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Hand rejuvenation can involve several steps. For volume replacement Radiesse and or fat transfer can be used. The volume needed will vary from patient to patient depending on the&nbsp;stating point and desired end result. Fat tends to&nbsp;last longer but is more variable in its longevity and results. For skin texture, gentle resurfacing with either lasers or chemical peels can work well. And for blotchy pigmentation cryotherapy or IPL treatments can work. For long term maintenance, topical retinoinds and alpha hydroxy acids and of cause sunscreen.
Hope this helps.

I have had 2 (1.5 cc) syringes of Radiesse injected to each hand. My skin is still very wrinkled. I would like to know, first, how much filler is too much? Second, can I have fat injected over the filler, is it going to help? Lastly what is best to improve the texture of skin on hands?

Filler in hands not helping?

Hydroquinone is NOT a requirement prior to any laser procedure ablative or none ablative. There is little proof it does decrease the incidence or severity of darker pigmentation after these procedure even though many physicians use it in the hope that it may. If you are having a reaction to it you should not use it. There are several alternative topical such as kojic acid. For patients at low risk for pigmentation after the procedure then no topical bleaching prep is needed.
Hope this helps

I am attempting to use hydroquinone as preparatory treatment for non-ablative laser resurfacing. After 3 tries with very small amounts (1/2 a pump) 2-3 days between applications I am convinced that the product is giving me allergic contact dermatitis. My face is so red &amp; swollen that I am icing it down. My skin tolerates 0.05% Tretinon daily very well. Is the non-ablative laser still an option for me if my skin cannot tolerate the hydroquinone cream?

Do you have to use hydroquinone before and after non-ablative laser resurfacing to get results?

Based on your photo and history I think there are 3 factors contributing to the swelling. Some of it may be normal reactive swelling after injections into the lips. For this aspect use of ice packs and giving it time would be all you need. &nbsp;However some of it may be misplaced or too much filler. If a filler such as Restylane or Juvaderm was used this can be reversed with the injection of a specific enzyme to dissolve the excess. Finally given the bruising I would suspect you may have a small hematoma. That's a small collection or pool of blood within your lip. It is only be feeling you lip that these factors can be clinically differentiated. So You need to see your provider for an in person examination to allow them to determine which factor is the main problem and help you decide on the best course of action at this stage.
Hope this helps.

So I had lip fillers 3 days ago. This isn’t my first time at all and it’s normal for me to bruise. On my top lip though I have developed a lump which is hard, doesn’t love from one spot and it’s turning whiteish on my lip. I have a feeling it’s filler. Could I have some advice?

Lip filler swelling after fillers 3 days ago. (Photo)

The theoretical "ideal" proportion is to have your upper lip two thirds the fullness of your lower lip. What is ideal for you will vary based on the proportions of the rest of your face and your own aesthetic desires. I would not do anything to your lower lip. It is full, attractive&nbsp;and normal. I think the only reason it may seem "swollen" to you is in comparison to its skinny neighbor, your upper lip. The solution is simple. enhance the fullness of your upper lip until a more satisfying proportion is achieved. This can safely and relatively simply achieved with injectable fillers such as Restylane or Juvaderm.
I hope this helps

Hi ... My lower&nbsp;lip is fat and swollen and my upper lip is slim ... How do I&nbsp;make my lower lip slim and upper lip a little bit swollen...

My lower lip is fat and my upper is thin, what is the solution? (Photos)

If it has only been a couple of days, I would not be too concerned. The darker discoloration and swelling&nbsp;is most likely just swelling and bruising from the procedure. However the whiter firm bump on the boarder of your lower lip may be misplaced filler product. If you injector used a hyaluronic acid filler such as Restylane or Juvaderm then the extra filler can be dissolve with a small injection of an enzyme. But even this bump may resolve itself in a few days with a little pressure and time.
Hope this helps&nbsp;

i got lip injections (1 ML) for my first time, its been 2 days and i have a lump on the bottom left hand side of my lip.. it seems to have a white bubble on it! im worried, what is this? it doesent hurt if i press it. all through there is bruising under my lip on the side of the bump.

