I got juvederm "voluma" yesterday!! I have cheeks!
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free skin care · Sun Feb 07, 2010 4:07 am

Dr. Rose,

Firstly, I'd like to thank you for sharing your knowledge and expertise with us here.

I am late 40s and experiencing sagging which
distresses me a great deal.

I've held the line on wrinkles and maintained good tone and texture through a combination of topicals and peels,dermarolling, etc.
Restylane in my tear troughs has made a big difference.
Ok...so here I am now, with jowls and sagging as my only big face issue.

I am not sure I am ready for plastic surgery, or if I am, what procedure would best fit my needs.
I would really appreciate your best advice for jawline tightening and lower face sagging - using techniques or procedures available on the East Coast of the US.
I would even consider travelling, except that I understand that some procedures require multiple trips.

Thank you,BF

free skin care · Sun Feb 07, 2010 4:27 am

bren21 wrote:

Thanks Mishey....I am so excited about this and can't wait to see what effect it's going to have on my face. A year ago, I was full out ready to have a mid-face lift...but after reading about what fillers can do and that they can give the illusion of a lifted face by replacing volume lost, I thought otherwise.

For one thing, I am only 39...I want to hold off going under the knife until I really, really need it. If I can get the effect of fuller cheeks and a lifted face in the process, it is well worth the $1250 once a year until the day the knife comes knocking on my door Laughing

...considering the average lift lasts about 5 years, I'd say that's not too shabby in regards to cost. And quite honestly, it is the only complaint I have about my face as almost every other issue I have with my face is being caused by this volume loss...I have no wrinkles, so once this volume loss is addressed, the only thing I will have to work on is evening out my skin color, taking care of this sun damage and a few red spots I have...

Sounds like a plan to me Very Happy

!!!!

Can't wait to hear how you go.

Sun Feb 07, 2010 8:54 am

Barefootgirl wrote:

I am late 40s and experiencing sagging which
distresses me a great deal.

I've held the line on wrinkles and maintained good tone and texture through a combination of topicals and peels,dermarolling, etc.
Restylane in my tear troughs has made a big difference.
Ok...so here I am now, with jowls and sagging as my only big face issue.

I am not sure I am ready for plastic surgery, or if I am, what procedure would best fit my needs.
I would really appreciate your best advice for jawline tightening and lower face sagging - using techniques or procedures available on the East Coast of the US.
I would even consider travelling, except that I understand that some procedures require multiple trips.

Thank you,BF

Hi Barefootgirl,

First of all, my bias is against anything surgical so take that into consideration when you assess my advice.

The key treatments for me are tightening the skin and restoring volume.

I did skin tightening with fractionated laser (Pixel at my place, Fraxel, ProFractional and other names elsewhere) every 2 months for a year. I should say I am 46 with northern European skin that suffered a lot from sun damage so I needed to restore a lot of collagen to my skin.

Now I do the laser about every 3 months (because I can Very Happy

).

Anyway, doing a series of 5 or 6 lasers at Pixel intensity did not interfere with my life and restored the tautness to my skin that I had 20 years ago. (I've got the pictures to prove it.)

I don't have enough experience with dermarolling to know how it compares with fractionated laser.

The other thing I did for my neck (double chin) and jowls was injection lipolysis or Lipodissolve with good results. Go to the NETWORK Lipolysis website to find a doctor in your area. I know the NETWORK Lipolysis protocols are proven to work -- don't know about other recipes that other people use.

If you only had volume in your tear troughs then I am pretty sure you need it in your cheeks too. The lower lid pouches when the volume is missing below it in the cheek area. Because the lower lid skin attaches at the tear trough, you think the problem is there when it is really in the cheek.

Doing your cheeks will lift your lower face and help with the jowls, not to mention making your midface look better.

If your skin is really firm and taut from the dermaroller and peels, then the volume is probably the only thing you are missing. You can use an HA filler, Sculptra or Beautical. The choice depends on what you prefer and what your injector is good at. Make sure you see lots of pictures of your injector's work before you go ahead.

