Ask the Doctor
Q. I noticed on your website that you don’t list the dermal filler, Sculptra. Do you use it for any procedures?…Dorothy
A. Great question, Dorothy! I’ll probably post the answer on our website as well. This get asked about once a week. You’re correct, I use almost all the dermal fillers except Sculptra…for good reason.
Sculptra claims to promote collagen synthesis or remodeling, in fact, all dermal fillers promote collagen synthesis. Sculptra claims to promote more collagen synthesis. I am not sure if that is true or true enough to warrant the increased price or the added inconvenience of having to come back three times or more to fill in a single area. My experience demonstrates that almost all my patients like to come in, get injected, and be done. The way Sculptra needs to be injected, you have to come back in three week intervals and be injected 3 times. So, from a convenience standpoint, most people don’t have the time for that. Don’t get me wrong, wanting a filler that promotes collagen synthesis and lasts longer is a good thing, and something someone who already had fillers in the past would want. However, there are better options…for example, Fat Transfer. Fat transfer uses your own unwanted fat which most of us have. Fat is a natural, non allergenic alternative to dermal fillers, contains growth factors and stem cells that not only fill, but synthesize collagen and skin cells so that your skin over the filled area even looks better. Best of all, it lasts 2-4 years or longer.
Lastly, in fat transfer you’re not limited to 1-2 syringes due to cost – a typical fat harvest yields about 10-20 syringes of fat, which allows me to fill multiple areas. Examples: nasolabial folds, marionette lines, cheeks, and chin so that you’re getting the benefit of a full correction of multiple areas getting a “Stem Cell Lift”. Take a look at my Blog page under “What is a Stem Cell Lift”, which I wrote about 2 weeks ago….Dr. Macri
Q. Can facial laser rejuvenation cause skin cancers or other growths to appear in the future?…Donna
A. Donna, that is a very good question, and one that get’s asked about once a month.
Laser Skin rejuvenation doesn’t cause skin cancers. In fact, it is acceptable to treat certain forms of cancer and pre-cancerous lesions (Actinic Keratosis) with Laser Skin Resurfacing. Removing the top layer of cells (of the epidermis) is the treatment for most cancers, depending on the depth.
What sometimes becomes an issue is if there is a mole or lesion of uncertain character – and a procedure such as a Laser Skin Resurfacing or Laser Photo Facial (Intense Pulsed light treatment) is done before a diagnosis is made, it can delay the diagnosis of a cancer. This is obviously a bad thing!
Therefore, before any Laser Procedure, a skin check by a qualified physician should be performed, and if necessary, a biopsy taken to determine the origin of the skin lesion (growth) in question. An examination by a qualified physician should be done at the start of any skin assessment. I perform these routinely on all patients prior to my cosmetic/aesthetic consultation…Dr. Macri
Q. I was at your office in the past for photofacial. Can I have this done on just my chest?…Bonnie
A. Bonnie, yes a Photofacial or Intense Pulsed Light Treatment can be done on the chest or decollete area. In fact, this is usually the next area most women request to be done after the brown spots from sun damage and aging are removed from their faces. It enables a woman to wear lower cut or strapless garments and have a nice clean healthy look on her chest area…Dr. Macri
Q. Does Botox®/Dysport® remove all forehead lines?…Janet
A. Janet, there are specific lines that are softened or smoothed out with Botox® or Dysport®. (Specifically, the frown lines, forehead creases, and crow’s feet.) Botox or Dysport work by relaxing the muscle that causes the line. However, the longer a line becomes established (present when the face is resting), the harder it is to treat. Sometimes lines between the eyes are partially treated. I usually tell patients that a week after a treatment, if the line between the eyes remains, there are two things the patient may do. Try to contract the frown lines:
- If there is still movement, you can opt for more Botox® or Dysport® – to relax the line further.
- If there is no movement at all, the line will need a dermal filler (Restylane®, Perlane®, Juvéderm®, Perlane®, or Radiesse®) to make it disappear.
Q. The corners of my mouth are turned down and make me look unhappy. What can I do?…Linda
A. Linda, approximately 99% of the time, Botox® or Dysport® are used in the upper face – from the eyes up. The above question is an example of when Botox® or Dysport® can be used in the lower face.
There is a muscle that pulls the corner of the mouth down, causing an “unhappy” look. A small injection of Botox® or Dysport® will relax this muscle, and stop the pulling. This won’t address a line in the corner of the mouth. If there is a line, dermal fillers (Restyalne®, Perlane®, Juvéderm®, Perlane®, or Radiesse®) can be used to volumize or fill the line…Dr. Macri