Ran Y. Rubinstein, MD

Hello and thank you for your question. Coolsculpting is a great non-surgical, non-invasive treatment to target areas of stubborn fat. It uses cryotherapy to freeze fat cells in the treatment area resulting in fat cell death and natural elimination from the body over a period of 3 months. The flanks are one of the 9 FDA approved treatment areas and can result in a 20-25% tissue reduction per session, where most patients will require 2-3. Consecutive treatments result in a further 20-25% fat reduction of the remaining tissue. During our consultations we map out the anatomy and create a custom treatment plan to achieve your desired goals. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Botox to the DAO muscle helps to minimize the downward pull on the corners of the mouth giving a subtle lifting effect. When placed precisely by an experienced provider smile asymmetry would be rare and jowling is typically not associated with DAO treatment. Temporary smile asymmetry can occur if the Botox is inadvertently injected or diffuses into the nearby DLI muscle. Again this would be a very rare occurrence when treated by a skilled injector. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Firstly, congratulations on your weight loss accomplishments! You are not alone and this is a common occurrence following treatment with GLP-1 medications. As we lose weight, so does our face lose volume and this can result in the gaunt appearance you describe. At our practice, we love using biostimulators such as Sculptra to address volume loss and to restore a more youthful appearance. While HA fillers can provide immediately gratifying results, oftentimes large amounts of product would need to be utilized following significant weight loss and a series of Sculptra can be more cost effective to address the full face. Sculptra is a biostimulant which is a regenerative treatment that stimulates the body's own natural collagen production in response to targeted injections. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. This is actually a great conversation that routinely takes place during consultations. Do you have any specific concerns or is this more about preventative anti aging? Depending on your age and goals, a tailored treatment plan would be created that aligns with your budget. All of these treatments would be beneficial in the long term as they address different aspects: skin quality, muscle movement resulting in fine lines & wrinkles, as well as restoring volume loss and providing structural support. For a more personalized approach and recommendations feel free to schedule a consultation! Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Lip lift candidacy would best be addressed in person during a surgical consultation. Most commonly, this is performed to shorten the distance between the nose and upper lip, providing a more youthful appearance and fuller upper lip. While this procedure may slightly improve the appearance of lines above the lip by stretching out the skin, the quality of the skin and muscle movement would not change. CO2 lasers are excellent for skin resurfacing resulting in collagen stimulation and improvement in overall skin quality. Vertical lip lines typically result from repeated expression over time and can be minimized with neuromodulators such as Botox by temporarily relaxing the muscle responsible for pursing the lips. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. At our practice we routinely utilize neuromodulators such as Botox to help diminish nasal flaring for the appropriate candidate. When injected into specific muscles around the nose, this treatment can reduce nostril flaring, especially during facial expressions. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Neuromodulator treatment (Botox, Dysport etc.) is individualized based on patient specific anatomy while taking into consideration personal preference when it comes to maintaining some flexibility vs having no residual movement in the targeted treatment area. Your injector can assess your muscle strength and administer an appropriate dose according to your goals. Keep in mind that dose does equal duration so a lower, more conservative dose would last shorter. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. It is not uncommon to naturally have one brow that is more dynamic or expressive than the other. To balance this, the forehead can be treated asymmetrically where the injection point/s above the hyperdynamic brow is slightly lower on the forehead than the other/less expressive brow to account for the increased motion. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Botox and filler are great noninvasive ways that can improve the appearance of the upper lip when smiling. Botox injected into the LLSAN muscle will relax the upward pull on the upper lip when smiling to minimize gum show. You mentioned you have tried the lip flip but that caused too much coverage of the upper teeth. You can also try the lip flip at a lower dose to minimize that effect. Dermal filler provides hydration and volume to the lip and in combination with Botox for muscle relaxation can attribute to a fuller lip when smiling. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Hello and thank you for your question. Fraxel Dual is a non-ablative fractional laser used for skin resurfacing. It is a dual wavelength laser and can treat various skin concerns. Because this laser is non-ablative, in our practice we do not typically prescribe antibiotic prophylaxis. Fraxel re:pair on the other hand is an ablative laser, meaning that it removes all layers of the skin within each of the tiny fractions of skin that are treated. This is a more aggressive laser which provides even better results. In our practice we do prescribe a short term course of prophylactic antibiotics for this treatment as the skin barrier is disrupted for a short time. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.