A woman in her mid 50’s who had blepharoplasty elsewhere 18 months ago and was still bothered by the appearance around her eyes. On examination she has some brow ptosis from the normal deflation that occurs with aging, and the excess skin around her eyes corrects as the brow is elevated. She also has prominent crow’s feet lines with smiling. Although we could consider a brow lift I thought it would be prudent to try Botox first and see how much shaping of the brows and lateral brow elevation that we might obtain. She also has some deflation of the midface and Juvederm Voluma was placed. She had 45 units of Botox and 2 syringes of Juvederm volume. The effect on her brows was dramatic. Her cheeks appear more youthful as well. Additional Juvederm Voluma could be placed to the cheeks but we plan to wait until she returns to repeat her Botox, typically at 4 months.
A woman in her late 30’s who is bothered by a weak chin as well as submental fullness. She is shown 7 ½ months after a chin implant and 3 months after the placement of 4 vials of Kybella to the submental area. She has had an additional 4 vials of Kybella 5 months before. She has gained 4 lbs since the Kybella treatment but the submental area is more refined and gives her the appearance of having lost weight. The Kybella treatment has been tailored in her case to include the jowls. A beautiful jawline is seen after her treatments.
A woman in her later 40’s who wanted fuller but still natural appearing lips. She is shown before and again, 2 weeks after a single syringe of Juvederm Ultra. Her lip has shape and fullness but is not overly prominent. She does not have “duck lips” or “the trout pout” which my patients do not like. Her friends notice that she looks better but are not sure why.
A woman in her early 50’s who is bothered by submental fullness. She is shown after 2 treatments with Kybella. Her first treatment was with 4 vials and her second treatment is with 2 vials. She is 2 months after her second treatment. Although her weight is up 2 lbs her neck has less submental fullness. An advantage of Kybella is that it can be tailored to each patient. In her case the lower jowls were treated as well. As a result, she has a more defined jaw line.
A woman in her later 40’s who is bothered by submental fullness. She is shown 4 months after her second treatment with 4 vials of Kybella. She has had 2 treatments with 4 vials during each treatment. Despite gaining 6 lbs, her submental fullness is improved and her jawline has better definition and an improvement in the jowling.
A woman in her mid 50’s who is bothered by submental fullness. She has had a total of 3 treatments, each with 3 vials of Kybella. She is shown before her first treatment and again, 2 months after her third treatment. She has lost 8 lbs between her first treatment and her after photos through diet and exercise, and this has helped to improve her result even further. Although Kybella is not specifically for skin tightening, she has had a nice tightening of her skin as seen best in the side view.
A woman in her mid 70’s who would like to look a little more rested in her appearance but without surgery. She has prominent “11’s” (corregator lines) of the forehead at rest. Because of age related volume loss the “marionette” lines ( chin-cheek creases) and nasolabial lines (lip cheek creases) are prominent. She is shown before and after Botox to the corrugator muscles and Restylane to the deep “11” lines. The Botox weakens the over active muscles here and the Restylane fills the “ditches” that have formed from this area being creased over and over . This gives her a less stressed look. 2 syringes of Restylane Lyft were placed to her “Marionette” lines and 2 syringes of Restylane Lyft to her nasolabial lines. This gives her a nice improvement that looks better in a natural way.
A woman in her early 60’s who is bothered by an aged appearance and wants to look better, but is not ready to consider surgery. She is bothered by brow asymmetry with her right eyebrow always being higher. Analysis of her face shows a strained appearance in the frown area ( sometimes called the “11’s”), age related volume loss of the midface and jowls, as well as prominent crow’s feet lines around the eyes at rest and with smiling. We decided on a plan of step wise correction. She first had Botox to balance the brows along with Restylane to the deep frown lines and Restylane lyft to the naso labial creases ( sometimes called “the parentheses” ) and chin –cheek lines ( sometimes called “marionette lines” after the lines around a puppets mouth). I then saw her 2 weeks later and placed some Juvederm Voluma to the cheeks. Finally, she returned for Restylane lyft to the “chin notch” and groove in front of the jowls.
She is pleased by her improvement which is natural in appearance. Friends ask her “if she has had her hair done”. This is one of my greatest compliments, because it means that others notice that she looks better but because it is natural, are not sure why, so they attribute the improvement to a new hair style.
A woman in her late 30’s who is bothered by a weak chin as well as submental fullness. She is shown 3 ½ months after a chin implant and 2 months after the placement of 4 vials of Kybella to the submental area. She has gained 4 lbs since the Kybella treatment but the submental area is more refined and gives her the appearance of having lost weight. We can typically expect the area of Kybella treatment to continue to improve over the next 2 months.
A young woman in her mid to later 70’s who has had previous face lift surgery in the Midwest but is bothered by an aged appearance and wants non-surgical improvement.
Evaluation shows a downward sloping position of the eyebrows that gives her a sad appearance. She has volume loss of the cheeks from the aging process. She also has deflation of the subcutaneous volume under the skin of her lips.
She is shown again, 5 weeks after Botox to shape the forehead, and 2 syringes of Voluma to her cheeks. She is also 3 weeks after placement of 3 syringes of diluted Restylane Lyft to the upper and lower lips, and “marionette-line” area.