Dr. Amy Paul, DO, FAAD is a board-certified dermatologic surgeon at Mountain West Dermatology Aesthetics in Grand Junction, Colorado. She has 15 years experience providing her patients with compassionate care, effective skin treatments, and beautiful results. Though she provides a wide range of non-invasive and minimally-invasive aesthetic procedures, she is best known for administering dermal fillers (especially cheek fillers and chin fillers), Botox injections, and laser treatments, including laser skin resurfacing. After graduating from the United States Military Academy at West Point, Dr. Paul received her MD from the Philadelphia College of Osteopathic Medicine. After completing a dermatology residency in San Antonio, she served as a military dermatologist and was deployed to Afghanistan. Dr. Paul and her family then moved to Grand Junction to join Mountain West Dermatology Aesthetics. She is board certified by the American Board of Dermatology and a member of the American Society of Dermatologic Surgery.
A: Thanks for your questions and helpful photos. It would be best for you to see a board certified dermatologist or plastic surgeon in person for an evaluation of how your face moves, check the skin and structures of the face under different lighting, and to talk about your goals. Fillers are usually a good option to start with, along with some preventative neurotoxins such as Botox, Xeomin, or Jeuveau. Make sure you are using a quality mineral sunscreen every day to protect your investment in your skin and see an expert. Good luck!
A: I would definitely recommend seeing an oculoplastic surgeon for treatment of this area. A lot can go wrong with filler placed directly under the eyes, and only a very skilled expert should do any further work on that area. You will need to have whatever filler is remaining dissolved with hyaluronidase if you had a HA filler placed originally. Make sure you know what product was injected so your surgeon can come up with a management plan. Fillers that are not hyaluronic acid, such as Radiesse, Sculptra, and Bellafill, cannot be dissolved. Best of luck!
A: Thanks for your question. Definitely multiple types of fillers can be injected in one appointment, but your dermatologist might want to do one area at a time to see how the first treatment settles. Sometimes you might not need as much as originally planned if you get a lot of improvement from one treatment. Talk to your doctor about the plan and I am sure they can give you an explanation for why or why not they might treat several areas at once. Please see an expert, and best of luck!
A: Thanks for your question. I am not sure where you read those long term effects of fillers - that is simply not true. Maybe the author meant that use of neuromodulators, such as Botox and Xeomin, can cause some muscle atrophy, but I have not heard of fillers doing that. Anyway, I would recommend a consult with a board certified plastic surgeon or dermatologist with experience in revolumizing the face. They will be able to assess your face at rest and in motion and help come up with a treatment plan for you with your safety and best outcome in mind. The good thing about the hyaluronic acid fillers is that they can be dissolved with hyaluronidase if you don't like it. Please see an expert, and best of luck!
A: Thanks for your question. Treating the DAO is a very simple and quick procedure with great results when done properly. The needles are very tiny and the medication is injected quite superficially in the muscles of facial expression, so not deep at all. Please see an experienced board certified dermatologist or plastic surgeon with experience in treating this area, and I hope you have a lovely outcome!