Vu Ho, MD

First of all, best of luck on your upcoming weight loss journey! I wouldn't worry too much about this having a significant effect on your filler's longevity. While some people's metabolism may cause filler to break down faster, I wouldn't think the effect of adding in a GLP1 would make a drastic / noticeable change on this. The combination of weight loss, medication, potentially adding in more exercise can all increase metabolism which may have an effect on your filler - but the benefits of all these things definitely outweigh the potential downside.

To preface, it's difficult for me to answer this without seeing your skin quality/elasticity and volume in person. There's no way to say how long sculptra is going to last - but it typically does last 5 years when done appropriately. The general rule of thumb is 1 vial per every 10 decades of life for your age (even if you do look much younger than your stated age, research shows we begin to lose more & more collagen as we get older) You can always try with 1 vial and give it 6-8 weeks to see improvement and decide if you'd like to add on more. I definitely do not think it would be a waste of money but it may potentially cost more than intended if you need more treatments. Hope this helps!

Aquagold involves very superficial "injections" that are more similar to microneedling procedure and the technique used varies significantly from dermal fillers. So while nothing is risk free, there is very low risk of blindness caused by vascular occlusion. Hope this helps!

In the case of hyperhidrosis (or excessive sweating) - I would stick specifically to injectable neurotoxin. While this is found in aqua gold, treating excessive sweating in the underarm area requires a specific amount of neurotoxin injected in specific locations. You could use aqua gold as an adjunct therapy to help with underarm skin appearance though!

In my opinion, PRP or PRF is worth trying in comparison to lifetime use of minoxidil (over time this price will add up and is a daily task and only works as long as you are using the product regularly). I would also recommend looking into exosomes — we are seeing great results in regards to hair loss!

Typically, hyaluronic acid based fillers do not last longer than 1-2 years. There are fillers that are not hyaluronic acid based that would need operative intervention to remove the substance. Without knowing which specific type of filler you had, I am not able to confidently recommend one versus the other. Going to an advanced injector who can perform physical exam to assess location of possible migrated filler will be crucial to successful management. Regarding your bee allergy, make sure to do an allergy skin test before getting injection to face. They should be able to inject a small amount into skin and observe for 30-45 minutes for your body's response

There are a few options for you! You can do botox in this area although you want to make sure to to go to an advanced injector because there is risk of injecting into certain muscles that can negatively affect your smile/facial expressions. There is also an option to inject small amount of filler into the lines. Adding volume to the lips can also help lessen the appearance of these lines. Using a product like restylane kysse would allow the injector to fill in both the 'smokers lines' and use the same syringe to add some volume to the lips. Keep in mind if you are wanting both areas to be treated, you may require more than 1 syringe. Best of luck!

Masseter botox is a great place to start -- this can be a very strong muscle and require larger amounts of neuromodulator. Without knowing how many units as well as before / after photos from previous session, I am not able to confidently recommend attempting again. However, it may be as simple of a solution as increasing the amount of units. Facial balancing with filler or other products like sculptra can also help minimize appearance of jawline. Going in for a consultation with an advanced injector would be crucial prior to formulating treatment plan.

I want to start off with reassuring you that facial asymmetry is very normal and common! Some people are born with it but we also tend to have it progress as we age due to certain muscles becoming hypertrophied or weaker, sun damage, effects on collagen loss, etc. You would be a great candidate for botox to try and help minimize your asymmetry. In order to fully assess this, it is important to see how your muscles are activating during different facial expressions. Best of luck!

You could definitely start with some botox at the lateral aspect of the brow for a subtle lift -- however, I do not believe this will give you as dramatic as a result as you are hoping for. You should also be cautious about getting a full treatment of botox in the forehead because that can unfortunately make your hooded eyes more prominent. I would see an advanced injector for in depth consultation and discuss attempt at trying botox brow lift but keep in mind that the mainstay treatment for this is a surgical procedure called upper blepharoplasty or potentially a brow lift (I am unable to see full face in the photo so cannot be certain which would be better option for you). Hope this helps!