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It would be too early for hyper pigmentation. Melanin would not be produced this fast. Vaniply or Aquaphor are the best for your skin at this time. No aloe vera or other homeopathic topical are recommended. &nbsp;Dr. Spera

I had a 25% mandelic acid peel. Used before. I forgot I used salicylicacid serum 2% morning of on problem areas near chin- those are the areas visibly irritated. During peel patches looked white, thickened, and raised. After rinse skin was still white. It later turned red and I put aloe vera + occlusive before bed. Photos 12 hr post peel. Areas are sensitive and dark not bright red, smooth. I alternate tretinoin cream and AHA serum nightly. I have L-ascorbic based Vit C, can this help/irritate?&nbsp;Will I have patches?

1day PO Chemical Peel-Is this a burn or hyperpigmentation? What to do to get my skin back to normal (photos)

Thank you for the excellent question. &nbsp;Fat is an alternative but it is quite a bit of volume and some, all or very little of the grafted/transferred fat may survive. &nbsp;Silicone cheek implants are an excellent choice to permanently augment the cheek area. They are placed thru 2 small incisions in the mouth under local anesthesia, sedation or general anesthesia. &nbsp;They come in many different shapes and sizes.&nbsp;
&nbsp;Dr. Spera

I’m interested in getting either cheek implants or fat transfer to the face, as I’m tired of spending money on 3 syringes of Radiesse each year. Radiesse is a rather harder filler which causes a lift much like bone would, which makes me feel that only cheek implants can replicate that. Is it possible fat transfer to the cheeks could replicate the lifting affect Radiesse has?

Does fat transfer to the face cause a lifting effect as much as cheek implants do?

Provided you are a candidate the PermaLip implant is an excellent option. &nbsp;There are 3 diameters 3 mm, 4 mm, 5 mm. &nbsp;Placement is very straightforward and can be done with local anesthesia. We have treated many patients with PermaLip and they have been very pleased. &nbsp; Dr. Spera

seeking <a href='/reviews/lip-augmentation'>fuller lips</a>. tired of injections that dont last. what is permalip, is it safe, how much does it cost?

What is PermaLip Lip Augmentation?

The asymmetry of the lip will carry over if an implant is used since this is for volume only. Fillers are the best option to correct any asymmetry. &nbsp;Dr. Spera

I really don't care about inflated lips just want them to be even and full and look attractive

I have uneven lips and would like to make them even. Would Permalip be a good option?

Thank you for your question. The outcomes for fat transfer/grafting can be very variable especially for larger amounts. I would recommend a more permanent solution to restoring or increasing volume in you cheek area. Cheek/malar&nbsp;implants prove to be a wonderful treatment option for the situation that you are describing. There is very little downtime and recovery is typically 5-7 days. The look and feel are incredibly natural. Best, Dr. Spera

My question is for surgeons who perform fat grafting. I ask this question I'm interested in cheek and hip augmentation. I am very thin and look that way on superficial examination. Although my surgeon says that I have little fat, I notice what appears to be a lot of belly fat on my abs. Note: my surgeon hasn't yet examined me there. I'm 35, 109 lbs, and 5'9. I am also type 2 diabetic. My endocrinologist and I suspect that I also have lipodystrophy. The most I've ever weighed before is 150 lbs.

If a patient has a documented case of lipodystrophy, might you be willing to perform fat grating on them for cheek augmentation?

Thank you for the excellent question. The Implant comes in 3 different lenghths ( 55,60,65 mm) and 3 different diameters (3,4,5 mm). The selection of the correct size is based on an experienced surgeon carefully evaluating the patient and of course the patients desire in terms of volume increase. &nbsp;The previous fillers do not have to be dissolved before permanent lip implant placement. &nbsp;Best, Dr. Spera

I have lip filler but I want to do permalip soon. Do I have to dissolve all the lip filler first or does it not matter? Will it cause problems during surgery if I have filler?

Interested in Permalip. Is it necessary to remove lip filler first?

I like sequential staging of minimally invasive therapy. I would say that a light glycol peel would be ok 2 weeks after micro-needling. &nbsp;This is entirely dependent on your skins response and healing after treatments.

I just had my first microneedling session and it was great. They did it with the pen needle thing, applied anesthetic and used Hyaluronic acid during the treatment as well. I’m coming back for another session in 4 weeks. Would it be okay to do a 30% Glycolic acid peel after 2 weeks of healing from the microneedling, then 2 weeks of healing from the acid peel and repeat? I read a study online that Glycolic acid peels coupled with microneedling is great for your skin.

Can I do a 30% Glycolic acid peel between microneedling sessions?

Thank you for the question. Typically with the appearance of this scar surgery versus injection would be indicated. Injection can help but the scar has to be revised. Dr. Spera

I have injected 5-6 injection and using silicon get too its bit reduced though kancod injection but not cured. I am planning to go to surgery for the same, will it be safe to do surgery, or there are chances of reoccurrence.

Would surgery fix this hypertrophic scar below my lips? (Photo)

Scar Removal

The best procedure for resurfacing can be laser, radio-frequency based treatment or chemical peeling. This can only be determined after a complete and through examination. &nbsp;
In terms of the best filler that also would depend on the amount of volume loss in the face the options would include Juvederm Volume, Bellafill or Juvederm XC. &nbsp;In some instances I recommend silicone implants to the cheek/malar area. This gives a long lasting permanent result that is very natural in appearance.

In your opinion: What is the best procedure to have for resurfacing of the skin and why? What is the best procedure/most effective to have for collagen and Elastin production and why? What is the best filler to have for loss of volume in the face, around the cheek area which has caused nasolabial folds and marionette lines and why?

Skin resurfacing: Collagen/elastin production and loss of volume in the face?

Thank you for your question. Swelling in the peri-orbital area (malar/cheek area) typically lasts a bit longer than other areas of the face due to the nature of the lymphatic system in this region. The swelling that you see now will resolve. &nbsp;Keeping your head elevated and using warm moist compresses &nbsp;will encourage fluid movement and resolution.&nbsp;

Can active FX laser cause permanent swelling? I had procedure done a month ago and still have some swelling on upper cheekbones

Joseph F. Spera, DMD

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