restylane Defyne® or Juvederm Voluma® to see if the new look suits you, if so just take a few pictures then schedule the surgery because no matter what the fillers will metabolize and you will have to re-do every year or two. 

Hope this helps.

We do our micro-needling with autologous platelet rich plasma, if your micro-needling treatment was done with only a peptide gel (or something like it) than it is not as reactive, and the inflamation response is not as important. But it is still a good idea to wait and let your skin heal naturally without any harsh acids or alcohol based compounds.

Pain is a normal factor in lip augmentations, it is something to be expected. Bruising and swelling are usually worse with Juvederm products because they have pre-mixed lidocaine in the syringes. While it may help a bit with the actual injections, it causes allot more swelling immediately upon use, and creates a massive inflamation response in some patients resulting in bruises and unnecessary swelling. The swelling will push on nerve endings, which will cause the pain you are feeling. Wait a couple of weeks, apply arnica gel, and then return to your practitioner. Cheers

Everyone is different, the longevity of paralyzation your muscles will experience is based on your metabolism for the most part. The "average" is 3 months. I have patients who last nine months and I have a couple that last 3 weeks. I have a fast metabolism and my Botox seems to bareley make it a month. The theory is that with continued use you can achieve a more steady state of facial muscle atrophy, but this is just a theory. Hope this helps.

These are not dimples at all but rather something I call hollows, basically it is just a genetic form of volume loss. Very typical and easy to fix. A cheek filler such as a thicker restylane or voluma can fill them in. Don't go to permanent fillers for the first injection, get something non permanent so you can see if you like how it looks. By filling your upper cheeks it will also have the added effect of pulling your jowl line up from the added volume displacing surface skin area, which will also define your jaw line. (Just an added bonus)  

PS: One side is worse than the other because thats the side you sleep on for most of the night. Just an observation ive made over the years. 

Good luck! 

Cheers from Palm Beach