Michael A. Persky, MD

Hello Good, I would treat you differently. You appear to have very good facial volume. I would treat you with "foundational" Sculptra, two vials and then wait and re-evaluate at 3 or more months. Depending on how you look at that time, I would likely maximize your treatment with 1 or 2 more vials over the course of a year if needed. I doubt that you should need more than 3 vials over a year, particularily if you wish to avoid a puffy, enlarged face. Good luck and be well. Dr. Persky

Hello Harriet, An upper blepharoplasty will should make you appear rested and more youthful. I believe that upper bleph is one of the most "bang of your buck" treatments that make one appear more youthful and rested. From the photos it does not appear that you have excessive lower eyelid "bags", but have them evaluated at the time of your consultation. Choose your bleph surgeon carefully. Good luck and be well. Michael Persky, MD Encino, CA

Hello H, You should be able to find a Sculptra expert in London. I would treat your temples at the first session and observe how you react. I doubt that you will form a nodule, but it so it should not be a problem as it would be deep below your muscle. "Mind the Gap!" Good luck and be well. Michael Persky, MD Encino, CA

Hello Magic, I would recommend the placement of Restylane Lyft directly on the medial bony edge of your pyriform process, approximately 0.5 cc each side. This is an advanced injection technique in an area of large blood vessels, you must choose a physician injector with experience, knowledge of the anatomy, and who has natural artistic vision. Good luck and be well. Dr. Persky

Hello Remy, I prefer to initially treat my patients with 1 vial of Sculptra on each side of their face at their first visit which in a 36 year old female will give subtle yet refreshing noticeable natural results over the course of 2-3 months. You can begin with 1 vial at a time but may not notice much of a change at all. I certainly would not recommend 3 to 4 vials of Sculptra at your initial treatment , that would be asking for a robust response and not what you desire. As with any aesthetic treatment it is important to choose your physician carefully based on their experience, expertise, knowledge, skill, results, and most importantly their natural artistic vision. Good luck and be well. Michael A. Persky, MD Encino, CA

Hello P, Yes, you may have a hyaluronic acid filler injected in your nose to increase the radix. I prefer Restylane Lyft for this treatment. It actually may give your nose a narrower appearence. Make sure that you have an expert physician injector treat you, this is an advanced injection area for safety and effectiveness. We enjoyed hosting Norway during the World Cup...Row!!! Good luck and be well. Dr. Persky

Hello Rubynan, Microneedling with radiofrequency is not effective at dissolving true Sculptra nodules. Fortunately, most Sculptra nodules resolve on their own over time. I treat visible Sculptra nodules with injection of low dose steroid and 5-FU, it usually takes multiple sessions separated by 3 to 4 weeks. Feel free to contact our office with further questions or concerns. Good luck and be well. Michael Persky, MD

Hello E, I would treat you with Fraxel CO2 laserand platelet rich fibrin. Each time you have this treatment your skin texture and scarring will improve. Good luck and be well. Michael Persky, MD Encino, CA

Hello E, I just treated a beautiful young woman with your exact concerns. The best treatment non-surgically is fractionated CO2 with platelet rich fibrin topically and injected in the area as well. a micro dose of botox in the orbicularis muscle will help when you are smiling. Feel free to contact me with any further questions or concerns. Good luck and be well. Michael Persky, MD Encino, CA

Hello A, I would use a combination of subcision, Sculptra, and Fractionated CO2 laser treatments. I would also use a combination of exosomes and prp during your laser treatment. Given the depth of your scars, you will likely need a series of treatments but should see nice improvement after each session. I would estimate 3 to 4 sessions separated by about 3 months. Feel free to contact me with any further questions or concerns. Good luck and be well. Michael A. Persky, MD Encino, CA