Kishen Nara, MBBS, FACCSM(Surg)

Warning: For adult viewing only.

Thank you for sharing your photo and description. I appreciate you sharing your concerns.

Filler placement in the nasal bridge may constitutes non-surgical rhinoplasty. This procedure requires immense skill, experience, precision and after-care. There is an extensive consent process involved including the potential risks and complications of the procedure. To give you an idea, even 0.1mL may make a considerable difference.

It is difficult to make an assessment without seeing you in person. Moreover, I cannot see any before injection photos to make an objective comparison. The "Klingon" appearance which you referred to may refer to the fullness of the facial area nasal to the medial canthus including the appearance of widening of the nasal bridge at the level of mid pupillary line. Not uncommonly, this appearance occurs following facial surgery especially with blepharoplasty procedures or rhinoplasty. However, it is usually self-limiting once swelling resolves after several months.

In your situation, this may be due to several reasons:-

-localised swelling due to filler placement. As a comparison to above, the filler remains after the procedure, where there may be a venous lymphatic plexus transient obstruction.
-migration of filler. Depending on the type and quality of filler used, this may potentially influence the position of the filler. Other factors that influence this may involve the depth placement and technique used for filler placement.
-granuloma formation. Any facial filler, has a potential risk of developing a granuloma. There is an encapsulation around the filler that results in a full appearance and firm feel during palpation.
-cyst formation
-infection is fairly unlikely.

Where to from here?
It is imperative that you seek a second opinion from a qualified medical practitioner who is formally trained in aesthetic medicine and surgery. They would be able provide you with a detailed assessment and tailored plan for you.

Sometimes it is important to take a step back and assess the situation through cosmetic imaging. Some radiologists and radiographers are experienced in analysing facial filler related issues or complications through specific imaging tests and views such as with the use of radiographs, ultrasounds or magnetic resonance imaging. You may want to consider this depending on the advice of your physician. These findings, with the help of our radiology colleagues, may alter the management strategy.

Is this transient? This is always a possibility, without performing a clinical assessment on you it is impossible to say. Some patients may have other active health issues that require further assessment.

If this is due to filler migration, dissolving it through enzymatic medication such as with "hyalurodinase" may be useful. This in itself is complex as there are different ways of doing this. There are also different preparations of hyalurodinase. The expected results following this will be dependent on your assessment.

There are various ways of treating granuloma due to facial filler injections. Surgical excision is of course an easy statement but requires meticulous planning if this is considered.

Seek the best advice and opinion you can get from medical practitioner experts who are formally trained in aesthetic medicine and surgery. Take time to make your decision.

Disclaimer: The content of this description is for educational purposes only. It is imperative to seek a second opinion from a medical professional who is qualified, experienced and skilled in aesthetic surgery and medicine.

Hi thank you for sharing your presentation and concerns.

Each patient is unique with significant differences to another patient. Although the photos are of low resolution and hard to visualise, it may appear that there is excess skin in the lower abdomen.

There are limitations and clear indications for all aesthetic procedures including energy based liposuction. At times, the use of certain modalities may make the appearance of excess skin more prominent. This may not meet your satisfaction. It is best to get a quality consultation from a qualified medical practitioner trained in aesthetic medicine and surgery.

Whilst you may not be keen in tummy tuck surgery for valid reasons, it is important to look into all your options including the variations of tummy tuck surgery. Mini -Abdominoplasty may address lower abdominal excess skin. Again, please consult a specialist in cosmetic surgery and medicine. You may want to refer to some basic information about tummy tuck surgery at our webpage at the link below.

In conclusion, take time to look into all options including surgical options prior to making a quality decision for your presentation.

Disclaimer: These answers do not constitute medical advice. All cosmetic procedures have it's inherent risks and complications. Please seek a second opinion from a qualified medical professional trained in aesthetic surgery and medicine prior to committing to any procedure.

Thank you for your question. It is a hard one. The tear trough region is known to be a difficult area to treat. An experienced aesthetic practitioner would not only understand the varied aesthetic treatments available but also the diversity of genetic composition of patients. Underlying medical conditions may predispose patients to develop a certain presentation of the tear trough. The tear trough region in itself is complex with its lacrimal system, venous drainage and thin skin to name a few. Orbital skeletal resorption makes it more complicated with varying angular anatomical changes of the tear trough in time.

