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Forehead Reduction

A forehead reduction surgery could be performed with an incision at your current hair line. &nbsp;This would allow your hair line to be advanced and therefore shortening your forehead. At the same time, you could also have a the skin of the forehead re-draped and improvement of your forehead wrinkles. &nbsp;Most certified plastic surgeons should be able to perform these procedures for you. You need to be evaluated in person though to make sure that you are a candidate and to cover all the risks and benefits of the surgery with you including setting expectations to how much of an advancement of your hair and how much of an improvement of your wrinkles can be achieved. &nbsp;You should also have your eyebrow positioning assessed during the evaluation to make sure they are sitting in the right position as they could be changed or may be altered during the procedure.

I hate my forehead and would like to know if it's possible to smooth out the static lines and also reduce the size of my forehead in one go. What would it involve and how much recovery time would be needed. How much roughly would it cost and is there anyone suitable in the Uk

Is there a way to reduce the size of my forehead and smooth it at the same time? (photo)

There is no problem or additional side effects of using Botox in your age group. &nbsp;However, please see a certified physician before seeking this treatment. &nbsp;Without a picture or seeing you in person, it is difficult to assess your problem that you are experiencing. &nbsp;A "droopy" brow line could potentially be made worse if you use Botox because you are paralyzing the muscles that elevate your brows.&nbsp;

My eyebrows are droopy. Especially when I smile. The distance between my eyes and eyebrows are fine, just the eyelid makes it like this, i think. But it really bothers me. That is why I hate smiling or laughing!! Do you think for a young girl it is okay to do botox? what are the side effects for my age?

Is botox for eyebrows okay for 21 year old?

It is difficult to provide clear recommendations without a picture, but a white birthmark usually means there is absence of the pigment in the area. &nbsp; This is more noticeable when you have darker pigmented skin types. &nbsp;Lasers are used to remove colors from the skin and therefore would not help you in your case. &nbsp;Depending on the size and location of the spot, you could elect to have it excised. &nbsp;This would completely remove it, but you would have a scar. &nbsp;This may be okay if it is in an area that the scar is concealed well. &nbsp;The other option is Recell. This uses your body's own pigment cells to restore the color to the area. &nbsp;It will likely not correct the spot to normal, but it can greatly improve it. &nbsp;I hope this help and always seek out a certified physician before undergoing your treatments.

I want to remove my white birth mark on my right cheek.can I remove it by laser treatment?

I have a white birth mark on my right cheek. Can I remove it by using laser treatment?

Birthmark Removal

I agree with Dr. Lim, Recell would greatly improve the area, however, it is unlikely to correct it 100%. &nbsp;You would then need to undergo hair transplantation as you mentioned to restore your hair line. &nbsp;Another options would be to excise it and to get the best outcomes in this area it would require serial or multiple excisions since the skin is relatively tight on the back of the neck. &nbsp;By taking it out in smaller portions, the skin will "stretch" and loosen between surgeries. It then will be able to be completely removed and with minimal tension allowing for a better scar. &nbsp;Now with this procedure, you would have a scar that would be visible with your hair being short, but the incisions should be designed in a fashion to help make it less noticeable to the eye. &nbsp;The advantage of this procedure is that the area would be completely removed and you hairline would be restored without the need for hair transplants (which could give you a donor scar anyway depending on the harvesting techniques. &nbsp;These procedures could all be performed under local if you choose as well. &nbsp;Good luck and as always, please seek out a certified physician when deciding on which procedure to have.&nbsp;

It encroaches into my hair so I would be open to hair transplantation during or afterwards...I've attached a couple of photos.

I was wondering if there are any improvements so far in medicine that could completely remove this? (Photo)

Since your smile was already higher on the right, the Botox injections the left would make this more pronounced since muscles on the left are not functioning as well. &nbsp; If you like the how the left side looks now, then you could add Botox injections to the right side to try and lessen the pull of the muscles on that side and lower your smile. &nbsp;You could also allow the Botox to wear off on the left side over the next several months and see where your smile sits and then make decisions on how you would like to proceed if anything. &nbsp;Remember, it is very difficult to use Botox in this way to adjust your smile and asymmetries are likely after treatment. &nbsp;Also, using Botox in these areas can also cause a frozen face look where your smile looks unnatural and your facial muscles are not functioning in the normal manner. &nbsp; There are lots of things to consider including surgical lip procedures as Dr. Blinski described. &nbsp;Please make sure that you are being treated by well trained certified physicians to get the best care. &nbsp;Good luck and I hope this provides some insight into your question.

I've always had a slight lift when I smile on my upper lip's right side but I feel that's it's now exaggerated after receiving Botox/Juvederm 5 months ago. I revisited doctor 4 months later and we did Voluma w/ focus on left cheek. It's been 5 weeks and I still have an uneven smile. To be clear, I like the Voluma cheek filler just not my crooked smile. Can it be fixed with lip injections? More cheek fillers?

Asymmetrical smile fix, exaggerated after facial injections. Will upper lip injections help? (Photo)

Botox and Dysport will wear off overtime if no further injections are given. &nbsp;There may be some residual effects from the long term injections from the the atrophy or shrinkage of the muscle that were injected, but they can rebuild mass once they begin to function again as the medications wear off. &nbsp;In regards to the appearance of your eyes, this may not improve and the treatments may or may not have been the cause of it. &nbsp;It is difficult in pictures to determine facial functions and symmetries. &nbsp;You eye problems could be the result of treatments or from things like changes in the eyelid muscles that occur over time or global facial aging changes such as fat regression (I know sounds weird but everyone gets it). &nbsp;You should be evaluated by a certified physician that is adept in craniofacial analysis and surgeries. &nbsp;They can determine if there is a functional problem with you lids, a change in your eyeball position, or other problems that may be able to be addressed to help your concerns. Good luck and I hope this helps guide you. &nbsp;

I have been getting botox and disport injections for the past 5 years. In the past year, I went from getting it injected in my forehead to getting it injected into the forehead and crow's feet area. What I didn't really notice until it became more prominent was that eyes have taken on a "bug-eyed" look in one eye, with the white showing. My eyes look very dissimilar now - I was wondering if this would go away if I stop using Botox. This has really affected my self esteem and my confidence.

