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CLAIM YOUR PROFILEI think you are an excellent candidate for fillers in the tear troughs. This is a very safe and effective technique that adds volume to the hollowed tear trough area. It also improves the appearance of dark circles under the eyes. Newer techniques utilize a cannula instead of a needle to inject the filler. The results are beautiful and the risk of bruising is far less using this technique.
Teresa Mann, MD, FAAD
Board Certified Dermatologist
I am not aware of any publications in the medical literature demonstrating the use of dermal fillers to treat CVG. Depending on the severity of the CVG it would take considerable volumes of filler to achieve any significant correction. In addition to surgical options, there is a case report of CVG being treated with a series of hyaluronidase injections. Hyaluronidase is an enzyme used to dissolve hyaluronic acid which is a component of our skin that contributes to its thickness. It is important that you see a dermatologist to evaluate your CVG as there are some secondary causes that might impact your general health and well being.
Teresa Mann, MD, FAAD
Board Certified Dermatologist
Dermal filler placed in the tear troughs can dramatically help the appearance of deep set eyes. The technique is very safe and lasts up to 12 months in many cases. Newer techniques using a cannula instead of a needle are being used to minimize the risk of bruising.
Regarding your profile, I would encourage you to look into either CoolSculpting or Kybella to treat the fat pad under the chin (aka submental fat pad). Either of these will tighten and refine your profile. They are safe, effective and reasonably priced nonsurgical options! Neurotoxins are not good options for these issues. Good luck!
Teresa Mann, MD, FAAD
Board Certified Dermatologist
If you suffer from chronic sinusitis it is important that you are under the care of an Otolaryngologists (Ear Nose Throat Doctor). There are several reasons people develop chronic sinusitis and various treatment options depending on the cause. In general, cheek augmentation using a filler such as Voluma that is properly placed on the cheek bones is not contraindicated in the setting of chronic sinusitis. I would suggest you also get approval from your otolaryngologist before proceeding with the treatment.
Teresa Mann, MD, FAAD
Board Certified Dermatologist
Photographs have limitations but based on what I can see I would suggest leaving the filler in place and not removing it. Swelling can persist for weeks after filler injections (especially in the lips) and it is important to be patient as some asymmetries and other issues often resolve with time. I think you will actually really like your lips as the filler settles over the coming months. Moreover, "removing" filler is not a simple task. Hyaluronidase is injected into the areas but doesn't always dissolve the filler in a uniform and predictable fashion. I would strongly recommend use of hyaluronidase if you had dramatic asymmetry but I don't think that is the case. It's also important to recognize that every face has baseline asymmetries that often go unnoticed until such a time that people start looking very closely (usually after having a procedure). Before and after photos can help sort out what was present before the filler injections and what is a result of the filler procedure. I hope this helps you in your decision.
Teresa Mann, MD, FAAD
Board Certified Dermatologist
I do not think this is of any health concern, It is not uncommon for individuals to have symmetric dents (concavities) on the forehead. This is usually related to the anatomic variations in the frontalis muscle. The frontalis is a broad, thin, vertically-oriented muscle that originate along the hairline an extends down the forehead inserting/attaching to the skin just above the eyebrows. Its purpose is to elevate the eyebrows. There is very little fat under the skin on the forehead which makes it easier to see contours under the skin. Neurotoxins can sometimes change forehead contours by temporarily immobilizing some parts of the frontalis while leaving other parts intact.
Teresa Mann, MD
Board Certified Dermatologist
I do not see any problem with you proceeding with your tear trough filler while on nitrofurantoin. I would not advise you to have the procedure if you have ongoing symptoms such as fever or chills from your urinary tract infection. In addition, it is important that you inform your provider that you are currently being treated for a UTI with nitrofurantoin.
Teresa Mann, MD
Board Certified Dermatologist
There are several things to consider to improve the appearance of your feet. First of all, if your toenails are thickened and have a white to yellow colored debris under them then you likely have nail fungus (onychomycosis). The best way to treat nail fungus is with a medication called terbinafine (Lamisil) that you take by mouth for 90 days. The over-the-counter and prescription antifungal nail solutions such as ciclopirox have a very low cure rate. You will have a much higher chance of curing your toenails with the oral prescription medication. Your primary care doctor or dermatologist can give you more information on treatment of onychomycosis.
