Just facial stuff here....

[general_antiope 189]

I'm only 32 but I have a very heavy, low hanging brow, have had it since birth. I always pull my muscles behind my ears so my eyes look open. When I am relaxed, people on the street stop me and tell me to "smile, it's not that bad" and I'm thinking...I AM quite happy!! LOL

I actually get a muscle ache behind my ears from overcorrecting this issue. I thought a browlift would be a great permanent fix for me.

I thought Botox lasted about 4 - 6 months? I heard the cost was about 500 - 600 a session, that's $100/month! Am I right about these numbers or am I misinformed??

[TerriDoodle 6]

I'm only 32 but I have a very heavy, low hanging brow, have had it since birth. I always pull my muscles behind my ears so my eyes look open. When I am relaxed, people on the street stop me and tell me to "smile, it's not that bad" and I'm thinking...I AM quite happy!! LOL

I actually get a muscle ache behind my ears from overcorrecting this issue. I thought a browlift would be a great permanent fix for me.

I thought Botox lasted about 4 - 6 months? I heard the cost was about 500 - 600 a session, that's $100/month! Am I right about these numbers or am I misinformed??

I can relate to people telling you to cheer up all the time! I got that a lot too. Mine was mostly caused by the deep wrinkles between my brows and now only made worse by sagging eyelids caused by natural aging.

I was amazed at how the botox de-wrinkled my whole brow, not just between them. And because my surgeon knew just where to place the needle I also got a little mini brow lift as well....meaning my eyelids have a higher arch to them now!

My botox treatment cost $325 here in Houston, but I"m sure that varies widely.... also depends on how many areas you are treating. Is it worth $100/month? Only if you have it to spare!!! I wouldn't take it out of the family food budget!

[kareyquilts 1]

Dr. Schulman: Thanks for the tips about bruising and the lycogel make up. I also read your article about non-surgical facelifts and found it to be very enlightening. Too bad you're so far from Utah! I had my touch up with Juvaderm yesterday. The ps filled in some more of the vertical lines on my lips. I went off all my Vitamins, fish oil and aspirin for 2 weeks before. I still have some bruising and swelling. The bruises aren't black this time. I've been icing, using arnica, etc. I have some puckering and a bumpy spot on one side. How can I tell if this is an overfilled area or just some localized swelling?

[Dr. Schulman 2]

Dr. Schulman: Thanks for the tips about bruising and the lycogel make up. I also read your article about non-surgical facelifts and found it to be very enlightening. Too bad you're so far from Utah! I had my touch up with Juvaderm yesterday. The ps filled in some more of the vertical lines on my lips. I went off all my Vitamins, fish oil and aspirin for 2 weeks before. I still have some bruising and swelling. The bruises aren't black this time. I've been icing, using arnica, etc. I have some puckering and a bumpy spot on one side. How can I tell if this is an overfilled area or just some localized swelling?

NYC is not so far.....

If the Juvaderm looked OK right after, than it is probably just swellng and not over-corrected. The most swelling is at 24-48hrs after injection - right where you are now! The Juvaderm (like all other hyaluronic acids, ie. Restylane and Perlane) will absorb Water and appear to be fuller...this improves as the Juvaderm settles into place.

For all you who love to see pictures...

Lip augmentation with filler

Nasolabial line reduction

cheek augmentation with filler

And for those who think fillers are only good for the face.....

An article featuring the use of fillers to help in breast reconstruction (The Breast Journal)

[kareyquilts 1]

Dr. Schulman: Thanks for the prompt response! Do you ever get any sleep? I'm wondering about doing some sort of ablative laser to get rid of all the fine lines on my face. Do you have any articles about this? My lines are fairly fine, would this be overkill? Can the laser be combined with a surgical facelift? Are there any long term consquences to an ablative laser? I know I'm asking alot of questions, please bear with me. A local dermatogoly office is advertising a fractional ablative laser. They are claiming that through a series of sessions you can get the same effect with less down time. It's really hard to sift through all these claims because of the profit motive. One last question (sorry, this may be too much). How do you know when you are ready for a surgical face lift? Can it be done too soon? Thanks!

[Jachut 487]

I found a name for my problem! I have tear trough deformity, lol. A bit of filler should take care of it. Or maybe a new head.

Too bad I have 3 kids, a mortgage, private school fees to pay and am 18 months finishing my degree. Which at the rate I'm going now (4 essays due next monday, ergh) I should look about 100 on a good day! I'm also beginning to believe the theory that running ruins your face (and I'm a walking example of how bad it is for your boobs).

Dr Schulman, how long do fillers like restalyne really last in the eye area?

[Dr. Schulman 2]

Dr. Schulman: Thanks for the prompt response! Do you ever get any sleep? I'm wondering about doing some sort of ablative laser to get rid of all the fine lines on my face. Do you have any articles about this? My lines are fairly fine, would this be overkill? Can the laser be combined with a surgical facelift? Are there any long term consquences to an ablative laser? I know I'm asking alot of questions, please bear with me. A local dermatogoly office is advertising a fractional ablative laser. They are claiming that through a series of sessions you can get the same effect with less down time. It's really hard to sift through all these claims because of the profit motive. One last question (sorry, this may be too much). How do you know when you are ready for a surgical face lift? Can it be done too soon? Thanks!

sleep is for the weak!

