Gregory Albaugh, DO

Your skin seems to be a perfect candidate for BBL photo facial. You have some freckles on your four head and redness on your nose. BBL has the ability to focus the energy on each different issue on your face. In my practice I usually recommend 3 to 5 treatments spaced 3 to 4 weeks apart. The first treatment is usually less aggressive because it is uncertain how your face is going to respond to the therapy. When doing the therapy you look for clinical endpoints to see if what you're doing is going to make a difference. Each one of those freckles on your four head should darken while the procedure is being done. We usually stay dark until they flake off a couple weeks later. In experienced hands BBL is a great tool and you skin will look better three or four weeks after the first treatment.

BBL photo facial should treat your whole face with 3 to 5 different steps. If you're provider is only treating your nose you won't get the full benefit of BBL.

A variety of things can happen your skin after BBL treatments. This also depends on what you are having treated with BBL. It's common for swelling of the face or darkening of pigmented lesions to occur after a photo facial. The face can feel like it's sunburned for few days so it's important to stay out of the sun. Bruising however is not a common side effect. If the bruising is severe it can also be treated with BBL and I sometimes do that if there is some bruising at injection sites. Your provider should check your medication list to make sure that there's nothing that will make you more prone the bruising. Things it will make you more prone the bruising are usually aspirin and Plavix. If she continue to have BBL treatments it would be good to have a cold pack to put on your face afterwords. This can reduce the post procedural swelling and should decrease the bruising as well.

The picture looks like you do not need any Voluma in your cheeks. The fat pads of your cheeks show no signs of ptosis. The temple region is not apparent on the photo provided. Voluma may be of benefit in that region but you should be evaluated in person. It would be nice to know what you are looking at and what you want it to look like.

It is difficult to say. I am not sure which product you used but the Juvederm product which works best for the cheeks is Voluma. This should be injected deep down to the bone or periosteum. This results in lifting of all the tissue not just the skin. I would recommend you continue to massage the area to get it to even out. Some juvederm products like XC will absorb lots of water and make it swell for a few days. Give it a week to see how it all settles out. if it is still unacceptable, get reevaluated by your injector

Superficial venous reflux is almost always the cause of spider veins and varicose veins in the legs. It is common not to have much in the way of symptoms early on but the spider veins are unsightly. That leads to evaluation and sclerotherapy. I treat venous reflux regularly and I have many patients that have had many sclerotherapy treatments for many years before getting evaluated for the source of the problem. If you are active and run and lift weights I would recommend you get evaluated for superficial venous reflux soon. I would also quit spending money on sclerotherapy until you get that issue straightened out.