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Hi,
Thanks for your question and sharing your pictures. Lip asymmetry can be fixed with a variety of dermal fillers. You have naturally full lips so I would advise a consultation with an experienced cosmetic dermatologist or plastic surgeon near you to discuss which dermal filler would give you the optimal results. I hope this is helpful and wish you all the best!
Kevin Cavanaugh, MD

Is it possible to fix my asymmetrical lips with Juvederm? What are some other alternative solutions? I've had braces and that did not seem to fix the problem.

Is it possible to fix my asymmetrical lips with Juvederm? (photos)

Hi,
The indentations you have are temporary and should go away with time. If you notice they are persistent I&nbsp;recommend you make an appointment with your injector / dermatologist to have them assessed.&nbsp;
Best,
Kevin Cavanaugh

I had a face mask on for part of today and after I removed it I noticed an indentation from where the mask was sitting on my forehead. It's been a few hours and it's still there. Is this going to last for then the next few months or will it go away?

I just had Botox injected in my forehead 3 days ago. Are the indentations in my forehead permanent?

Hi,
Dropping after Kybella is possible and is a side effect of injection around the marginal mandibular nerve. Typically this side effect is temporary, but I&nbsp;would recommend calling your injector to have a formal evaluation in clinic. They can discuss with you what to expect and the typical duration of symptoms. Time is typically the best medicine for this type of side effect. In our clinic we see patients in follow-up from 10-12 weeks because we do not notice maximum fat loss and skin tightening until this time point. I&nbsp;would expect improvement in&nbsp;your symptoms (or resolution) by this time point. I'm sorry you had a bad initial experience and hope you are happy with the final results. Best of luck!
Kevin Cavanaugh, MD

I received Kybella today and as of this evening the left side of my smile is drooping and numb when I try to relax my face. This is not present on the right side at all. Is this permanent?

Left side of my face drooping after Kybella?! Is this normal? (Photos)

Hi,
Thanks for your question and sharing your pictures. Dermal fillers under the eyes typically swell quite a bit and this can last up to two weeks. Product choice in this area is quite important. Juvederm under the eyes will often absorb water and end up looking puffy/swollen. At this point I&nbsp;would recommend ice and an antihistamine, like zyrtec, to help expedite the resolution of the&nbsp;swelling. If you still have considerable swelling /puffiness after two to three weeks I&nbsp;would follow-up with your injector to discuss your concerns. Hyaluronic acid based fillers can easily be dissolved with hyaluronidase. I&nbsp;hope this is helpful and wish you all the best!
Kevin Cavanaugh, MD

My left eye has a puffy bump close to the corner of the eye. The right eye looks great other than the injection spot.

Is this a normal amount of swelling for tear duct Juvederm filler treatment?

Hi,
Thanks for your question and I'm sorry you had a bad experience with your first Kybella injection. Based on your description you have injury to the marginal mandibular nerve. When injected on label using the grid system provided by Allergen this is a rare side effect. If the injector explained to you that he/she was going off label to inject a pocket of fat around this nerve then it is more of an expected side effect. I&nbsp;have heard from most injectors that this side effect is temporary. That being said, I&nbsp;would still call your injector and explain what is going on. They should bring you back into clinic and do a full assessment. If it is the marginal mandibular nerve, time is usually the best medicine. In terms of your second session of Kybella, I&nbsp;would wait it out and see how things shape up after the first injection. At our clinic we only inject four vials to start and typically wait ten to twelve weeks to see patients in follow-up&nbsp;because in our experience maximum fat loss and tightening do not occur until this time point. Swelling can also last several weeks. I hope this helps and wish you all the best.
Kevin Cavanaugh, MD

Received first Kybella treatment yesterday, experienced immediate paralysis of mandibular nerve. During very start of procedure, tasted a strong metallic on underside of mouth exactly where she was injecting product. I told her immediately that I was tasting it. She stated the reasoning was because of it being a shallow fat area. She suggested Botox to even it out. Shoul I run far &amp; fast from this Dr? Now drooling when I drink/eat &amp; awful crooked smile, hoping no permanent nerve damage done.

Experienced immediate mandibular paralysis after Kybella. Should I be trusting this Dr to perform the second treatment?

