Paul P. Daraei, MD - Account Supsended

Hi There,

FUE can be very helpful to add hair volume, even after a previous FUT procedure. Shock loss is very common. If you experienced shock loss after your first hair transplant, I would anticipate that you would have shock loss after your second hair transplant. Even if some of the hair are "non-native" or previous transplants, I would still estimate that you would experience shock loss. Using minoxidil and finasteride will help reduce the risk of shock loss, but not completely eliminate it.

Hope that helps,

Paul Daraei, MD
Facial Plastic Surgeon
Premier Image Cosmetic and Laser Surgery
Atlanta, GA

Hi There,

There are multiple options available for skin tightening, ranging from creams to peels to lasers and to minimally invasive treatments. The more aggressive the treatment, the better the long-term result.

Fractional CO2 laser skin resurfacing can be excellent for skin tightening, especially around the eyes and mouth. It can help with fine wrinkles of the face and skin pigmentation issues as well. However, it will not improve jowling or significantly improve skin laxity in the neck area.

Microneedling is also helpful to improve the quality of the skin and is less invasive and less aggressive than fractional CO2 laser resurfacing. For that reason, the results are usually limited and not as noticeable when compared to CO2. However, it is a good option to improve skin quality and to improve fine wrinkles of the face. Again, it is not helpful for jowling and neck fat/skin laxity.

There are also minimally invasive surgical treatments such as necktite/facetite and other radio frequency skin tightening procedures. These are typically the most aggressive minimally invasive techniques and are often combined with submental liposuction or other procedures to improve facial appearance. However, treatment depends on your anatomy and degree and location of skin laxity.

Consulting with a facial expert is the best first step. A proper examination is critical. You can then discuss the above with that provider.

Hope that helps,

Paul Daraei, MD
Facial Plastic Surgeon
Premier Image Cosmetic and Laser Surgery
Atlanta, GA

Hi There,

Botox to the masseter muscles can help with facial contouring and bruxism. When the masseter is mildly enlarged, injecting botox can help soften the appearance and improve the width of your jaw. The effects last upwards of 3-4 months. Dose of Botox to the masseter can have a large range from 10-40u per side, and depends on previous treatments, size of the masseter, and your anatomy. Botox injected into the masseter can also help improve night time bruxism. You may also want to consider filler along the jawline and chin to further contour your face to achieve the results that you want. I would start with a consultation with an expert facial injector so that an in-person examination can be performed and recommendations can be discussed.

Hope that helps,

Paul Daraei, MD
Facial Plastic Surgeon

Hi There,

Asymmetry of the face is normal and natural. The facial muscles, skin, and bones are naturally asymmetric and small difference are normal. Some of these asymmetries, such as those along the jawline and those that are volume based can be improved with filler. For your jawline, injecting filler can help improve symmetry. Achieving symmetry with botox is often more difficult, as botox affects movement of muscles. Adding volume and reshaping the jawline and lower face with fillers is often more natural and easier to accomplish for both you and the injector. I would begin with an in-person consultation for a full examination and recommendations, ideally with a facial injector specialist.

Hope that helps,

Paul Daraei, MD
Facial Plastic Surgeon
Premier Image Cosmetic and Laser Surgery
Atlanta, GA

Hi There,

The brows are controlled by 3 muscles: the procerus, the corrugator complex, and the frontalis. When the procerus and corrugator muscles contract and flex, they create a frown/angry expression. The procerus creates horizontal lines and the corrugators create vertical lines, both of which can be seen with an angry expression depending on your anatomy. The frontalis muscle raises the eyebrows. Based on your question, if you want to treat the inner brows only, botox can be injected into the procerus and corrugator muscles to soften vertical and horizontal lines between the eyebrows and to provide lift in the middle of the face. It is important that you see a facial injector specialist for a consultation so that they can examine you and provide treatment.

Hope that helps,

Paul Daraei, MD
Facial Plastic Surgeon
Premier Image Cosmetic and Laser Surgery
Atlanta, GA