Ronald Sulewski, MD

These look like a common reaction that is in the acne family. After the laser treatment, small oil glands or follicles can get blocked causing the bumps. There would be ways to “fine tune” your before and after care to minimize this reaction, but it might come up every time you get a resurfacing treatment.

The most common side effects after a Fraxel treatment are pain, swelling, and redness. All of these things should be short-lived, so we really think of them as part of the procedure. As your skin heals from these is where your body does all the work! Once you get over the side effects, you start to see improvement in sunspots, surface scarring, skin tone, texture, and fine lines. We go over a few other, less common possible reactions. Trust me, my patients think the downtime is worth it!

Fraxel is an excellent option for acne scarring on the face. It’s the best option for patients that have no active acne, mild scarring, and don’t want downtime. The best way to be sure of your needs is to see a physician that can treat acne AND can work on your scarring. As an example, we treat patients every day with the simplest topical treatments all the way up to the strongest treatment – Accutane. We also perform other in-office treatments for scarring such as chemical peels, subcision, injectable fillers, and stronger lasers, such as the CO2. Good luck!

Fraxel is a brand of lasers made by Solta Medical. The name is very well recognized but there are actually a few different types of Fraxel lasers. We have the Fraxel Dual, which is one of their newest systems. It utilizes two different wavelengths to target different goals for our patients. The price for the Fraxel laser depends on the areas treated. Our range is between $400-650 for one treatment. Many patients repeat their treatments over time.
The “Restore” is an older version of the “Dual” and the “Repair” is a stronger, ablative laser similar to the CO2RE that we have in our office. These ablative lasers work better, but with more downtime and are typically more expensive. Hope that helps!

We like our patients to keep exercising after treatment, but we want them to hold off for 24 hours. Although it would be possible to move the filler, the bigger risk is bruising from pumping a lot of blood while your heart rate is up. We do discourage pressing on the areas that were treated as this definitely could affect how the fillers appear.

This is a difficult line to “cure” but you definitely can work on it. Likely a combination of a soft filler to the area and Botox should improve it, and depending on your response, I would consider using Novathreads as well. All of these treatment will require some maintenance or repeat treatments to keep up the improvements.

Most day-to-day activities are alright to continue immediately after Botox and filler injections. Walking, talking, driving a car or riding a motorcycle are all fine. We usually ask patients to avoid exercise for 24 hours. With fillers, like Juvederm, you should also avoid dental work for 2 weeks to prevent some rarer adverse effects that can happen. All of these concerns are addressed during evaluation and treatment by your experienced cosmetic doctor.

The best filler for under the eyes is Restylane. Each patient is unique though and there are times when I consider using Belotero or Volbella. We also always consider treating the cheek area as this can support the under eye area and give patients great results. In contrast, upper eyelid hollowness is best addressed with surgical options as fillers may not be safe there, and it is difficult to get a natural looking result.

Great question! Most patients would benefit from a combination of different fillers to address their needs. Usually we use a softer filler for the fine lines around the lips. The best examples are Belotero, Restylane Silk, or Volbella. Our patients’ concerns around the mouth usually need to be targeted with a number of treatments besides just fillers. Options we use regularly are strong resurfacing lasers, chemical peels, NovaThreads, and of course sunscreen daily to prevent worsening.

Restylane is typically my first choice for treatments under the eyes. This is a delicate area of the face, and using thicker fillers poses a higher risk of side effects such as bruising and nodule formation; an unnatural look overall. Oftentimes I will combine the “softer” Restylane with a “thicker” filler in the central cheek for support. This combination leads to longer-lasting results with a natural appearance and less risks of side effects.