Victor Hugo Zuniga, MD

Yes, it’s generally safe to have Dysport injections one day before your cheek filler appointment. The two procedures target different areas and layers of the face, so there’s minimal risk of interference. However, for optimal safety and to avoid complications like swelling or bruising, some providers recommend spacing them out by a few days. This way, any initial reactions or side effects from the Dysport can settle before proceeding with the filler. Always consult with your injector to confirm what’s best for your specific situation.

It’s common to notice changes in your skin by your mid-20s due to several factors:
1. Natural Aging: Starting around age 25, collagen and elastin production decreases by about 1% per year, causing fine lines and reduced skin elasticity.
2. Exercise and Weight Changes: While great for overall health, significant changes in body composition or fat loss can make facial features appear leaner, highlighting fine lines or dark circles.
3. Stress and Lifestyle: Even with a good diet, chronic stress affects skin health, impacting hydration and increasing oxidative stress.

Improving stress management and a tailored skincare routine focusing on hydration, antioxidants, and sun protection could help.

SUNEKOS, a popular skin booster in Europe, is less common in the U.S. mainly due to regulatory hurdles with the FDA. It uses a patented mix of hyaluronic acid and amino acids, which may not yet have full FDA approval for aesthetic use. This differs from Profhilo, which only contains hyaluronic acid and has clearer approval pathways. Additionally, limited awareness and distribution networks in the U.S. may also contribute to its lower usage, despite its benefits for certain patients needing both hydration and collagen stimulation.

To treat a depressed or hollow area just under the nose (also known as the premaxillary area), there are a few effective options:
1. Dermal Fillers: Hyaluronic acid fillers (like Juvederm or Restylane) can be injected to add volume and smooth out the hollow area. This is the most common approach and offers immediate results.
2. Fat Grafting: Using your own fat, this provides a more permanent solution but involves a minor surgical procedure.
3. Skin Boosters or Collagen Stimulators: Treatments like Sculptra can improve skin quality and add subtle volume over time.

A consultation is important to choose the best option based on your anatomy and aesthetic goals.

If you’ve received Botox and have an asymmetry, it usually takes 3 to 4 months for the effects of Botox to wear off completely. This timeframe may vary based on individual factors such as your metabolism, the dosage used, and the area treated.

During this period, the asymmetry might gradually correct itself as the Botox weakens. However, if the asymmetry is significant or bothersome, a touch-up or small correction with additional Botox can be considered. I’d recommend giving it at least 2-3 weeks post-injection before reassessing, as initial swelling may also contribute to uneven results.

Applying heat or using radiofrequency treatments after Botox could potentially speed up the breakdown of the product, as both increase blood flow and can cause muscle activity, reducing the duration of the Botox effect. However, this is not always predictable and may not guarantee correction of the asymmetry.

If you’re considering using radiofrequency, I’d suggest waiting at least 2 weeks after your Botox injection, when the product has fully settled. It’s best to consult with your provider first, as it could unintentionally worsen the asymmetry or affect the results differently.

You already have a nice amount of volume and definition in your lips, which is great! Adding more filler at this point might not be the best option for you because it could make your lips appear overdone or out of proportion with the rest of your facial features. Instead of adding more volume, I’d suggest we focus on enhancing the quality of your skin and working on facial harmonization to bring more balance to your overall appearance.

For example, we could consider treatments that improve skin texture and hydration, like skin boosters or microneedling, to keep your lips looking soft and youthful without changing their size. These treatments will give your skin a healthy glow and make your lips appear even more defined naturally.

Ultimately, our goal is to enhance your natural beauty, so let’s focus on treatments that bring out the best in your overall facial harmony

BBL works by targeting the underlying causes of rosacea and visible capillaries, such as dilated blood vessels and excess pigmentation. To achieve lasting and optimal results, it's important to finish the entire BBL treatment protocol, which typically involves multiple sessions (usually 3-6 treatments spaced about 2-4 weeks apart).

Why "More" Can Happen at First
It’s normal to sometimes experience temporary increased redness or darkening in the areas being treated, particularly after the initial sessions. While it may feel counterintuitive, this is something to expect and it doesn’t mean the treatment isn’t working.

Vascular Response: BBL targets blood vessels by using light energy that heats and constricts the dilated vessels. In some cases, this can cause the blood vessels to temporarily appear darker before they break down and are naturally absorbed by the body. This darkening effect is usually temporary and part of the healing process. As the body clears away the treated vessels, your skin will gradually look clearer.

Skin Healing and Regeneration: BBL stimulates collagen production and skin regeneration, which can sometimes cause temporary irritation or redness in the treated areas. This is your skin healing and improving, so while it might seem like things are getting worse for a short time, they are actually improving beneath the surface.

If the bulge along your upper lip is caused by filler migration or uneven distribution of the filler, Botox would not be effective in resolving the issue. Here's what you can consider:

1. Filler Migration or Buildup:
After lip filler injections, sometimes the product can migrate or settle unevenly, causing lumps or bulges, especially if the filler was injected too superficially or too much was placed in one area. This is a known issue and can happen over time, particularly with hyaluronic acid-based fillers like Restylane or Juvederm.

2. How to Fix It:
Massage: If the bulge is mild and recent, gentle massage can sometimes help redistribute the filler and smooth out unevenness. However, this should only be done if your injector has advised you to do so.

Hyaluronidase: If the filler is still hyaluronic acid-based and the bulge persists or is noticeable, hyaluronidase (an enzyme that dissolves hyaluronic acid fillers) can be used to dissolve the excess product and restore a more even lip shape. This is a quick, safe procedure that can resolve the issue.

Re-evaluation by Your Injector: It’s crucial to return to the professional who performed the filler treatment (or another experienced injector) to assess the situation. They can evaluate the bulge and recommend the best course of action, whether it’s massage, dissolving the filler, or adjusting the volume.

3. Botox's Role:
Botox won't resolve filler-related issues because it doesn't affect the filler itself—Botox works by relaxing muscles, not by altering the structure of hyaluronic acid or other injectable materials. If your bulge is related to overfilled muscles or uneven filler distribution, Botox would not be the appropriate solution.

Dermaheal Dark Circle Solution is a treatment designed to reduce dark circles under the eyes. It typically contains ingredients like peptides, hyaluronic acid, caffeine, vitamin K, and botanical extracts, which work together to improve circulation, reduce pigmentation, hydrate, and strengthen the skin.

It’s usually applied via mesotherapy injections (small amounts of the solution injected into the skin), though some versions may be available as topical creams. For injections, 4-6 sessions are usually needed, spaced about 1-2 weeks apart, with maintenance sessions every few months. Results can be seen after a few sessions, with improvements in circulation and skin appearance.

For topical use, you apply the cream once or twice a day, but it may take longer to see results. Side effects are rare but can include mild swelling or bruising post-injection. Always consult a professional before starting treatment to ensure it's right for you.