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Thanks for this honest - and fairly&nbsp;frequent -&nbsp;question. Kybella is a treatment to biologically destroy fat. Your body's biological response is an 'inflammatory' response, which means: swelling. If you didn't have swelling after a Kybella treatment, it means it won't work! That can be a surprise for many people, so I feel it's worth repeating: no swelling after Kybella means no results. The time your body takes to reabsorb the swelling - and the fat! - can take six or eight weeks, possibly even longer in some people, and for this reason, repeated treatments are recommended when the swelling is resolving and there's still an undesirable degree of fat.
So, counter-intuitive as it may seem, the more swelling you get, the more you should look for a good response in the end.
As always, consult your treatment team for the correct expectatons for your individual results.

It was done by medical doctor, what do you suggest me doing I want my chin look perfect Thank you!

I had Kybella done twice and I feel like it looks worse than before.

Thanks for your question. There are already a couple of generations of technology designed for tattoo removal:&nbsp;Q-switch, Pico-switched and they achieve impressive results. In your case, I'm seeing&nbsp;a couple factors that ought to get you a good result.
First: it's&nbsp;black ink,&nbsp;the color most&nbsp;susceptible&nbsp;to laser treatment. Blues and greens usually also respond with a few treatments, while reds and yellows may need the newer generation (Pico-switched) devices to get acceptable results in fewer sessions.
Second: it's small. The laser delivers ink-busting energy through a&nbsp;handpiece&nbsp;which&nbsp;covers only a certain area. A whole-back tattoo, for example, is going to take a lot more time because the handpiece&nbsp;has to go spot by spot, and you'll want a good playlist to get through it all!&nbsp;
The cost and number of treatments are determined by your provider, who can also provide clear,&nbsp;realistic expectations for the treatment itself as well as the care you need to provide to allow for optimal healing. Good luck!

how much would it be for 4 small letter and how many times would you have to come in to get treatment how much would it be?

Tattoo on my finger and it looks terrible and need it gone, it has one bold letter and the rest is fading. Advice? (photo)

This is a good question and raises an important&nbsp;issue.
First, lasers should not in general&nbsp;treat&nbsp;moles, since the melanin&nbsp;in the&nbsp;cells will absorb the laser energy, as you experienced. This creates a minor burn, the superficial skin layer falls off, and the pink skin below is healing, regenerative tissue.
I could not tell you if the pigment will return when this wound completely heals: the color you are accustomed to may or may not come back! This is a detail that should be discussed ahead of time when you are doing your initial consultation.
The healing process may take another 10-14 days. during that time keep it moist with Aquaphor (or similar product) and a triple&nbsp;antibiotic ointment (Neosporin, Bacitracin, etc.).&nbsp;
This should be looked at by your doctor (or Dermatologist) for follow up -- and sooner if it appears to be getting infected.
 
Best of luck!&nbsp;

I had a laser hair removal, after the appointment I felt my birthmark like a scab it hurt here and there; minimal pain though. Three days later it fell off now I have open skin looks like a little pink hole the size of my birthmark. Is this normal if so what can I use to treat the are and will my birthmark disappear forever?

I had a laser hair removal and my birthmark/mole fell off. Is this normal? (Photo)

Based on your&nbsp;information,&nbsp;the amount of botox placed sounds about right. You should notice&nbsp;some difference with your eyebrows after 7-10 days. However, some patients do&nbsp;not respond as quickly and might take two&nbsp;weeks to see a true difference. If you have&nbsp;not noticed a&nbsp;difference by now,&nbsp;follow&nbsp;up with your provider to discuss this&nbsp;issue.&nbsp;

It cost me $500. The dermatologist told me it would help to lift the eyebrows and open the eyes. She Injected 33 units around my eyebrows and eyes.

Had Botox for the first time to help to slightly lift eyelids/eyebrows. It's been 14 days and I have not noticed a difference?

Laser hair removal causes no fertility problems for men.
Laser treatment&nbsp;directs bursts of energy to the skin (epidermis and dermis) only. Sperm production in the testes is anatomically remote and completely unaffected. This is an understandable&nbsp;concern, as you are likely to have heard that sitting in a hot tub or bath can heat the testes and lower sperm counts. Because laser treatments&nbsp;are essentially pinpoint energy pulses, it would be like lighting&nbsp;a match in New York and not&nbsp;feeling&nbsp;warmer in Philadelphia.

Can permanent hair removal make a guy sterile? Has this happened before?

Permanent hair removal on a man's genitalia?

Your laser treatments are aimed at destroying hair follicles under the skin. The&nbsp;follicles themselves&nbsp;have natural growth cycles, and these are permanently removed when timed correctly.&nbsp;
The hair itself however will continue to grow from a follicle for a period of time until it actually dies. Since&nbsp;shaving removes only the portion of hair growing out from the skin, it is safe to continue to do so until the follicle dies.
You should remember however that your skin will produce new follicles, which is why laser hair treatments are properly called "permanent hair reduction" rather than removal.&nbsp;

I have gone through laser treatment of my chin and upper lips 3 days ago. As a female is it okto shave my uoperlips n chin post laser. I have to go to work. Cant wait for shedding.

