Michael J. Weinberg, MD

Based on the photograph, it would appear you have a single scar on the lower lip that is raised, but not discolored. It is possible injecting filler on either side of the raised scar might help conceal it. However, this is not always successful. There are other treatments that could be considered for raised scars-I would advise seeing a board certified dermatologist or plastic surgeon for an in person appointment so they can examine your lip and discuss options.

Yes, it is possible to reduce the prominence of the cupids bow when performing lip injections. However, it is not usually possible to eliminate it all together. 

Whenever Lip injections are undertaken, the goal should be to achieve good proportion between the upper and lower lip. You do have quite a small upper lip relative to your lower lip. A small amount of filler in your upper lip might improve the proportion without changing the overall shape.

The commonest reason for a white appearance after filler injections is placement of the product too superficially ( ie too close to the skin’s surface), resulting in what is called a tyndall effect that is caused by the way light is reflected by the product. It can often take several repeat injections with hyaluronidase to get rid of the unwanted filler, which can be quite stubborn when it is located in the superficial layers of the skin.

So, it is often a misconception that filler “ migrates”. None of the hyaluronic acid fillers really move from the location they are initially placed. All hyaluronic acid fillers are “ hydrophilic”, meaning that water/moisture is attracted into the general area where they are placed and therefore there can be swelling in the vicinity. It may be that in your case filler was placed mostly in the central area of the lip in an attempt to achieve more of a pouty look. Over filling the centre can often give rise to “ duck lips”, where the lips stick forward too much, a look which many people hate. If width is what you are after, then yes, filler placed at the corners can sometimes achieve the appearance of a bit more width, and help the lips not disappear at the edges when you smile ( a common complaint). However, it is important to understand that lip filler injections cannot change the basic shape of your lips to a significant degree. Therefore, it is not possible to give you a celebrity’s lip shape. There is no one filler product I recommend. Different products may vary in terms of their feel as well as their look. Many do a good job. Both Juvederm Volbella, and Belotero Lips are lovely lip products with a natural feel and look.

There are several implant manufactures that can manufacture a wide range of implants. Most surgeons may carry several implants types.  Most surgeons likely feel more comfortable using one manufacturer. If you are set on one kind of implant and you have good reasons then your should first approach the surgeon of your choice and discuss it with them. If you still believe that the Sientra implant is the only or best implant for you, then I would look for a surgeon with extensive experience with that implant.

This is a difficult question to answer without good photos. Having sad that there are many really good  options in terms of implants shapes, sizes, shells and contents. In addition implants can be combined with various lifts and fat grafting. So please make sure to see a qualified and experienced surgeon to help you meet your goals.

The implants are sitting high as do most transaxillary places implants. You are still relatively early so they will hopefully drop. I don’t see a good reason why you cannot massage them or wear a bandeau. Those things will definitely help. If you are still worried then you should go back and see your Plastic Surgeon and see what they recommend . 

If you have ruptured implants then you should consult a Plastic Surgeon. There are many good options for you. I have never seen hives from ruptured silicone implants. I would suggest that you see your Family Physician first and then a Internist like an Allergist or Rheumatologist.

We don’t know the effects of a shingles injection and Botox injection timing. I would advise being safe and waiting a week.