For the thickened, rough skin I would suggest trying a "peeling lotion" that contains either glycolic acid, uric acid, or salicyclic acid. There are several over-the-counter options including Amlactin, Lac-Hydrin and CeraVe SA. My favorite is CeraVe SA cream. If applied at bedtime EVERY night for 8 weeks you will see softening and a tremendous reduction in the scaling and cracking. But you must be very consistent in using the cream and very patient because it takes time. Dermatologists can also prescribe Urea cream in different strengths to help this issue. Good luck!
Teresa Mann, MD
Board Certified Dermatologist
I think you would be best served by seeing a dermatologist to assess each of the lesions. Closer inspection with a dermatoscope could help confirm whether they are a milium (cyst), sebaceous hyperplasia, fibrous papule of the face, or other entity. Milia are tiny, hard, white cysts that are easy to extract with the proper instruments. It is not uncommon for more milia to form over time but your dermatologist or one of their staff members can likely extract them for you every 6-12 months as needed. Sebaceous hyperplasias look similar to milia though are not extractable. An acid preparation (dichloracetic acid) can be carefully applied by a physician to help minimize the appearance of sebaceous hyperplasias. Lastly, fibrous papules are benign firm small skin-colored growths that can be surgically removed with a simple shave biopsy. It is always a good idea to use skin care products that are labeled "non-comedogenic" to help prevent clogging of pores. Good luck!
Board Certified Dermatologist
Cryoglobulinemia and Cold Agglutinin Disease (CAD) are both relatively rare autoimmune disorders that are exacerbated with cold exposure. Patients with cryoglobulinemia often have symptoms that include skin lesions (lower leg ulcerations), joint pain, and peripheral neuropathy (numbness in hands and feet). Cold Agglutinin Disease causes destruction of red blood cells (hemolysis) triggered by cold temperatures and leads to anemia, dizziness, fatigue, dark colored urine, jaundice, cold hands and feet, vomiting, and diarrhea. Both diseases get worse in the colder winter months and require a number of different blood tests to properly diagnose. Both tend to occur in people 50 years or older. The cold exposure associated with CoolSculpting can trigger these diseases with symptoms and complications as referenced above. It is possible, though highly unlikely, that an individual could have one of these two diseases and not yet have a diagnosis. However they would likely have a history of recurrent leg ulcers (cryoglobulinemia) or anemia in the case of Cold Agglutinin Disease.
I think you are an excellent candidate for CoolSculpting given the localized area of your fat. Liposuction is another option though it is much more invasive and can leave the area with contour defects that appear "lumpy." Good luck!
Board Certified Dermatologist
Pure Dermatology/Dr. Mann do an excellent job keeping my skin looking refreshed and natural. I greatly respect the team's advice and suggestions and I trust their suggestions implicitly. I have been seeing the Pure Dermatology team for over 10 years and I am so grateful to have such a highly-skilled medical and aesthetics team here in Bozeman, Montana.
I had obsessively researched and combed through reviews and photos on here before finally deciding to try Coolscupting on my stubborn "mom belly", aka the area around my middle abdomen. I'm 39 yo and have two young kids-lost the pregnancy weight but developed a new "spare tire" type fat distribution around my belly button that extends out to almost my flanks/love handles. I consider myself to be quite fit/active and follow a (for the most part) healthy diet, and always had a toned abdomen pre-pregnancy. My consult was with Kristen at Pure Dermatology and she was knowledgeable, honest and friendly. I felt very comfortable with her assessment and recommendations, especially in regards to potential risks with treating this area since I have a small umbilical hernia (which is a contraindication). I felt well informed and decided the risk was one I was comfortable with. Had my first treatment 5 days ago, and the whole process was really supportive and professional! Kristen decided to go with one "petite" applicator on each side of my belly button, placing them in a way to minimize contact with my hernia location (but still target the most fat), and each side received a "double" cycle-length treatment (for a total of 35 min on each side). We did my right side first and then