A: At your age, loss of fat and bone structure in the face is uncommon but will appear and progress as we age. Addressing your concerns with filler now would be the start of a life long commitment but well worth it if you achieve a look that makes you happy! Juvederm Voluma and Juvederm Ultra Plus would both accentuate the natural curves, no matter how apparent they are now, and enhance the curvature of the face. Proper injection will provide a natural look without the "filled face" look that is less desirable. The new VYCROSS fillers from Allergan/Juvederm, including Voluma, can last up to 18-24 months requiring less frequent injection. Juvederm Ultra Plus in the mid-face can last up to a year in most people. Achieving your ideal level of correction may take more time and filler initially but if you are good about maintaining the filler you should not have to use the amount initially required. These products are hyaluronic acid fillers which have been seen to boost natural collagen production which will help maintain natural cheek plumpness over time- waiting for the "official" study on this to come out- just personal/professional experience talking in that regard. Good luck!
A: Botox very unlikely to cause vascular or vein issues other then the bruising you have experienced. I would recommend applying topical Arnica and/or Vitamin K cream to the bruised area which will help clear the bruise much faster then letting it dissipate on its own. You can also pre-treat with arnica for a week prior to your next Botox treatment to help prevent and lessen bruising which is the most common side effect with a facial injection! Arnica is available over-the-counter from various herbal or skin care companies, many online. Good luck!
A: You have great bone structure in the cheek and jawline. We tend to lose fat and bone in the supporting structures for our face which provide lift and prevent the flattening effect in the mid-face. Juvederm Voluma is the product I would recommend for the outer portion of your cheeks to provide the natural lift while enhancing and highlighting your naturally good bone structure. You would not need much filler but enough to correct the deflation effect you see when you look in the mirror and also to prevent further loss and progression of the changes you don't like! Best wishes!
A: You can resume your multivitamins. Applying Arnica to the bruised area can help diminish it faster.
A: Using Arnica and/or Vitamin K cream (over-the-counter) topically to areas of bruising
may help decrease the amount of bruising faster then if no treatment is done.
At least one week prior to your appointment, avoid the following as they can increase your risk for swelling and bruising. Aspirin, NSAIDs (Ibuprofen, Motrin, Aleve, etc.), Ginko Biloba, Garlic Supplements, Green Tea, Fish Oils, Vitamins A and E, and essential fatty acids.
Tylenol is appropriate before and after injections.