Hope this helps.

Dr. Rose

free skin care · Sun Feb 07, 2010 9:41 am

snowqueen67 wrote:

Doodles this would not be a sculptra nodule yet...it takes weeks to develop and "fluff". So I would guess it it some localised reaction or injury. I would stop massaging and take some arnica if you can get it orr ibprofen to see if it settles. By all means get back to your doctor.

Let us know what happens.

Thanks snowqueen. I'm just kind of freaking out! I didn't figure it was a nodule as I know it takes more than a few days for one to develop. I took some advil this morning so hopefully that will help. The last two times that I did my massage I pretty much avoided the lump and although I don't think it has gotten any smaller it hasn't gotten bigger and it hurts a little less. I will definitely be getting in touch with my doctor tomorrow.

free skin care · Sun Feb 07, 2010 9:50 am

Hi Doctor Rose, just wondering if you had a chance to read my post.

doodles wrote:

Hi Dr. Rose,
Just wondering if you could answer a couple of questions if you read this before Monday morning. I had two vials of Sculptra done on Wednesday - mostly in the cheeks with a little on the sides of my chin and jaw line. It looked ok at first but starting Thursday I started to develop a lump about the size of a nickel about 2cm out from my nostril. It is painful and quite noticeable especially if I pull my skin taught. It kind of looks like a raised bruise. I have been doing the massage for 5 minutes 5 times a day but the lump is getting bigger and more painful. I have been massaging the area quite vigorously thinking that would help but am now thinking that I'm only making it worse. My smile is also worrying me. It is very lopsided now. When I smile I only have one smile line. The other side of my face has no smile line now and a horizontal crease or indent about a fingers width right beside where my smile line should be. The lump/bruise is on the nostril side of the indent. When I smile the two sides of my face do not come close to looking the same. I am scheduled to see my doctor again on Wednesday but I think I will give her a call on Monday morning as this is quite worrisome to me. My question is do you think I should keep massaging the lump and also do you think that the asymmetry can be corrected? Do you think that the doctor will use more Sculptra to address the problem? When she was injecting me she said that I needed more filler on the one side (the side with all the problems). Thanks in advance for any help you can offer.
Doodles

TIA

free skin care · Mon Feb 08, 2010 7:58 pm

Thank you Dr. Rose...

So, if I understand correctly - as an alternative to plastic surgery, one should be able to correct lower face sagging and jowls through use of Pixel treatments, a cheek filler (Juvederm or Beautical (never heard of that) and lipodissolve...?

Is the concern regarding plastic surgery related to "unnatural" results, prolonged recovery or something else?

Thanks again,BF

Wed Feb 10, 2010 9:08 am

[quote="doodles"]Hi Doctor Rose, just wondering if you had a chance to read my post.[quote="doodles"]Hi Dr. Rose,
Just wondering if you could answer a couple of questions if you read this before Monday morning. I had two vials of Sculptra done on Wednesday - mostly in the cheeks with a little on the sides of my chin and jaw line. It looked ok at first but starting Thursday I started to develop a lump about the size of a nickel about 2cm out from my nostril. It is painful and quite noticeable especially if I pull my skin taught. It kind of looks like a raised bruise. I have been doing the massage for 5 minutes 5 times a day but the lump is getting bigger and more painful. I have been massaging the area quite vigorously thinking that would help but am now thinking that I'm only making it worse. My smile is also worrying me. It is very lopsided now. When I smile I only have one smile line. The other side of my face has no smile line now and a horizontal crease or indent about a fingers width right beside where my smile line should be. The lump/bruise is on the nostril side of the indent. When I smile the two sides of my face do not come close to looking the same. I am scheduled to see my doctor again on Wednesday but I think I will give her a call on Monday morning as this is quite worrisome to me. My question is do you think I should keep massaging the lump and also do you think that the asymmetry can be corrected? Do you think that the doctor will use more Sculptra to address the problem? When she was injecting me she said that I needed more filler on the one side (the side with all the problems). Thanks in advance for any help you can offer.
Doodles[/quote] Very Happy

TIA[/quote]

Hi Doodles,

Please go back to see your doctor right away.

