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Photodynamic therapy, or PDT, is a procedure in which levulan, a photosensitizer, is applied to the skin and incubates (is left on the skin) for a period of time.&nbsp; Levulan is then activated by a light source, such as blue light, or intense pulsed light.&nbsp; Actinic keratoses (precursors to squamous cell carcinoma) and acne both respond well to the treatment.&nbsp; While initial studies for the treatment were done with longer incubation times (8 hours), many studies have shown that shorter times (1-2 hours) are just as effective.&nbsp; Generally, the incubation time varies with the part of the body treated and the condition being treated.&nbsp; It is very important to protect skin from the sun for at least 48 hours post treatment. &nbsp;&nbsp;

I am having a PDT treatment with levulan in a couple weeks. my doctor said the "incubation" period before going under the light is 1 hour. I've read that longer incubation periods result in a better outcome. is this true? are there any risks to longer incubation? should I ask my doc if I can incubate for longer than one hour? thanks for your help.

How long should I do Photodynamic Therapy with Levulan?

There are several keys to achieving a natural lip augmentation. 1. A board certified dermatologist with cosmetic experience should perform the procedure 2. The filler should be one suited to the lips, such as hyaluronic acid (Juvederm or Restylane).&nbsp; Radiesse&nbsp;and Sculptra will form lumps&nbsp;and should never be injected into the lips. 3. A conservative amount should be injected.&nbsp; Remember, more can always be added later. 4. The&nbsp;normal anatomy of the lips must be followed: the natural shape and proportions of the lips should be maintained.&nbsp; Asymmetry can be corrected, but the anatomy still needs to be respected. For a consultation with Dr. Bilu Martin, call 305-521-8971.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

My lips appear to be thinning with age but I don't want to look of fake over plumped up lips.  Tips for natural appearing lip plumping?

How to get a natural looking lip augmentation?

We dermatologists have eagerly been awaiting the FDA approval of Voluma. &nbsp;Made by Allergan, the makers of Botox and Juvederm, it is the only filler specifically approved for mid face volumizing. Some great things about Voluma: it's made of hyaluronic acid (like Juvederm, Restylane, and Perlane), so it can be dissolved with hyaluronic acid if needed. It's a thicker product designed to lift, so a little goes a long way. Voluma is meant to be placed deep, right on top of the cheekbone, similar to Radiesse. As with all fillers, a board certified dermatologist with cosmetic experience should perform the treatments.&nbsp;

Is Voluma (By Juvederm) FDA Approved Yet? If Not, Why Not? What Could Be the Concerns?

Is Voluma Filler FDA Approved?

Those&nbsp;prone to cold sores (herpes infections) can be treated with prescription&nbsp;oral antiviral medications prior to treatment and after treatment.&nbsp;

I did three sessions of IPL last year, it was fantastic. However, I've got terrible cold sore a couple of weeks later before my period, and had another cold sore a month later. I've never had it before. It's really nasty that I even had to take antiviral pills. My GP told me that I should avoid doing IPL in the future. Is it true that I will get cold sore again if I do IPL in the future?

Teribble Cold Sore After Three Sessions of IPL, Can I Do IPL in the Future?

Radiesse is a great option for filling and reshaping the jawline.&nbsp; It is injected deeply, over the bone.&nbsp; This is an advanced, off-label technique.&nbsp; While Radiesse is longer lasting (12-18 months), it is not permanent.&nbsp; Facial movement will not affect the filler.&nbsp; As with all filler procedures, a board-certified dermatologist with cosmetic experience should perform the procedure.&nbsp;

Seems Like Radiesse is the Filler of Choice for Augmenting the Jaw Angle but Won't Facial Movement &amp; Normal Aging Compromise It?

	People like Radiesse cause it's supposed to build some permanent collagen / scar tissue. Masseter muscle is extremely busy -- allowing us to constantly talk, chew, &amp; eat. Doesn't this movement make it hard to keep the perfect shape jaw angle created, as the Radiesse does it 's work ? How does filler look when people move the area injected ? Aging: You have filler in one area, but everything around it ages, loses collagen, &amp; sags. How will filler look when this process happens ?

Won't Facial Movement &amp; Normal Aging Compromise Radiesse?

Nodules are a possible risk when injecting Sculptra, however, with careful preparation and injection technique, they can often be avoided.&nbsp; When Sculptra first came out, physicians were trained to use dilutions of&nbsp;4 mL.&nbsp; However, this low volume tends to promote nodules.&nbsp; Most physicians now dilute to a volume between 6-9 mL.&nbsp; In thinner skinned areas, such as&nbsp;hands and chest, even more dilute formulations are recommended.&nbsp;&nbsp;When injecting the face, the injections should be placed deeply.&nbsp;&nbsp;Sculptra should&nbsp;not be injected around the eyes or&nbsp;mouth, as&nbsp;these areas will form nodules.&nbsp;&nbsp;Massaging after treatments&nbsp;is helpful, as well.&nbsp; As always, treatments should be performed by a board certified dermatologist or plastic surgeon with&nbsp;cosmetic experience.&nbsp; &nbsp;&nbsp;&nbsp;

I suspect my plastic surgeon didn't properly mix my third vial. I am also suspect when he reconstituted it. I don't think he waited long enough before injecting it. He had a very difficult time injecting and had to change out for larger needles. Large hard nodules developed in the hollows of my cheeks in 2 wks with significant swelling that has not resolved in over 2 months. 2 previous vials I received 8 months ago from the same physician resulted in great results with no problems.

