Monica Bonakdar, MD

Thank you for your question and photo.  It is safe to have Botox in the neck with an existing thyroid condition.  Botox Cosmetic can be used off-label for treatment of Neck Cords, Jowls and Necklace Lines. Treatment is quick and minimally invasive consisting of a few tiny injections.  Your doctor will determine exactly where to administer these injections to achieve the best results.  However, much more than a still picture at rest goes into determining if you are a candidate for this treatment and if you will have the expected benefits. From your picture and the level of skin laxity that you have, you may be a better candidate for tissue tightening either surgically with a neck lift or noninvasively with treatments such as ThermiTight and ThermiSmooth and also Ultherapy. I suggest a consultation with an expert.

Wishing you the best,

Monica Bonakdar MD

Thank you for your question.  It is difficult to know if you will have the same response to Jeuveau unless you try it. Jeuveau is produced with 20 years newer technology and purification system and has less protein load which may make a difference for you.  It works a little bit faster. Neurotoxins have been around for 4 decades.  As a class, FDA approved neurotoxin injected by a reliable injector are very safe, give predictable results, and have very high patient satisfaction. 

Wishing you the best,

Monica Bonakdar MD

Jeuveau and Botox belong to a class of aesthetic injectables called neurotoxins or neuromodulators. These two products are more similar than dissimilar. For example they are the same size molecule, they are injected the same way and have the same rare potential side effects. Jeuveau has had US studies that showed similarity to Botox. However, Jeuveau's European study showed that it is slightly better than Botox. This difference may be because of the twenty year newer manufacturing technology of Jeuveau.  In my practice I have seen Jeuveau have a slightly faster onset of action.

Wishing you the best,

Monica Bonakdar MD

Thank you for your question.  Jeuveau is a premium aesthetic product. Because Jeuveau is manufactured using newer technology and purification system than Botox Cosmetic and takes effect a bit faster than Botox, I believe it should be more expensive that Botox Cosmetic. However, in most practices, you will be delighted to know that Jeuveau is being offered for less because it is priced lower and more fairly by parent company Evolus making Jeuveau  affordable for the consumer.   Jeuveau is more similar than dissimilar to Botox Cosmetic.  So if you have done well with Botox, it is easy to try Jeuveau and see for yourself how you like it. Remember, there will be newer more improved neurotoxins coming on the market the thought leaders will continue to bring these new products into their practice.

Wishing you the best,

Monica Bonakdar MD

Thank you for your question and photos.  Ultherapy is the only non-invasive, non-surgical treatment approved by the FDA for LIFTING the skin of the face, neck and body.  Over one million Ultherapy procedures have been done worldwide.  The Bonakdar Institute has been doing Ultherapy treatments since 2010 and we do them daily.  Ultherapy is the only nonsurgical treatment that uses ultrasound energy.  Ultrasound is used to visualize below the skin surface.  After visualization there is ultrasound delivery of heat to 3 different tissue levels.  These are the deep tissues that are targeted during a surgical facelift.  Ultherapy results in Neocollagenesis which is gradually creation of new collagen.  This improves your skin from the inside out without disrupting the surface of your skin.  The number of treatments depends on the age of the patient, their skin condition, and the results desired.  Most clients start with one treatment initially which they may repeat in 6-24 months.  Comfort management techniques are used during the treatment to make the patient experience as pleasant as possible.  There is no pain after the treatment is complete.  The areas that are treated during an Ultherapy can be the face, neck, and body areas.  Body areas include the Chest,  Upper Arm, Upper Legs and Buttocks.  There can be some lifting and tightening immediately following the treatment.  Full results occur gradually over the course of three to six months.  This treatment is not like injectable treatments with a finite life span.  Each treatment will help to lift and tighten the skin.  It is like increasing the balance in your collagen bank.  However, aging continues the minute the treatment is over.  The bank is continuously being depleted.  The patient’s commitment to maintenance determines how long the results last.  Post treatment, the skin may be a little red for a few hours.  The skin will feel sore to touch after treatment for the next week. 

The second issue that I see in your photos is the beginning of jowl formation which can be disguised with fillers. Correction of this area will enhance your overall look.  Wishing you happiness on your aesthetic journey,

Monica Bonakdar MD