The most likely thing is that this is a bruise, causing some pressure effects on nerve and will all resolve over time but I would prefer that you have the doctor look at you to be sure.

That lump will need to resolve completely before doing any more Sculptra or filler.

Let me know what happens.

Dr. Rose

free skin care · Wed Feb 10, 2010 9:58 am

Thanks Dr. Rose. I'm going to see my doctor this afternoon. I think you're right about it being a bruise as it seems to have gotten somewhat smaller over the last couple of days and it doesn't hurt as much. I will let you know what happens.
Doodles

free skin care · Wed Feb 10, 2010 1:54 pm

Pollyanna wrote:

I'd also be curious how well it works for lip correction/augmentation. I am always looking for a filler that can actual slightly 'lift' the upper lip..

There is something called a lip lift where they remove a strip of skin below the nose to raise the upper lip. I'm very interested in having this done because the area between nose and upper lip is rather long. If you have a short area, like Keira Knightley for example, you would probably be better off with filler.

Also, there is quite a bit of difference in where they place the filler -- central area of lip vs entire lip length. Depending on your lips, one may look more natural than another. I think some of the duck lips would be avoided if filler was only placed in the central area, especially of the lower lip. Think Isabella Rossalini, for example.

free skin care · Thu Feb 11, 2010 9:17 pm

Hi Dr. Rose and Snowqueen,
I saw my doctor yesterday and she said that the lump was a bruise probably caused by hitting a blood vessel. It is much smaller today and doesn't hurt anymore. She told me to gently massage it a few times a day and that does seem to be helping. Anyway, thanks for your concern. I will keep you posted. BTW the Sculptra seems to be settling nicely and I can already see an improvement. Injecting the cheeks makes a huge difference!
Cathryn

free skin care · Thu Feb 11, 2010 11:57 pm

doodles wrote:

Hi Dr. Rose and Snowqueen,
I saw my doctor yesterday and she said that the lump was a bruise probably caused by hitting a blood vessel. It is much smaller today and doesn't hurt anymore. She told me to gently massage it a few times a day and that does seem to be helping. Anyway, thanks for your concern. I will keep you posted. BTW the Sculptra seems to be settling nicely and I can already see an improvement. Injecting the cheeks makes a huge difference!
Cathryn

Good to hear!! Hope it works out well for you.

rebecca

free skin care · Mon Feb 15, 2010 4:18 pm

Dr. Rose(or anyone else with experience)

Pollyanna has said that extracting the fat from her body for fat facial injections leaves the fat in the extracted area lumpy...which i would not want...has anyone else had this experience...or has anyone had an experience where this didn't happen?

Also how long do fat injections last.

free skin care · Wed Feb 17, 2010 9:51 am

hoping to get a response to my previous post by bumping this thread today!

free skin care · Wed Feb 17, 2010 11:06 am

Got my cheeks done yesterday and we opted for Juvederm instead of Radiesse and oh my, I cannot believe the difference it made in my face!! Shock

It is exactly what my face was missing and it's so good to have my cheeks back again....

I bruised fairly well on my right side, not too bad on my left even with taking Arnica and cutting out Vit E, flax oil and the like...I guess I just naturally have thin blood Wink

For all the gals who've had their cheeks done, when you got your cheeks injected, did they inject high up on your cheek bones and also in the apple area of your cheeks...or just one or the other?
For myself, she just injected high on my cheeks, like a bit diagonally down from the outside corners of my eyes...I feel that my apples are also a bit deficient as well and was a bit surprised that she did not put any in the area where my troughs are extending in to my cheek...I really do feel I need some there....any thoughts?