Specific to your question, dermal filler and lower blepharoplasty cannot be equated. They are two different treatment modalities. Dermal fillers, or non-surgical treatment, may address structural visual changes to the tear troughs. Lower blepharoplasty or surgical cosmetic procedures may not necessarily address visual changes to the tear troughs. There are advantages and disadvantages for each respective treatment.

I cannot see any imaging provided. Even so, it is imperative to gain a comprehensive consultation with a medical practitioner trained in aesthetic surgery and medicine to give you better insight into your enquiry.

Pleas view some examples of blepharoplasty surgery with its changes to the tear trough presentation.

I hope this give you some perspective into your question.

Disclaimer: The answer provided does not constitute medical advice. It is imperative to seek a consultation with a medial practitioner who has training specific in cosmetic medicine and surgery.

Dear Jaspsadie,

Thank you for your question. This is relevant not just for yourself but also many others who seek an answer for this common presentation. First of all, well done for looking after yourself and losing some weight with a focus on healthy living.

Understandably, by this stage, we should have advanced with non-surgical techniques to alter the appearance of soft tissues after massive weight loss. Although a lot has improved in terms of techniques and research pertaining to radiofrequency, dermabrasion, lipofilling, platelet-rich plasma, and energy based devices, we still have a lot to learn and improve on. This is why cosmetic research is essential.

Without performing a thorough clinical assessment, it is impossible to provide a dedicated and accurate plan for you. However, upon basic visual inspection, it appears that you may have moderate skin excess with associated irregularities of the surface of the skin.

Of course, serial non-surgical procedures may assist temporarily in the mid-term especially with tightening the skin. Please realise that tightening the skin may not necessarily translate to the outcome you desire. This is a whole assessment on its own. The cumulative cost and unpredictable outcomes may be expected should you require further amendments following skin tightening.

Non-surgical options may have it's role for specific goals but this needs to be carefully assessed.

There is another option, which is surgery or brachiaplasty with or without simultaneous liposuction of the arms. Disclaimer: All surgical procedures have it's inherent potential risks and complications. It is imperative to seek a second opinion from a qualified medical professional prior to any surgical undertaking. Always consider your decision carefully after being fully informed about the procedure of your choice.

The benefits of surgical excision of the soft tissues of the arms may involve permanent removal of the redundant excess tissues that may present as "sagging" or "rippling" and the likely reduction of volume and diameter of around the arms. The downside of surgery of course are the potential risks of surgery such as scarring, numbness and contour irregularities especially around the scar line.

It is essential to have a comprehensive consultation with regards to your presentation from a trusted and experienced doctor or surgeon specific to aesthetic surgery.

To learn more about our quality consultation in Melbourne especially related to the component of liposuction you are welcome to click below. Learn about your options with confidence.

Dear Ace,

Thank you for your question. I am sure you want to have this fixed soon but please consider all your options carefully before deciding on what is the best option for you. First of all, well done on making the effort to look after yourself through health living! Let's understand what happens when a person has massive weight loss. The body goes through a lot of changes especially with regards to losing soft tissue elasticity. This translates into the tissues being unable to retract back favourably when there is moderate to large changes of volume. The soft tissues of the upper or lower abdomen in the body is sensitive to these drastic changes which result in excess skin. It is important to get examined by a doctor trained in aesthetic surgery to give you the best options available for any cosmetic procedure. If, on examination, you have moderate skin excess, there may be an option to consider surgical removal of excess skin. Of course, this leaves a permanent scar, but with the realisation of removing redundant skin. You need to also have the underlying structures beneath the skin assessed to ensure you do not have any herniation of the deeper soft tissues. There is certainly a lot more to the examination. Whilst it's tempting to think that energy based devices may assist the situation, sometimes there are advantages and disadvantages that need to be openly discussed to help you make an informed decision. Don't rush, get a second opinion from a qualified medical professional before proceeding. All cosmetic non-surgical or surgical procedures carry potential risks and complications. To learn more about skin excision procedures such as mini abdominoplasty coupled with liposuction feel free to click the link below. Thank you for your question and I hope it gives you some
insight into important factors to consider for your presentation.