Unhappy with Results - Best Way to Approach Dr?

Three wks ago had liquid lift-Botox/Juvaderm which have had before w/great success by same Dr. Two wks ago had IPL on left cheek-same Dr. Well into healing notice: Tremendous bunny lines-appear as squinting; Droop-both eye corners; Hollows below eye/above cheek-look tired; Cheeks don't feel/look full; Don't feel filler as in past; More wrinkles. Can IPL affect effect of Botox/Fillers? If no, why results? What is best way to: Fix and bring to Dr.'s attention-reluctant as yrs seeing. Thank you.

Doctor Answers 1

How to approach Dr when unhappy with results of procedure

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Dear Ingrid,

I will approach your question in two parts: 1. Best way to approach Dr and 2. What can possibly be done to achieve better results.

First, if you have a great relationship with your doctor, and it sounds like you want to maintain that relationship, there should be no problem with talking to him or her about your unhappiness.  From your concern I gather that you are a very polite person and are hesitant about hurting both your doctor's feelings and your relationship with him or her.  That is truly appreciated on the doctors' part.  Sometimes adjustments need to be made, especially when we are talking about extensive procedures like a liquid facelift.  Make an appointment and be straight with them, tell them exactly what the issues are and talk about how they can be resolved.  There is great value in a straight-forward approach.

Second, regarding the bunny lines.  If your forehead and glabella were injected with Botox and your bunny lines were not, the bunny lines are the only thing you have left to make your customary facial expressions, a so called compensatory action.  It can be fixed by injecting very small amounts of Botox into the bunny lines.

When the cheeks are filled and have more volume and the tear troughs are not, the hollows under the eye get more accented.  That can be addressed with injecting Restylane (my favorite under eye filler) into the tear troughs.  Make sure your doctor has experience in doing that.

I am not sure about the droop at the eye corners.  Is it the brow that's drooping or the eyelid?  That's important.  If the eyelid is drooping, it is possible that Botox had drifted down into the levator muscle of the eyelid and relaxed it.  There are eye drops that can help with that until the issues resolves which usually takes about a month. 

If it is the eyebrow that's drooping, it does depend whether it's the outside or inside area that's lowered.  Usually the brows can be lifted by injecting a few units of Botox into the muscles that pull the brows down.

IPL should not affect the results of Botox or fillers.

Talk to your doctor.  It sounds like you have a great relationship with them.  Most if not all the issues can be addressed.

Short Hills Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.