Also did botox for the first time between my brows...have had a bit of a "brain freeze" type headache since last night, albeit not really bad...just kind of irritating...did anyone else experience this?

free skin care · Wed Feb 17, 2010 11:24 am

I'm happy that you are pleased with your results, Bren

free skin care · Wed Feb 17, 2010 11:29 am

jasminerosey wrote:

Dr. Rose(or anyone else with experience)

Pollyanna has said that extracting the fat from her body for fat facial injections leaves the fat in the extracted area lumpy...which i would not want...has anyone else had this experience...or has anyone had an experience where this didn't happen?

Also how long do fat injections last.

hi jasminerosey
well I can tell you for me the bumpiness only really got bad when I gained weight years later. I believe the area you take the fat from during liposuction doesn't re-gain fat as easily and the new fat tends to gain around the area instead. This is my experience and this is having had ultrasonic (ultrasound) liposuction about 10 years ago on the inner thighs. This type of lipo is less invasive than regular liposuction in my understanding and should give a smoother result.Nowadays there are even better newer techniques like Lipodissolve. I can't comment on those but I do think that when you remove fat from an isolated area and then go on to gain more weight back it makes sense it would come back in an odd ditribution pattern as a result..I am sure though there are gadgets or in office machines that would smooth the lumps out...I haven't tried
Again I only experienced this problem when I went up in weight about 10-15 lbs from what i was at the time of surgery..
as for fat transfer- in my experience my lips really over-retained the fat-must be careful there not to overcorrect- it stays forever. Couldn't get rid of it! Though I imagine with most people this wouldn;t be the case because of all the regular actvity with eating/chewing/kissing etc..
Having it under my eyes only lasted about 1-2 years but looked GREAT! I am sure there is some still in there but not sure as I topped it up with sculptra a few years later as it faded..

I think if you get a doctor very experienced in the latest forms of fats transfer (lipostructure) you can get a fairly long-term result but not longer than these new fillers like juvederm voluma and this 'Beautica'l Dr Rose mentions. These last up to 2-4 years and you know what you're dealing with. It dissolves eventually if you don't like it and there is no hassle of additional liposuction and recovery.
Of course if you need lipo somewhere then it's a nice bonus but I've never really seen anyone have a real smooth skin result from lipo.Maybe the newer Lipodissolve treatment works better...?

Just to add I had a very prominent, respected doctor-noone shabby -so as good as the doctor is -these were still my results..

hope that helps somewhat. Smile

free skin care · Wed Feb 17, 2010 12:22 pm

Thanks so much Pollyanna, this helps me very much.

free skin care · Wed Feb 17, 2010 1:15 pm

bren21 wrote:

Got my cheeks done yesterday and we opted for Juvederm instead of Radiesse and oh my, I cannot believe the difference it made in my face!! Shock

It is exactly what my face was missing and it's so good to have my cheeks back again....

I bruised fairly well on my right side, not too bad on my left even with taking Arnica and cutting out Vit E, flax oil and the like...I guess I just naturally have thin blood Wink

For all the gals who've had their cheeks done, when you got your cheeks injected, did they inject high up on your cheek bones and also in the apple area of your cheeks...or just one or the other?
For myself, she just injected high on my cheeks, like a bit diagonally down from the outside corners of my eyes...I feel that my apples are also a bit deficient as well and was a bit surprised that she did not put any in the area where my troughs are extending in to my cheek...I really do feel I need some there....any thoughts?

Also did botox for the first time between my brows...have had a bit of a "brain freeze" type headache since last night, albeit not really bad...just kind of irritating...did anyone else experience this?

Bren! Well done! Thats how mine were injected too...along the cheek bone rather than the apple. If I get some money this year Rolling Eyes

then I will add some there...but I agree, such an improvement!

