Jessie Cheung, MD

You're referring to the current FDA indications for Bellafill  - which means that the studies and safety data have been done at one year for acne scars, and at 5 years for naso-labial folds. That doesn't mean that Bellafill lasts only 1 year when treating acne scars - that's just when the clinical studies ended. Bellafill should last much longer than 1 year for your scars, and maintenance should be done when you notice that you need it - as your collagen and elastin get thin from aging and the sun. 

You can top off with any brand of botulinum toxin after 2 weeks. Botox should still work; you may just need more total Botox to relax your frontalis muscle. Comparing Dysport units to Botox is about a 2.5-3:1 ratio, so 50 units of Dysport is about the same as what you were first injected with, and you may not need that much. Instead of having Botox injected every 3-4 months, consider having filler injected into your forehead, to support your muscle, or even laser skin tightening of your forehead skin. 

When addressing the undereyes, it makes sense to treat the cheek first since the cheek supports the tissue under the eyes. A filler injection to your cheek and under your eyes will help the shadows that you're noticing. Restylane is a good choice for this area. 

There are multiple factors contributing to your skin's ability to generate collagen. Your sleep, nutrition, genetics, and environmental exposures all play a role. After controlling for smoking, sun exposure, levels of vitamin D, zinc, vitamin C, vitamin B, iron, proteins, and estrogen, we recommend topical skincare and specific supplements that promote wound healing. You can try Juven, which is an easy to find therapeutic nutrition drink mix. 

PDO threads have been used for many years to help redrape and revolumize skin, with the added benefits of collagen stimulation. PDO threads are very safe when placed by a trained physician, and they can be used all over the body. Common areas are faces, knees, chests, arms, and buttocks. 

Bellafill has published the longest and largest filler safety study, through five years, showing high patient satisfaction and long-term safety and effectiveness. It is worth considering Bellafill to replace your usual dermal filler injections, since it is much longer lasting. We often use Bellafill in the cheeks in our office, I would recommend seeking a physician who has been injecting Bellafill for many years. 

Xeomin is not a wrinkle filler, but a wrinkle relaxer. Injecting Xeomin, or any other botulinum toxin, to the thin vertical lines around the lips will relax the underlying muscle, which will to prevent the lines from getting any deeper. A filler can also be injected to fill in the actual wrinkles, or even deeper, to help smooth the lines out. Xeomin and filler are a great combination for this area, since Xeomin will help the filler last longer. 

There have been recently published studies with Radiesse that show its bio-stimulatory effect of collagen production, similar to Sculptra. Since there is no filler that lasts very long in the hands or temples, it makes sense to use a stimulatory filler so that you may have some long-term benefits. 

The O-shot, which involves platelet-rich-plasma (PRP) injected to the clitoris and G-spot, helps with sensitivity and orgasm. The effects are not permanent, since the body continues to age, along with the decline of other contributing factors to sexual health, such as hormones. The O-shot is a great start, but you should have your hormones checked, along with your pelvis, to make sure that there is nothing else contributing to your inability to orgasm. Consider injections of Amniotic Membrane Allograft, or Exosomes, which are more active, and with more long-lasting benefits. 

Yes, treating the abdomen with Emsculpt can improve diastasis recti since the abdominal muscles get stronger and thicker. It's worth seeking out this non-invasive procedure if you're not ready for surgery, which involves stitching the separated mid-abdominal muscle bundles back together, We have seen nice improvements with diastasis recti after a series of Emsculpt.