my left. I felt minimal discomfort during the treatment-some suction and numbing but no real pain. Staff were attentive, friendly and went out of their way to make sure I was comfortable during the entire process. The post-treatment massage was more uncomfortable and there was slight pain but it was tolerable. No unusual pain in my hernia area, so fingers crossed we managed to avoid worsening that condition. The area felt really tender to the touch and swollen for the first 3-4 days, and I had red marks from the applicators for the first 2-3 days. But nothing that interfered with my daily activities or exercise (yoga, barre workouts, running, hiking, paddling a raft). Now at day 5 the swelling has gone down and I'm still a bit tender to the touch. I've been doing 4x daily massage on the area (per Kristen's instructions) and it's a bit painful but will stick with it until day 7 as advised. Will update (and add more photos) once I hit the 1 month and 3 month marks (and hopefully start to see results!). Updated on 15 Oct 2020: It's been about 1.5 months and I feel I'm starting to see results! It's subtle, but I can tell the difference in the appearance of my belly button area. Excited to see what happens in the next few months...feeling optimistic! Updated on 28 Jan 2021: It's been about 5 months and I'm still thrilled with the results. I feel it's a noticeable reduction around my belly button area. Went in for my 3 month follow-up and they said I was a hyper responder (or something like that)...at any rate, they seemed really excited about my results too :). Posting a photo taken today. There's a teeny-tiny bit of unevenness visible between the right and left sides (slightly more reduction on my left side), but I think it's only noticeable to me. Kristen said that's not uncommon and may have existed before my treatment (but I just didn't notice). Considering one more cycle on just the right side to even it out if it continues to bug me (I'm kind of a perfectionist), but going to wait and see for now.
I’m 49! I had the old grams bat wings . Thanks for that mom . I had great results prior on my flanks am thought would give it a try. I had both arms done March 3/21/18. Procedure was easy Newer machine than previous procedure . Left arm more sensitive . Bruised quite a bit an sore when massage them . Look bad as of now really swollen but Should be less swollen over course of week . Will post more pix as results come in .
I was feeling like I was ready for a little refresher (my first ever) and went to Pure Dermatology for a consult. I was pleased with the office and the consultant. I booked my appointment and was seen by Pam Burrows. She did a great job. The look is very natural which is what I wanted. She also fixed my tear troughs and most recently completed BBL treatment. She is conservative and I like that. I am going back to her in a few weeks for a couple more maintenance services. The office is almost two hours from me but it's worth it.
I've been a patient of Dr Mann's for years and was so pleased when she opened Pure Derm. I've been in for skin checks, botox, filler, and coolsculpting (I am very pleased with all the results). To be honest I never thought I'd try any cosmetic procedures, but Dr Mann and her PA-C's really listen and I always leave very happy. Kriste met with me for a consult prior to the coolsculpting and I felt well informed and had accurate expectations. I even went back for a second procedure as it was so easy and Kriste was very attentive! The entire staff is friendly and accommodating.
I was feeling so bummed. I'm 49 and my face was looking sad. I took pictures and put them on Realself and all of the Dr.'s said I needed a face and neck lift. This was out of my price range and I couldn't afford the down time. So while I was visiting relatives in MT, I scheduled two apps--one for filler, one for the Ultherapy (I've had ultherapy before). I waited a month for my appointments--this is a popular office! I have to say, I am really happy. I will continue to post my progress... Changes continue for 6 months... Updated on 9 Feb 2016:
I am 40 hours post all three procedures. Staying indoors and reading, listening to upbeat music. Skintyte was a breeze, micro peel was a real tough challenge due to discomfort. Had dental I ejections so that the fraxel around mouth would be tolerable. Look like extreme sunburn, slight itching. Lots of Vaseline, was challenged sleeping with Saran wrap over face -- couldnot get my slits for both, mouth and eyes to line up. Will post again once I am thru this uncomfortable, red post procedure.