In a day's time, gently and superficially massage the bruise, I have found it speeds up clearing it through your circulation.

rebecca

free skin care · Wed Feb 17, 2010 4:29 pm

HI, Everybody, I'm getting a filler tomorrow! I'm excited. I think she will use Juveder, but I'm not certain. My area of concern is my cheeks (althoug I could use a filler at the corners of my mouth, too). Anyway, I just got so very tired of trying different gadgets and products to no avail. It was making me feel bad about myself. Having said that, I won't give up my gadgets. In fact, I'm considering some ultrasonic something or the other. Laughing

I will get back to you sometime tomorrow afternoon to let you know how it goes. Smile

free skin care · Wed Feb 17, 2010 6:27 pm

Thanks Snow for the advice and thanks Jasmine Wink

...I will massage them gently to get those bruises moving along because I really want to wear my hair up and at this point I don't want to... Laughing

I just can't stop staring at my face in the mirror the last 24 hours...they seem to look better as time goes on and it's starting to settle down. I will probably go back in next month to have a touch put in my apples, just to give them a little lift. My mouth corners are not as saggy looking either which is great!! It was money well spent...

The botox seems to be doing well too and my muscles are already starting to smooth out and freeze a bit...although I still have a slight headache. Hope that goes away soon.

Mars! Have fun tomorrow Very Happy

It is really exciting to see how your face transforms after your injections...it's like an instant moral and confidence booster for sure!! I am excited for you and look forward to hearing about it....

free skin care · Wed Feb 17, 2010 7:17 pm

Bren, so glad you're happy with everything. It does make a difference to the face doesn't it? Could you tell me how much you got injected into each cheek.

free skin care · Wed Feb 17, 2010 7:23 pm

bren21 wrote:

Thanks Snow for the advice and thanks Jasmine Wink

...I will massage them gently to get those bruises moving along because I really want to wear my hair up and at this point I don't want to... Laughing

I just can't stop staring at my face in the mirror the last 24 hours...they seem to look better as time goes on and it's starting to settle down. I will probably go back in next month to have a touch put in my apples, just to give them a little lift. My mouth corners are not as saggy looking either which is great!! It was money well spent...

The botox seems to be doing well too and my muscles are already starting to smooth out and freeze a bit...although I still have a slight headache. Hope that goes away soon.

Mars! Have fun tomorrow Very Happy

It is really exciting to see how your face transforms after your injections...it's like an instant moral and confidence booster for sure!! I am excited for you and look forward to hearing about it....

BTW the headache is common and I have had it a few times.

free skin care · Wed Feb 17, 2010 7:38 pm

snowqueen67 wrote:

BTW the headache is common and I have had it a few times.

Yes it is, I've had it too.

free skin care · Wed Feb 17, 2010 7:47 pm

Congrat.

free skin care · Thu Feb 18, 2010 4:12 pm

HI, everyone, Got back from seeing my doc a little while ago. Guess what.....she didn't do anything!

She said my biggest issue right now is that I am too thin, especially my face. She said the second she saw me, the first thing that came to her was that I had lost a lot of weight. Interesting, huh? We talked about the apples of my cheeks needing a boost (filler). However, she said until I gained some weight, that procedure could actually accentuate the gauntness in my mid-face. Also, she said she would be more comfortable "working on" me without my braces.

Here's something that blew my mind: without any prompting from me, she said I looked younger now than when I first started seeing her. W H A T ??? I told her I just couldn't believe that. She said my skin looked really good (for me) and for someone who's lost weight, I didn't really have loose skin. I still cannot / don't agree with her on that.

Anyway, to sum it up, we both agreed for me to put on 5 lbs. or so, get my braces off (supposed to be in 3 weeks, but we'll see), wait about a month and go back to her. The thing she emphasized was that if I didn't gain some weight, I probably wouldn't be happy with the results of anything she did to me.

How great of her to to be so honest with me. She easily could have taken my money. I feel like now I have a good game plan. Yippee!

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