Ratnaja Katneni, MD

Dear Victoria,
Lower face slimming can be achieved by injecting botox into masseter muscle especially if masseter muscle hypertrophy or enlargement is causing lower face widening. Another place to inject botox is the chin muscle if you have dimpling of the chin. Chin filler and proper jaw line contouring can also slim lower face into a more V shaped look. Another option to consider is to add PDO threads for more of a lift. The key is to balance your upper, mid and lower face to have appropriate proportions so make sure to go to an experienced injector.

Microneedling works great for skin texture issues while botox will help relax muscle in the chin that causes texture irregularity called peau d orange or orange peel like skin. Many have both issues. Acne that affects the chin may have to be treated separately. All in all combination therapy works best.

Dear 909 baby,
Morpheus 8 is a great option for collagen stimulation, and helping with lifting jowls and can help with contouring your lower jaw line and nasolabial folds. It works by creating small micro injuries that help stimulate your own body's collagen and help remodel your skin and underlying tissues. You have some volume loss that I can see from your pictures, underneath your eyes and mid face, cheek area. Nasolabial folds are also treated with fillers in areas of volume loss and with PDO threads to create a lift and collagen stimulation. You may need combination treatments to see satisfying results. In your case, I think Morpheus would be a good option to try starting with lower settings and more treatments, gradually, so that melasma and hyperpigmentation will not be an issue.
Hope this helps.

Dear yntorr 30,
As previously answered, Botox lasts about 3-4 months and you will get your original smile back. Your masseter muscle lies close to muscles that affect your smile and it is extremely important to avoid hitting those muscles that impact your smile while injecting, and hence it is important to choose an injector who is well versed with facial anatomy. Prevention in this case is best. Perhaps go back to the same injector or seek a second opinion on what can be done to lessen the impact of your changed smile. There are no pictures posted so would be difficult to make recommendations.

Dear ahveeahnah,
In the second picture, those ridges have a bluish tinge look like veins, blood vessels can be prominent in some people. Forehead skin and muscle called frontalis is very thin and blood vessels can be seen prominently with thin skin. Another factor that may be adding to these ridges is the way your muscle anatomy is with forehead muscles. There are several blood vessels in the area and when you smile there will be contraction of muscles that makes these veins prominent. If these are veins, then Botox is not the solution. Botox helps relax muscles of your forehead and can be started to prevent wrinkles in the forehead. I hope this helps.

It appears to be scar tissue from repeated injections or injury in the past that is becoming more prominent and the defect gets more enhanced with fillers because of the depth of the injection of lip fillers which is typically superficial. You may have had a deeper injection /injury resulting in scar tissue that involves skin and tissues underneath. If it makes sense, filler is going to fill surrounding tissue and not the dent which is deeper than the tissue surrounding it. So in my opinion, more filler will not help. You may see improvement with fat grafting from an experienced plastic surgeon under imaging.

Dear Marissa,
Swelling of lips after lip filler injections are common and subside on their own, and with icing. If your lip swelling is around the time you had viral infection and with COVID, it could have been an immune response. This does not mean that you are not a candidate for fillers in the future unless if these reactions continue to reoccur. if there is a true allergic reaction, you would have seen any type of significant immune reaction immediately after the injection and this is exceedingly rare. Volbella is a hyaluronic acid filler made by the company Allergan and is highly regulated and a fantastic filler for lips. Furthermore, hyaluronic acid is found in our body in various parts such as joints, and immune reactions are very uncommon, not to say that they never happen. I hope this helps you with your future decision to undergo filler treatment.