Will wide-eyed look from 5 years of botox/dysport go away? (photo)

This is a typical appearance of a flap on the nose. &nbsp;The skin on the nose is very thin and when other tissues are moved into the area there often discrepancies in the thickness, skin type, etc. &nbsp;This is what we call "pin cushioning" &nbsp;as it has the appearance of pin cushion. &nbsp;You are early on in the reconstructive healing process and the area will continue to remodel overtime. &nbsp;The remodeling process continues for up to about a year. &nbsp;You can approve the appearance but rubbing the area several times a day with enough pressure just to feel it. &nbsp;This will soften it a little. &nbsp;However, the often times revisions are needed to help these appearances. &nbsp;Things like flap thinning and or laser resurfacing/dermabrasion can provide the final contouring needed to give you the best result. &nbsp;These procedures can be performed at anytime and are only needed if you wish to continue sculpting the flap otherwise you appear to be healed from the surgery do not require any further procedures if you choose. &nbsp;Good luck and I hope this helps with your care.&nbsp;

I had a basal cell taken from the right tip of my nose and the dermatological surgeon who performed it did a local flap taken from the nose itself. Its been 7 weeks and the end of my nose appears to have a foldover effect where the flat is not really joined with the rest of the nose correctly in my opinion. Should I have a plastic surgeon look at it?

Should a nose flap after Mohs surgery look fairly normal after 7 weeks? (Photo)

There are many people that cannot handle even small procedures. &nbsp; You know your body best and already do not respond to pain medications and local anesthetic well. &nbsp;I would recommend that you see a certified plastic surgeon to discuss your diagnosis and your concerns with the procedure. &nbsp;The surgeon will be able to offer you the option have it performed under conscious sedation or full general anesthesia if you choose. &nbsp;While they do not perform Moh's surgery by definition, they can send frozen sections if needed during the procedure to be more certain that all of the cancer is removed, but final pathology usually takes a week or so confirm. &nbsp; The surgeon can then perform whatever reconstruction needed close the defect. &nbsp;The excisions are very straight forward and commonplace for plastic surgeons along with their reconstruction. &nbsp;I would not recommend any radiation treatments especially on your nose. As. Dr. Rueckl said there are some side effects to the treatment and the long term tissue changes that occur surrounding the treatment site can have disfiguring consequences that are not easy to correct. &nbsp;The changes after radiation treatments usually take years to present. &nbsp;I hope this helps and good luck with your care.

I have almost 0 response to pain med. Shot in nose for biopsy did nothing. Produced 30 minute panic attack. hung on to table for dear life while lower body jumped around. Versed, Demerol, Compazine, Atavan act like heavy caffeine, when given in hosp. before for ERCP. So how do I manage Mohs? Dentist uses gas +. 5 minute stent removal physician used general anath.

How can I manage Mohs surgery on my nose? Basal, caught early. Get major panic attacks if someone tries to touch me.

Birth marks are classified into vascular and pigmented lesions and it is difficult to determine the type of "birth mark" this is in the photo. If you noticed any changes in it recently such as enlarging, ulcerations, or pain you should have it evaluated soon by a physician. &nbsp;You "mark"&nbsp;does appear to be small enough that you could have it excised and the area closed with a suture line. &nbsp;The bald patch would be gone, but you have would have a linear scar that would not have hair but could be easily concealed by the surrounding hair as long as you keep the your hair with some length. &nbsp;This can be performed under local anesthetic or general if you prefer. &nbsp;Depending on the exact margins and the amount that needs to be removed, it may need to be performed with multiple excisions to avoid tension on the closure and widening of the scar. &nbsp;Please seek a certified physician in your area to assess the mark and discuss the procedure details with you in person. &nbsp;Good luck and I hope this helps.&nbsp;

I have a birth mark in my head and its a bald spot. Is there a way i could get it removed or? (photo)

The skin graft is considered healed once the top layer or epidermis is intact (no scabbing). This is usually within several weeks following the initial surgery unless there were complications. &nbsp;The graft then remodels over the next year to year and a half. &nbsp;This is when it should lighten and soften. &nbsp;Since your surgery was over 5 years ago, your skin graft has healed, has fully remodeled, and you should not experience any noticeable changes. &nbsp;To try and lighten the graft now, laser therapy is your best options. &nbsp;Try to find an experienced certified physician in your area that has multiple laser options for you. &nbsp;You can discuss then differences with them, but the options include things like the IPL laser to help remove the color or a resurfacing laser such as Erbium:YAG (Sciton) for more dramatic changes. &nbsp;Hope this helps and gets you in the right direction for treatment.

I had a skin graft done to my nose in Feb 2010 at Bethesda Naval Hospital in DC. It healed well; but, it continues to be bright red at times. My doctor did laser therapy on it until he retired and said that it would eventually heal the rest of the way on its own. Isn't 5 years excessive?

Is there anything I can do to make my cherry red skin graft less noticeable other than thick make-up? (Photo)

Robert Paul, MD

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