Hi Dionica: Thanks for your question. Wrinkles around the eyes (or peri-orbital rhytids) are one of the more difficult areas of the face to treat - and you've hit upon the reason why in your question! The skin around the eyes is very very thin. This has some interesting effects - the thin skin allows the muscles underneath to be more visible, and changes in the fat below the skin or the springiness (elasticity) of the skin itself are more easily apparent as well. There are several options for improving the appearance of wrinkles around the eyes, depending on the cause and severity of the wrinkles. You have pointed out that what bothers you is the wrinkles that appear when you smile. These are called "dynamic rhytids" - i.e. wrinkles that aren't present when your face is at rest, but only appear because the muscles that create your facial expressions are wrinkling the skin. Botox is very effective for dynamic rhytids, because it prevents the muscles from activating, and so the skin cannot wrinkle. In this area, Botox is most commonly used for the wrinkles at the outside corner of the eyes (called the crow's feet). In your photo, it appears that your crow's feet wrinkles are not particularly severe. If you are more concerned about the wrinkles of the lower eyelid itself, it is a different story. Botox to the lower eyelid directly is not often done, because it can cause problems with your eyelid - it can significantly worsen the appearance of the eyelid, cause dry eyes, and cause your lower eyelid to lose its support that keeps it against your eyeball. If your main complaint is that your lower eyelid has wrinkles because of your cheek pushing up on it when you smile, you are likely to have better luck by improving the elasticity of your lower eyelid skin. This might involve a light peel or a laser treatment. In general, your first step should be to visit your plastic surgeon who can examine you in person to be able to discuss your goals in detail, and to assess the cause of your wrinkles, the quality of your skin and muscles and so on. That will allow him or her to provide you with the best options for your particular situation and allow you to make a good, informed decision on what treatment to choose.
Hi ingrid87, First of all, congratulations! Now as for your question - it's always hard to know for sure whether a certain drug or treatment is safe during pregnancy. It's difficult - if not impossible - to ethically perform blinded, randomized, controlled studies during pregnancy. So most of the information we have comes from situations where women had Botox before they knew they were pregnant, or had Botox for non-cosmetic reasons. A 2017 review in the Aesthetic Surgery Journal found that there isn't much published data on this topic. Only 18 women have been reported to have received cosmetic Botox, mostly during their first trimesters. One of these women suffered a miscarriage - but she had a history of previous miscarriages. The other women had normal pregnancies and no fetal problems either. Studies in animals on the other hand, have found a risk of miscarriage, fetal malformation, and even maternal death - although the Botox doses used were quite high. In conclusion, it's impossible to say definitively whether Botox during pregnancy is safe. So as a general rule, it would be wise to put off Botox for the duration of pregnancy. Similarly, there are no good studies to tell us what the effects of Botox are in breast milk. So again, it is safer to put off Botox as long as you are breastfeeding. Finally, what about fillers? Most fillers are made of hyaluronic acid, which occurs naturally in your body. The odds are that these injections should not have any untoward effects on pregnancy. However, again, there are no studies on this question - so the honest answer is: We don't know! In the end, the decision on whether or not to have fillers or Botox during pregnancy is between you and your doctor. You have to balance the unknown risk of pregnancy complications against the fact that pregnancy is temporary. One thing is for sure - you will stop being pregnant within a year, and then you'll be able to have these treatments without worrying that they might be hurting you or your baby.
Lasers and sun tanning don't mix, but it sounds like you already know this. Just to reiterate though, this is because sun exposure after laser treatments can result in skin damage, scarring, or hyperpigmentation. In addition, tanned skin responds differently than untanned skin to laser treatments. Spray tans are just chemical sprays that react with epidermal cells to produce a brown color change. If you have IPL treatments after getting a spray tan, it can be problematic. The laser energy can be absorbed by this superficial tanning spray pigment rather than the intended target of the laser. This can cause burns or ineffective treatment. So you should certainly not get a spray tan if you are going to have further IPL treatments. Finally, if no further IPL or other laser treatments are planned, then it's a slightly different story. Once the skin has healed from the laser, spray tanning should be quite safe. IPL generally doesn't cause significant skin injury like blistering, so waiting about a week after IPL to get a spray tan should be adequate for safety. On the other hand, if you have any open wounds, blisters, or peeling, you should wait to have a spray tan until these are fully healed. This will avoid adverse skin reactions and uneven tanning. Hope this was helpful to you, and good luck!
I'm very sorry to hear you're unsatisfied with the results of your lip filler injections. Volbella is a newer type of filler that is soft and flows easily. As a result, some of the lumpiness after a Volbella injection will settle down after 1-2 weeks. Patient is critical here, both to give the swelling time to resolve, and the filler time to spread a bit. Gentle massage can help with this process. You should certainly follow up with your doctor for an examination as this can reveal whether the lumps are resolving or likely to resolve, and whether there is any other problem going on causing the lumps. If the lumps persist after 2 weeks or so, your doctor can inject hyaluronidase to dissolve away some of the Volbella. In any case, follow-up with your doctor is critical to fine-tune the results and ensure that you are satisfied.
This is called the tear trough. The tear trough is a normal anatomic structure caused by the difference in the skin and soft tissue of the cheek and the lower eyelid. Eyelid skin is thin and has less fat than cheek skin. In addition, there are ligaments attaching the thin eyelid skin down to the bone underneath. These anatomic features can result in the appearance of a tear trough. Treating the tear trough can be accomplished through fillers, like Juvederm Volbella, Belotero Balance, or Restylane Refyne. The key here is that the fillers used in this area have to be soft and flow easily to prevent contour irregularities. The filler also cannot be placed too superficially, otherwise it can be visible. Severe tear troughs can also be treated surgically, with a lower blepharoplasty. This allows fat in the lower eyelid to be redraped over the area of the tear trough, acting as a natural filler. It is important to see a Plastic Surgeon for an in-person consultation to determine the best option for you.