White bump on my lip after lip filler?? Should I be worried? (photo)

Thanks for your question. Without examining your face or at least photos it is difficult to give you very specific guidance but as a general rule: depressed acne scars can respond very well to laser resurfacing and if there are only a few lesions you do not need to treat the whole face as the surgeon should be able to "blend" the treatment into the surrounding normal skin. For very deep "punched out" acne scars surgically cutting out the scar&nbsp;with a appropriately sized punch biopsy and either suturing the wound closed or filling the defect with a punch graft followed a few weeks latter by laser resurfacing can work wonders. There is a lot written about different types of resurfacing lasers and each surgeon will have their own preference (often based on which laser they happen to have!). CO2 lasers (either faxel or not) have a great track record and our the most commonly used for this. If you do microneedleing I would do so after the laser treatment has healed and use it on your whole face including the lasered areas.
Hope this helps.

Hi, I suffered from Acne in the past, but thankfully it's clear now. I'm going back to school soon and I have a few scars one on my left temple and three on my right cheek. They're depressed and look more like actual scars rather than Acne scars. I have a chance to have laser resurfacing done, is it recommendable to have laser resurfacing on just those parts? If so, what laser treatment? Keep in mind I had a VI peel 3 weeks ago next Thursday. Can I also have microneedling done?

Laser resurfacing, Vi Peel, microneedling and acne scars.

Sorry to hear about the problems you have had. Infection due to injection of fillers is extremely rare. (I have personally never seen it occur). There are some people who asymptotically carrier bacteria, in particular Staphylococcus Aureus, in the nose and surrounding skin. In these patients wound infection from any procedure may be more likely. I would suggest you have a bacterial culture taken from inside you nose and if you are found to be a carrier, treatment for that can be given prior to other elective procedures.&nbsp;I hope this helps.

In December I had a bacterial infection in my lip (due to unhygenic medical practise). One half of my upper lip turned into an abscess, which was drained early January and then the lip was completely dissolved February. I got my lips redone again in May, and they became infected. Am I prone to infection now or was the filler not dissolved accurately? I am planning to get them done again in September by a cosmetic doctor, would I be wasting my money if another infection may occur?

Reinjected after lip filler Infection?

Based on the photos you submitted, the scars you have will likely&nbsp;improve with time as the color slowly fades. However I think you could get a very significant cosmetic benefit from CO2 laser resurfacing.&nbsp;This will help smooth the transition and contour from normal skin to scar. (There is a certain amount of judgment and experience needed in deciding which laser and which settings will likely afford the best results so seeing an experienced expert may be worth the extra expense).&nbsp;After that has healed you can speed the fading of the redness with a vascular laser although the redness will usually fade a lot on its own over several months.
I personally do not think you will need surgical scar revision and I would suggest you keep that option in reserve if laser treatments and time do not get you the results you are hoping for.
I hope this helps

I have a vertical scar over my right eye from a deep facial wound. The scar is fresh with the wound having occurred 2-3 months ago. I have been applying silicone gel with sunscreen daily. The size and position of the scar can be seen in the photo bellow.

Recent scar from a facial wound, could I benefit from laser resurfacing and what results could I expect? (Photo)

Laser resurfacing is a great treatment for fine wrinkles and can allow some tightening of the skin and a more even complexion. However laser resurfacing is NOT the ideal way of treating unwanted hair and small veins on your face. There are specific lasers for laser hair removal and specific lasers for treating superficial blood vessels. I recommend you consult with a dermatologist who has each of these lasers rather than using&nbsp;one laser&nbsp;for everything because that's all they have in the office!

Would laser resurfacing help with facial hair and or small veins on the face?

The healing from any resurfacing procedure is largely dependent upon the depth of the injury (laser resurfacing, mechanical dermabration or chemical peels). In general for ablative CO2 laser resurfacing you can expect to be red and "oozing" for about a week. After 7-10 days you can usually start using makeup and cover the pink / redness that will take a few more weeks to slowly fade completely.
During the few days you will look terrible and not want to be in public and you will be wondering if you made the right choice, but by the second week you are already looking good&nbsp;happy you did it!
 
Hope this helps.

I am booked to have a deep co2re laser next week and been prescribed anti-viral meds to take the day before treatment and each day after until fully healed. Naturally I am getting more nervous about the procedure and I am really looking for any information possible on what to expect during and then recovery period. Are there things I can do to speed up the recovery and ensure correct healing/no infection.

Full Ablative Laser Co2re - what to expect?

Ralph Massey, MD

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