I am a 49 year woman. I 5'7" 1/2 and have always weight between 128 - 136. I had maintained a flat stomach all of my life until I hit my early 40's. It was driving me nuts to suddenly have this belly appear. On June 21 I had cool sculpting performed at my Dermatologist office on my belly area. As others have mentioned it is shocking how much it sucks you in to the machine but certainly not painful or anything. I did feel as though I had to whisper and not inhale/exhale to deeply for fear it would pop off. In about 8 minutes I was totally comfortable. I had brought my Ipad and sat and read a book. Truly, I thought it was a piece of cake. When my time was up, I was dreading them taking me off of the suction because I had heard that it hurts when they massage the area. My belly looked like a giant stick of frozen butter - the nurse said she had never seen one as frozen as mine. She started to massage and yes, it is definitely uncomfortable but not screaming agony or anything. I then got up, got dressed and went shopping and resumed my day. By the end of the day my belly was very tender and very swollen. Again though, completely manageable. For 2 or so weeks my belly was still fatter than my original size and sore. Not only is it tender but ITCHY! I just put it out of my mind and kept telling myself that it is only temporary and it will be worth it. Some people have said how horrible it is, I would not say that at all, simply uncomfortable at times. I am now a little over 3 weeks since I had it done. I can see that definitely my belly is going down in size and I only have a very slight itching, no pain. I am confident that I am going to have good results. In fact, I have scheduled to have my love handles done too! I wish I had photos to share but unfortunately I didn't think to take before pix. I am going to ask when I go back in (at the 3 month mark) to see if they will email me my before picture that they took. Updated on 21 Jul 2012: It has been one month since I had my procedure. I can definitely see a difference. Even my husband said just yesterday that he could tell that my belly was getting flatter. I am hoping that when I go in for a 3mth checkup that they will let me have a copy of my "before" picture, then I can post my before and after. :) I am really excited now that I am seeing some results and only expect that it will get even better in the next month or so. Updated on 12 Oct 2012: Just had my love handles done on the 8th of October. Piece of cake! Again, the suction is really strong. Truly felt no pain, I sat and read a book for the whole 2 hours. Afterward the areas were a little painful and bruised but certainly managable. I grocery shopped when I was thru with the procedure. It is now Oct. 12, very little pain, still bruised and not a big deal. Can't wait to see the results in a few weeks. My lower ab (first procedure) looks GREAT!, my upper ab (second procedure) which was done a few weeks ago is starting to show some difference too. My opinion so far - Little discomfort and TOTALLY worth it!!! I am going to submit before and after pics when I am all done. Updated on 12 Jan 2013: I am so so happy with this. It has now been 6 months since I started with the cool sculpting. First did my belly, then my upper ab, then my love handles. No down time, minimal discomfort. I would highly recommend this. The staff at Dr. Mann's office was awesome to boot! Updated on 20 Apr 2016: I loved my cool sculpting and the results from 3 years ago. About a year ago I was diagnosed with Ulcerative Colitis and had lost about 15 pounds - I was quite skinny. I took medicine which pushed it into remission but after that I gained my weight back plus another 7-8 pounds. Also, in my early 50's I am peri-menopausal. I have kept the extra pounds on and as a result have my pooch and side flab back. I have since moved from Montana to Illinois and went to someone different for Cool Sculpting. Had it done today on my belly and each side. They have a couple machines so I was able to do it all in one day. Same as before, a piece of cake! minimal soreness right after we got done but now its numb. I know I can expect more soreness tomorrow and at some point the intense itchy-ness will start. It was totally manageable before and I'm sure it will be this time as well. I am hoping for the same great results as last time. My cost for all of this today was $2300. As soon as I have pictures I will post them.
I went in today and had my flanks done. It was super easy and pain free. I'm at home now relaxing. I have zero pain and can't even tell I had anything done. I hope I get good results. I will keep everyone updated. I'm doing my belly next Monday. This is NOT cheap. It's almost as much as Lipo so I hope it works!!!Updated on 21 Apr 2012:It's been almost two weeks and I'm still swollen. I measured myself at 36.5 in hips before CS and am 38 in now. I really hope I'm not going to stay that way....stinks!!!Updated on 25 Apr 2012:I'm getting a little worried. I'm still measuring 38 in!!!! I have seen no difference obviously because I'm still swollen. My flanks are fatter now than they were! I'm not sure this is going to work for me. I should of just got Lipo for $1000.00 more.Updated on 29 Apr 2012:Ugh! Started a suger free diet 5 days after I did the CS. Now I will not know if it was the diet or CS if I see results. Nothing yet...I still feel weird little nudges and I'am still a tad numb.Updated on 22 Jul 2012:Well, have now done two sessions on my love handles and one on my stomach. The love handles are easy and not painful at all! The stomach on the other hand OUCH! Be prepared for two weeks of pain. After that it's easy. It's been 4 weeks since I did my stomach and I already see a big difference. The love handles I do see a difference but not as much as my stomach.
I don't do well with surgery and don't need major surgery. No down time.
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