Ablative Lasers are the gold standard by which everythingis measured (CO2, Erbium). The problem is that there is significant "downtime" and the face may be left with an unnatural appearance that is shiney and may be hypopigmented.

Fractional Ablative Lasers may work.....they are very new and the data is not conclusive. They probably work well, but need multiple treatments (more than most doctors will tell you). And this can get very expensive - figure about 1000 -1500 per treatment with anywhere from 3-6 sessions.

Deep chemical peels work really well (TCA) and have less downtime than ablative lasers. The cost is also much less (around 2000 and only 1 session required)

I am not the type of doctor that "jumps" on the newest technology. I let other people prove that it is not just a "gimmick." Remember SmartLipo?

Regarding a facelift....here is my tip to tell if you "need" it. Lie on your back, and look at your face in a mirror. Like what you see? This is the result you will get with a facelift! This will reduce lines, but may not get rid of the very fine lines that you have. This may still need some "spackle" in the form of microdermabrasion, chemical peels. etc.

I routinely do facelifts on women in the 50s. This seems to be the most popular age to have this done. Most people are happy with the results for about 10-15 years. It is a nice age because you are still young and can "enjoy" your more youthful face.

[Dr. Schulman 2]

I found a name for my problem! I have tear trough deformity, lol. A bit of filler should take care of it. Or maybe a new head.

Too bad I have 3 kids, a mortgage, private school fees to pay and am 18 months finishing my degree. Which at the rate I'm going now (4 essays due next monday, ergh) I should look about 100 on a good day! I'm also beginning to believe the theory that running ruins your face (and I'm a walking example of how bad it is for your boobs).

Dr Schulman, how long do fillers like restalyne really last in the eye area?

tear trough deformties are very common. It results from a descent of the malar (cheek) fat, which leaves a groove between the cheek and the eye. Fillers work well for this area, but make sure your PS is an experienced injector because this area requires advanced technique.

Hyaluronic Acids like Restylane and Juvaderm will last 6 months (Juvaderm may last up to a year). I find that these materials are a bit too thick and can be lumpy when placed int his area (because the ski is sooo thin). I prefer to use Sculptra or Radiesse. Sculptra requires 2-3 sessions and will last 2 years. Radiesse needs 1 sesson and will last about 1 1/2 years.

Here is a picture of someone with a similar problem. This picture was taken immediately after putting Sculptra beneath only one eye (yes, I did then put it in the other).

[kareyquilts 1]

Dr. Schulman: You're the best! Thanks for answering my questions. It's obvious that you enjoy what you do. NYC is far away to go for a peel, but maybe not for a facelift! Your pictures are a great help too. So many decisions... When you lie down to look at the face, does that include what a neck lift would look like? This must be a tricky area, because I haven't seen too many that look that great afterwards (not that I've seen a lot)! I guess that my neck bothers me the most, a lot of crepey skin since I've lost weight. Sounds like I have options for the fine lines on my face, but surgery is probably the only option for the neck?!

[gerry 0]

I'm developing a jowl problem, very unattractive. Would liposuction help? What is the name of the doctor you used and where is he/she located? Thanks in advance

[kareyquilts 1]

Gerry: I do think that Lipo is sometimes done on the face and under the chin. I haven't had that, but I did have Thermage after I had lost about 50 pounds and had developed the jowls. It totally took care of my jowls. It made a huge difference. From what I understand, Thermage results are variable depending on how much collagen or elasten you have in your skin, but I found it to be a great treatment. It's uncomfortable to have done, but there is no down time and your face looks plumped up and nice afterwards. The total affect of the procedure can take up to 6 months, however, because it works on the underneath layers of your skin. I bet Dr. Schulman has some before and after pictures on his website. Check it out!

[TerriDoodle 6]

Well, I'm sitting here recovering from eyelid surgery...blepheraplasty... doing pretty well. I'm at day 8 now and there's only a small bit of bruising left, swelling is 'bad' only in the morning, and the suture lines are healing pretty well.

I'll post pictures when it's all said and done...if I only posted this weeks nobody would ever get it done! I pretty much looked like hell for the 1st 5 days. I took 10 days vacation to avoid comments from co-workers and I'm so glad I did. 8-10 days is just about right.

I can't wait to see the final results as the weeks go on!

[Frangipani 1]

Hi Terri,

Thanks for the update, glad to hear that it all went so well!!!!

I'm looking forward to seeing your photos. I see blepharoplasty as one of those "absolutely necessary" plastic surgery procedures as time marches inexorably on -- and I will definitely be having that done at some point in the future.

Did you have much pain at all?

[luluc 6]

good for you terri, hope your healing continues. my mom had this done several years ago & had an allergic reaction to her stiches - but the results were phenominal.

i've been telling my husband i want my eyes done for about a yr now. i have the "inherited" - hood & dark circles from both parents. even when rested i sometimes look tired & if i'm not rested - well the bags come out.

dr schulman - what is the best treatment for this? i'll be 40 soon, have no other wrinkle issues - but would really like to get my eyes to match how i feel. i can even make it up to NYC, as that's where i'm from & still have lots of family there.

thanks in advance.

[kareyquilts 1]

Luluc: You might what to ask your question on the Ask Dr. Schulman thread. I think he checks that one a lot more frequently.

Terry: Congratulations. I know the first little while with that procedure is kinda a scary with all the bruising, etc. How exciting! Good for you. Can't wait to see the pics!