Is it OK to shave as female? (Photo)

This is a tricky concern with several good solutions!
Microblading and permanent makeup can provide you the fuller appearance you are looking for. Because you are considering a permanent enhancement, you might find&nbsp;the expense to be a worthwhile investment in a look that makes you happy!&nbsp;
You can already go to a makeup bar and for a low cost gain&nbsp;a temporary look. Once you know what suits your face, over the long run you will save money (and time each day!) with a permanent fix.
As always do not settle for anyone who does not have a current state licensure to guarantee the highest standards in safety procedures, follow up care and expert consultation.&nbsp;

My picture is attached. As you can see, my brows are practically nonexistent. I want a natural looking, not too expensive solution. Is microblading a good option?

What is the best and most natural looking process to repair thin, sparse eyebrows? What about microblading? (Photo)

Thanks for asking - this is a hot topic and a great question.&nbsp;
When you choose to have permanent makeup performed by a licensed and experienced&nbsp;specialist, the&nbsp;pigment applied is&nbsp;comparable&nbsp;to the tattooing process, so the&nbsp;safety concerns are equivalent. Think of iit this way: each day, when you put on&nbsp;lip liner or eyebrows, you are already&nbsp;applying&nbsp;safe, gentle and licensed&nbsp;products - with no real risk involved. Permanent makeup exposes you to fewer chemical applications over time!
There is a minor&nbsp;risk&nbsp;for infection&nbsp;as there is with any procedure involving a needle, however,&nbsp;licensing standards are designed to control and prevent this. Always research your licensed professional to assure yourself&nbsp;they&nbsp;meet their state requirements. Beyond that, you can get a good sense of their dedication to professionalism and experienced training which a good provider regards as paramount.&nbsp; 
Finally, you must be in good health (and not currently prengant!) to be a candidate for this procedure.

Is it dangerous to get lip liner or eyebrows tattoed? Does it have any health risks?

Permanent makeup. Is it dangerous to get lip liner or eyebrows tattooed?

You have already done a nice job of identifying some of&nbsp;the causes of skin damage. There are intrinsic factors such as your genetic predisposition that affects how quickly your immune system repairs damage, the elasticity of your collagen (the net that keeps your dermis supple), and how fast your skin itself ages.
There are external factors which might be a little more under your control: exposure to sun, smoke, humidity are just a few things.&nbsp;
A dermatologist is the right specialist to begin with, as their training and experience is directly related to your skin's&nbsp;health as well as problems (thyroid, immune conditions) that directly show up in your skin.&nbsp;
&nbsp;Once you have had a complete medical evaluation, a wonderful option is fractional laser treatment. This sends energy pulses into your dermis, the support layer under your skin, and triggers your body into repairing older collagen and stem cells. The options are 'ablative' and 'non-ablative'&nbsp;which permit&nbsp;either shallower or deeper repair mechanisms to get to work. Find the right medSpa or dermatologist to review which options will work best for you.

The issue is mainly on my forehead. I'm not sure what caused this, I have struggled to find information about it online because I can't find anything that looks similar. I have had a lot of sun damage in my teenage years and also had acne. Im guessing genetics play a role as well. I am now 28 years old. What does it look like the problem is? Have you seen this before,? What are suggestions for fixing it? Is dermabrasion a good option?

I have very rough-textured, loose skin with scars and wrinkles. What is wrong with and what can be done to fix it? (photo)

Great question. Microneedling,&nbsp;an excellent choice with&nbsp;a proven track record for success,&nbsp;allows skin to rejuvenate, and is a natural, biologic process.&nbsp;A common misperception is results are going to be immediate. In fact, three is just a start and you may be surprised to know six is an optimal number of treatments. You can expect very nice results once you have had the full course&nbsp;of treatments.&nbsp;
Another aspect of this is the fact that the more dramatic scarring you have, the faster you will see results, and so comparing before and after shots may reveal a better result than you imagine! One option to enhance the results is PRP: platelets from your own blood sample act as stem cells. They contain growth and healing factors and augment the effects begun with microneedling.&nbsp; 
Starting yourself on microneedling&nbsp;in the first place is the right move.&nbsp;Allowing your immune system to work its magic may take time and patience. And, as always, you should keep in mind that individual results vary based on age, degree of scarring, sun, smoke or other environmental&nbsp;exposure,&nbsp;

A board certified dermatologist performed 3 treatments. There was blood. My scarring is mild. Each treatment has been 6-8 weeks apart. No prp or growth factors were used, but to my understanding, results should still be there. What gives?

How come I've seen zero results with microneedling?

Julian Orenstein, MD

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