Kishen Nara, MBBS, FACCSM(Surg)

Thank you for your question. Whilst it's easy to assume that dermal filler would lessen the appearance of the recognised and known nasolabial or marionette lines, it is first important to obtain a comprehensive clinical assessment from a medical practitioner trained in aesthetic medicine. The nasolabial lines are commonly referred to the area lateral and above the corners of the lips. The marionette lines usually refer to the indentation of skin area just below the corners of the lips or mouth. There may be multiple reasons why this may have occurred. The face has varies anatomical layers including the underlying bony structure, retaining ligaments, SMAS, subcutaneous tissues, and skin. Any of these structures or combination thereof may have a role with regards to the appearance as described. The assessment of this may be rather comprehensive. Yes, dermal filler may help to reduce the appearance of smile lines preferably with a low cross linkage properties. However, this may not necessarily be the only way to manage this area or let alone the best way to address smile lines. Is there an element of not being adequately hydrated? There's a myriad of reasons. Take time to obtain a proper assessment. Some patients are happy to leave the smile lines as they are and may decide against dermal filler. A comprehensive and balanced assessment for your smile lines is invaluable for your overall result not just on the surface but also within.

Thank you for your question. Please note that clinical questions warrant a comprehensive clinical assessment for the best diagnosis and exploration of your issues. This will never be replaced by any form of technology. I have seen several patients who have puffiness of lower eyelid region following "filler treatment" after more than 12 months as described by patients. There are a constellation of potential reasons for this. Some patients do have residual "filler" that can be further investigated with radiological investigations such as with specific magnetic resonance imaging tests conducted by specialist radiologists who are familiar with these issues. If this is the case, dissolving the residual "filler" may help although it has its inherent potential side effects, complications as well as limitations. Other causes need to be excluded such as underlying conditions or infection. The ageing process may potentially contribute to this. It is important to take time to make a plan of treatment before deciding on any treatment. Seek advice from your general practitioner and get a full medical check up. It would be good to speak with the initial treating doctor , who performed the facial treatment, to get their advice. If you could please upload better imaging that might be helpful. Hope this helps.

Thank you for your post. It is imperative to have an assessment performed by a clinician trained and skilled specific to cosmetic medicine and surgery. It is good to have a second opinion performed by a health care professional.
A general practitioner assessment is important. The reference of mid section may differ to our understanding of the "mid-face". That is why it is important to have a consultation and examination performed by a doctor that you trust. Fat graft to the face has its merits and risks. Some merits include increasing the volume in some fat compartments of the face that may have reduced at the time of your weight loss as well as benefits to the skin. Risks involve asymmetry, bruising, lumpiness or even accumulation of fatty cysts. The fat resorption varies from individual to individual and so do the risks of of any procedure performed by your surgeon. Remember, you have time to think of what treatment is right for you. Looking at your photos, you may consider regaining the lost weight to see if it makes a comfortable difference without any intervention.

Good question. Many of my patients ask questions pertaining to your description. This is a valid and respected question since you not only care about your safety but especially your child. Any elective procedure that penetrates the skin will have some potential risk of infection. This may be systemically transmitted into the breast milk. It may be prudent to delay these cosmetic interventions later on so as to avoid these risks. All clinicians have different perspectives on this. However, in our practice we always maximise your health and minimise the risks as best possible. Getting informed about a treatment plan during this time at a consultation would be wise idea.