Incorrect Dilution of Sculptra?

Undereye hollows result from loss of volume (fat) and can cause a tired appearance.&nbsp; Hyaluronic acid fillers are an excellent choice to replace volume&nbsp;under the eyes.&nbsp; Restylane, Juvederm, and Belotero can all be used (off-label).&nbsp; Belotero is a newer hyaluronic acid filler that has less of a risk of causing the Tyndall effect, or a bluish discoloration.&nbsp; Injecting under the eyes is considered an advanced technique.&nbsp; If too much filler is used, or is placed superficially, it can appear lumpy.&nbsp; Of note, Radiesse and Sculptra should not be used in this area.&nbsp;

I've asked my dermatologist at my last visit if she would recommend it and she felt strongly that I should avoid getting it done. Unfortunately she didn't elaborate. I'd love to hear from both sides of why this may or may not be a smart decision. Is filling hollows an approved use for any of these fillers? I know that its a temporary fix and won't completely solve my under eye issue, but are there any more serious cons? Would keeping up with it for a long period of time have any side effects?

Would You Recommend Dermal Fillers for Under Eye Hollows? (photo)

Over time, fat compartments in the cheek atrophy, and the nice high cheekbones that many of us had disappears.&nbsp; This leads to hollows in the midface and deep nasolabial folds.&nbsp; There are different filler options for replacing volume.&nbsp; The longer-lasting fillers, Radiesse and Sculptra, provide a very nice, natural result.&nbsp; However, these products can not be dissolved or reversed, although they will dissipate over time.&nbsp; Perlane, a thicker hyaluronic acid filler, is a great choice for cheek augmentation.&nbsp; It also can be dissolved by hyaluronidase if need be.&nbsp; How much is needed depends on each individual patient and can be determined by a board-certified dermatologist.&nbsp;

I do not wish to have Sculptura,nor Radiesse, nor the invasive treatment of fat injections, which are unpredictable. I am wanting to fill out the below the cheeks, the sub malar region, not to have higher cheekbones at all, but to fill out the slight hollowness. Would Perlane be a good filler, would any injectables work in this area, and how many approximate mls would be required ?

Filler for Under the Cheek Area (Submalar)?

Perlane

The effects of Dysport, Botox and Xeomin all last about 3 months.&nbsp; Some people find that their results last a little big longer; others, a bit less.&nbsp; As always, injections should be performed by a board certified dermatologist or plastic surgeon with cosmetic experience.&nbsp;

I had 20 units of dsyport injected on jan 17th and it is WAY TO FLAT!! my facial expressions make me look like a clingon because I can move my eyebrows up and then NOTHING, flatness, weirdness. I NEED THIS TO GO AWAY NOW!!! When should I expect some movement. Some people have said the unit amount doesn't matter, other people say 20 units will go away faster! I am eating healthy and hoping everything grows back asap. When will it start to not look so flat! please help!

20 Units of Dysport in Forehead HATE IT When Will It Go Away?

Hyaluronic acid fillers are a great choice for lips.&nbsp; Juvederm tends to feel a little softer and should last about 6 months time.&nbsp; Restylane and perlane can be used as well, although perlane is a thicker,&nbsp;more robust&nbsp;filler.&nbsp; Some physicians inject silicone in the lips using the microdroplet technique.&nbsp; However,&nbsp;this is a permanent filler&nbsp;and should be used with caution.&nbsp;

I have used Restylane and normall Juvederme Ultra; unfortunately they both never lasted longer than 4 weeks!!! I am off back in search of fillers; have been advised by surgeon to go for Juverderme 4; but apprehensive as it may not last?? after reading reviews am quiet keen on Perlane; due to the length it stays but My surgeon is slightly apprehensive as he mentioned ""Bumping"" on the lip area, is this correct?? What would you suggest between the 2 for lip area?? Thanks

Perlane or Juverderm 4 for Lips?

Donna Bilu Martin, MD

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Dermatologists are board-certified doctors who have the training and expertise to diagnose and treat diseases of the skin, hair, nails, and mucous membranes.

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Gary Lawton, MD, FACS

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Ryan A. Stanton, MD

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Dilip D. Madnani, MD, FACS

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Donna Bilu Martin, MD

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IPL for my Melasma. Aventura, FL

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