Karen Sebastian, MD

I would also suggest staying away from filler in the area.  It’s dangerous and mostly not a permanent solution.  For a non surgical approach, I would try microneedling with PRP (platlet rich plasma) OR microneedling with radio-frequency and also PRP.   

Good luck   Hope you find good results with whatever you try   

Dr Sebastian 

Hi.  Thank you for you question.   Unfortunately the answer is no.  Pregnancy is a contra-indication to doing the procedure on any part of your body and generally, any elective cosmetic procedure should wait until after delivery and even until after breastfeeding is finished.   Although many things seem like they should be ok, there are no tests done on pregnant women to prove it’s ok and it just isn’t worth the risk.   

Wishing you a happy and healthy pregnancy!   As soon as you can, emsculpt will definitely be a good option to getting your body back.  :-) 

Hi... thank you for your great question!

I have a short answer and long answer.   The short answer is Filler would prob work best if I had to choose one treatment.   

I always talk to my patients about what they can afford and how full-out crazy do they want to attack the area that is bothering them.   One vial if filler could probably soften these lines enough that you will be happy.    

We used to just fill in these lines with filler.... and someone in their early 30s can probably still get away with this route and it may be the cheapest way to go.  The correct way with filler however is to revolumize the cheeks with filler.  Perhaps one whole vial on each side and that will lift the cheeks and those wrinkles/folds around the mouth will go away.  

Also though.... I would say to be sure your skin is healthy and moisturized.  Use a good product or get a good peel so that your skin has good moisture and elasticity.   There is a aquagold and microbotox procedure that can really help with this area of the face.  

Microbotox is injected superficial in the cheeks, not the muscles, so the pores tighten, and areas treated are smoother and the skin looks radiant.   Aquagold is  similiar but there are several product injected all at once with aquagold and not just botox.

Laser rejuvenation and peels can also improve skin by exfoliating and tightening the skin.   

So if you have lots of money to spend or someone wants to spoil you, get several treatments and then you will just need maintenance every now and then.   

Start with laser or a good peel.   Then continue to improve the skin with a microbotox session.    Then if you can add volume to your cheeks with a product like Restylane Lyft or Voluma. 

If you live in the real world, and really don’t have the money right now then invest in a really good exfoliating product at home and moisturize every day. Wear sunblock and buy one vial of filler and have those lines filled in.  Or ask your injector if one vial would be enough to add volume to your cheeks.  Depending on where you live.... this alone will probably be 500-600 dollars. Could last you a year while you save up for the whole shebang.   

Best of luck!   I hope you are happy with whatever treatment you decided for on!  

Thank you for your question and for sharing your photo. 

It appears that botox would benefit the areas you are concerned about.  Botox placed in the correct areas will weaken the muscles that are scrunching the skin and causing these wrinkles.  This will allow your skin to repair itself and those lines will soften.   You should see results about a week after your Botox.... so it is not immediate, but close.  The very deep forehead line may take a little extra time to improve but you will see improvement and probably do not need filler.   

Be careful if you do decide to go with filler in the forehead area.   It is very risky and the worst possible outcome could be blindness.    Many doctor do not inject filler in the forehead.   Just make sure you find the right injector and be sure you weigh the risks and benefits.  

Good luck. 

Dr Sebastian 

Hi.  Thank you for your question.   

I would first have you make sure your skin texture and moisture are maximized.    You may benefit from a good peel or skin Rejuvenation session with a laser or microneedling.   And make sure you are using good skin care products to give you the healthiest skin possible.  

After that I would consider adding some volume perhaps to your upper cheeks if needed.   I can’t tell from the picture but sometimes adding volume to the upper cheeks will help the lower cheeks.  

Finally.... if you have truly healthy skin, and you don’t need volume, the I think microbotox would help immensely.    

Microbotox is a treatment of the lower face and neck, in which hundreds of microdroplets of diluted Botox are injected into the dermis Layer of the akin to improve skin texture, and  smoothen horizontal creases.  

So I would go the a provider near you and have them evaluate your skin in person and they can help you decide what you need and blend this with how much you want to spend.  You may need a combination of all three treatments or just the 

Good luck. 

Botox comes to us as a powder and we reconstitute it by adding sterile solution.   The amount of units per cc depends on how much solution you add.   Most providers add 2.5 cc of solution to the botox and if done in this way then every 0.1 cc of botox has 4 units in it.    A 1cc syringe will contain 40 units of botox. 

  So 0.5 cc would contain 20 units.   This is generally what a forehead may need, but it depends on the forehead.   

Hope that helps.  Have a great day. 

Hello!  Thanks for the question.

I personally set pregnant women and breastfeeding women as Off limits. I do not inject them no matter what.   It is an elective procedure and not worth any risk that it may cause, and especially the liability that could be blamed on the injection.  

Having said that.... some providers will inject and if done correctly it is probably safe.   If your injector knew you were breastfeeding, they may have used a smaller dose or diluted dose and would have been extra cautious I’m sure.  

 The injection is into muscle or just under the skin, near the muscle.  It SHOULD NOT get into a vessel and travel through the body and enter the breast milk.  But it COULD be incorrectly injected into a vessel.  A small amount into your system may not affect you,  but could effect a baby. 

There are no studies to prove whether botox while breastfeeding is safe or not.   If a baby did get a large dose of the toxin, they would have signs of botulism.   This includes, weakness, “floppy baby” with no muscle tone, trouble breathing, loss of bladder control, droopy eyelids, nausea, stomach pain and diarrhea.    

Your child may just have a stomach bug, but if you aren’t sure, make an apt with your pediatrician just to be sure.   Good luck with everything.  Hope your child is feeling better. 

yes!  BOTOX would be a great choice to even out your smile.  I would use a very small amount of Botox on the opposite side and very slightly weaken your smile on the side NOT effected by Bells Palsy.   You can always add more Botox but can not take it out.  So start conservatively.   Just a tiny bit to start and wait at least a week or maybe 2 before you decIde to add more. 

Good luck.  

if your skin is very sensitive, you could have some swelling or redness initially.   You could ask your provider to start with a very small amount in a test area to see how your skin reacts.   

But having said that, you look like a good candidate for Botox and looks like you would benefit especially to soften the lines between your eyebrows.   Good luck!  

There is nothing you can do to “Mess up” the o-shot.   

The provider just has to do the shot correctly.... that’s all that matters.  There are no restrictions after the shot.    You can have sex (or use a vibrator or other toys) as soon as you feel up to it and have the desire.