Hi,
Thanks for your question and sharing your pictures. It appears you had a significant bruising after your injections. This can take several weeks to completely resolve. I&nbsp;recommend you speak with your injector about the use of a laser to help expedite the clearance of the bruises (IPL/BBL or excel&nbsp;V). The next time you undergo injections I&nbsp;recommend speaking with your injector about your bruising and request they use a cannula. Use of arnica and topical vitamin K can also be helpful in preventing bruising and treating existing bruises. I'm sorry you had a bad experience and wish you all the best!
Kevin Cavanaugh,&nbsp;MD

Staining under eyes after injections, looks like permanent bruising ? Seven weeks after!&nbsp;

Have you ever seen damage under the eyes after injections? Can it be corrected? Possible broken capillaries? (photo)

Eye Bags Treatment

Hi,
Thanks for your question and sharing your pictures. Unfortunately, there is no true permanent or semi-permanent solution to fine lines and wrinkles. I&nbsp;recommend regular use &nbsp;of Botox to&nbsp;soften fine lines on the forehead, glabella, and around the eyes. Botox will work quite well for dynamic lines (noted with movement), but will not completely soften more etched-in lines. For the latter, I&nbsp;recommend a laser resurfacing procedure. The&nbsp;shadowing underneath the eyes and worsening&nbsp;NL folds is the result of volume loss as we mature. This&nbsp;can be improved with dermal fillers&nbsp;or with fat transfer. The latter is a longer lasting solution, but&nbsp;can be quite difficult to perform and if the fat does not take correctly results can be disappointing. If you elect for this procedure I&nbsp;recommend you see a dermatologist or plastic surgeon that&nbsp;specializes&nbsp;in this procedure. Dermal fillers will not last as long, but the results are more predictable. In addition to the above I&nbsp;recommend you speak with a dermatologist about a strict topical regimen of products that will address existing sun damage and help prevent further damage.&nbsp;I hope this is helpful and wish you all the best!
Kevin Cavanaugh, MD&nbsp;

I am 32 years old and interested in addressing my sun and age-related facial issues. I would prefer to stick to techniques that would have a longer lasting impact than, say juvederm or other temporary fillers. My nasolabial folds are genetic and I've had them my whole life. Light wrinkles started in my mid twenties, likely from having a very expressive face and being out in the sun a lot. Would a laser treatment address these issues? Or would I be better off with fillers/fat X-fer?

What would be the best semi-permanent solution for forehead wrinkles, nasolabial folds and aging around the eyes?

Hi,
Thank you for your question. The type of filler used in the marionette lines really depends on the severity of the lines. Deeper lines can be treated with a thicker&nbsp;product, like Radiesse, and more subtle lines with Restylane. At our office we do not use Radiesse because we find it to be a bit harsh and find it&nbsp;sometimes gives patients an unnatural result. For deeper lines in the lower face we will often use Voluma (sometimes layered with another product). Botox can also be used in the lower face &nbsp;(the DAOs) to soften marionette lines. Depending on the severity of marionettes and the skin tone/texture we may also recommend a series of chemical peels or&nbsp;laser resurfacing procedures to soften these lines. I hope this is helpful and wish you all the best.
Kevin Cavanaugh, MD&nbsp;

Which works best for frown lines/marionette lines &amp; around mouth Radiesse or Restalayne

Restylane vs. Radiesse for marionette lines?

Hi,
Thanks for your question. I recommend you see a board certified dermatologist in your area for further evaluation and treatment. It is unlikely that one bout of insomnia had a significant / lasting effect on your filler. Depending on how long it has been since the filler was placed you may need more filler (from continued volume loss and filler breakdown). Restylane typically only lasts 9-12 months. The Voluma should last longer, but typically lasts less than 24 months. In the studies of duration of effect conducted by Allergen patients had an average of 5-7 syringes injected and this likely contributed to the duration of results. I hope this helps!
Kevin Cavanaugh, MD&nbsp;

So the other day I did what I HAVE not done since getting my fillers back last year (Voluma in midface and resty under my eyes). I played basketball only on three hours of sleep but for 8 hours straight (was up roughly 20 hours to break my bout of insomnia to tire myself out fully). The next day up till now my preexisting malar bags are 50% worse than they have ever been, especially on the right (could this be moved filler or sudden slight aging due to such high stress?)

Induced sudden aging or movement of my HA fillers to malar areas?

Hi,
Thanks for your question and sharing a picture. Botox can take up to a week to take effect. It is also important the injector placed the Botox in the correct area and used an adequate amount to soften movement in the desired location. When you first start Botox sometimes a touch up is&nbsp;required. The facelift and the cheek fillers do not have an effect on the Botox.I hope this is helpful and wish you all the best.
Kevin Cavanaugh, MD

I've had a facelift and cheek fillers, could this be a contributing factor? It seems like I have a lot of wrinkles in my eyelids that look like the same as my crowsfeet

My Botox isn't working around my eyes. (photo)

Kevin Cavanaugh, MD

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Dermatologic surgeons are dermatologists who use surgical and nonsurgical means to treat various skin, hair, nail, and vein conditions. This includes growths, skin cancers, aging skin, unwanted fat, excess hair, and varicose veins.

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