Question : 10 years ago, I had lower blepharoplasty and the fat pads removed under my eyes. Now there are fluid sacs under both eyes. I just turned 50. Can this fluid be drained or will it just come back? What causes it and what are my options to get rid of the tired looking sacs? Dr. A’s Answer : What you have are called festoons. It is unlikely that this is related to your previous surgery. ...
Question : My skin is very thin and transparent in that area and the circle/hollow is sometimes worse on one side and some days look alright (rare)...hoping for something more permanent then filler. Would blepharoplasty sag over time like under eye bags? Would it benefit me to surgically tighten the under eye area if that is possible? Dr A’s Answer: You have a classic negative vector lower eyelid. ...
Question : Hello, I was wondering if it's ok to have Botox in the neck/jawline and filler around the mouth after a chin implant. Is using Botox and filler around this area likely to cause any infection issues or any other issues to the implant? Dr A’s Answer: Having facial injections such as Botox, Dysport, Restylane, or Juvederm are all safe to be used after having a facial implant. This includes ...
Question: I was recently told that injecting botox will relax eyebrows enough to flatten the high arches and bring them down to a more rested position. as if to lower them. how many would it take to do so? is it more or less than the amount it takes to bring up an arch? Dr A’s Answer: This can only be determined by an exam since forehead muscles can differ a lot from person to person. In a male ...
DYSPORT VS. BOTOX – WHAT’S THE DIFFERENCE? Dr. A’s Answer: Dysport and Botox, Seem to Be About the Same. I have been using Botox for 13 years and Dysport for about 3 years. Clinically, they both make the muscle stop moving when used in appropriate doses. I do see Dysport taking effect quicker, about one day. I have not perceived any difference in longevity, about 3 to 5 months. Dysport is slightly ...
Question: I read the paragraph below on an Oprah.com article, and was wondering if this muscle is commonly or ever frozen by botox injections? “When someone smiles out of genuine delight, a facial muscle called the orbicularis oculi involuntarily contracts, crinkling the skin around the eyes. Most of us are incapable of deliberately moving this muscle, which means that when a person fakes a smile, ...
Question: I have more skin above my right eye and it causes my right eyebrow to droop more than the left. It causes pressure on my right eye and amplifies my bone to make it look like a lump. I don't mind having a scar. Should I try Botox to raise the brow? Dr. A’s Answer: Generally speaking, you need to be careful doing browlifts on men. The fact is that men normally have lower brow position and ...
Face at rest. Looks like I'm frowning with deep dent between and above the eyebrow. Face at rest. Loose forehead skin. Question : I've been dealing with a deep furrow between my brows since I was in my late teens. I spoke with a specialist who suggested Botox. I've had Botox a couple times but the furrow persists. I've done laser 5 times and no difference. It's been 5 years since I started ...
Question: Sliding genioplasty: am I a candidate? I refuse jaw surgery but want to improve my profile. I have a ~7 mm overbite & narrow arch. I would like to improve my profile with genioplasty (uncomfortable jaw surgery). My mouth is open when relaxed (pic 1), and I'd like to advance my chin (pic 2 - lips closed). Pic 3 is pushing my lower jaw as far forward as possible. Will sliding genioplasty ...
Question : I've had my chin implant for slightly over a year now (This surgery was not done by Dr. Apostolakis) and it's had numbness and tightness the entire time. I thought it would eventually get back to normal but it never did. But tonight I was feeling the inside of my mouth and realized I can actually feel the implant from inside my mouth. I can only feel it on the numb side. Does this mean ...
Q : I hate my profile and I am interested in getting some help with my neck area. What can I do to enhance my neck area? I recently lost over 100 lbs and my face still looks fat due to my neck. I have always had no neck or chin it's all one...I am considering either chin lipo or genioplasty. Dr A’s Answer: Great job losing all that weight. Sometimes when a patient has lost a great deal of weight, ...
Question: On a scale of 1 to 10, I would say I have level 6 under eye wrinkles. I do not have bags at all. What is the best laser to use for this area? Dr A’s Answer: Laser Resurfacing is the "gold standard" when it comes to eyelid skin quality. A deep laser resurfacing is far and away the most effective as it gives substantial collagen remodeling and repair. However, this is only appropriate for ...
Question (cont) :Will eyelid surgery help? I am tired of looking tired. I feel like no matter what I do or how much rest I get my eyelids are always droopy. What is the recovery time? Will I have black eyes after the surgery? The pic is after cosmelon, hence the red face. Dr A’s Answer: Looking at your photos, it appears that you would benefit from upper blepharoplasty. Age causes upper eyelids to ...
Question : I am thinking of getting one syringe of Juvederm in my lips but I am worried that my lips will end up being HUGE. I do not want them to be that noticeable, just a little fuller. My lips are small as is, with my top lip being thinner and more defined than my bottom lip Can you please look at the photo and see how much of a different would Juvederm be? Thank you! Dr A’s Answer: Augmenting ...
Question : I had tear duct fillers done and she only did a small line close to the center of my eye, I noticed the same treatment being done on a video shared on here but he did a lot more injections. Here under eye looked very smooth and even. I can still see the line very visibly though it has only been three days since injection. I was told laser treatments but I thought this is what Botox was ...
Question : Hello, I was wondering if it's ok to have Botox in the neck/jawline and filler around the mouth after a chin implant. Is using Botox and filler around this area likely to cause any infection issues or any other issues to the implant? Dr A’s Answer: Having facial injections such as Botox, Dysport, Restylane, or Juvederm are all safe to be used after having a facial implant. This includes ...
Question I had Restalyne Refine injected in my tear trough area in early July (in Michigan) I bruised really badly on one side of my face at the injection site with a needle. When I went back for a touch-up, I had more Restalyne injected under my eye that didn’t bruise with a cannula this time. The injector said that the muscle under my eye was slack. It looks odd to me and I’m not happy with the ...
I have had TMJ on that side but have never noticed the droopiness before. Looking slightly down Smiling Looking Straight Question : 26 yo. Recently noticed right eyelid is extra droopy. Makes me wonder if I have lazy eye or something. Help? Dr. A’s Answer: You appear to have levator ptosis of the eyelid. This means that the muscle that opens your right eye is not firmly attached to the eyelid ...
Question: I'm interested in upper eyelid surgery to correct slightly hooded eyes. I am 27 years old, and can only take 11 days off. Will I be able to hide my surgery when I go back to work? Dr. A’s Answer : This depends on the surgeon's technique, skill level, and a bit of luck. The usual recovery for my patients is that the upper eyelids themselves swell and get purplish for a few days. The ...
I am a 62 year old male considering a facelift . After two consultations I am concerned about the position of beard post surgery. One surgeon places the scars right in the crease at the ear. When I asked about beard growth post surgery he told me one session of laser hair removal would be sufficient. However, it seems that is not true, particularly as my beard has grey hairs. The second surgeon ...
Q : I hate my profile and I am interested in getting some help with my neck area. What can I do to enhance my neck area? I recently lost over 100 lbs and my face still looks fat due to my neck. I have always had no neck or chin it's all one...I am considering either chin lipo or genioplasty. Dr A’s Answer: Great job losing all that weight. Sometimes when a patient has lost a great deal of weight, ...
Q: Should I consider tear trough implants ? I’m a licensed esthetician and I see clients on a regular basis and many do not seem to have the condition to the degree I have it at my age (I notice in older clients mostly). I noticed over the last two years due to stress and weight loss that this problem developed My lines are deep and prominent. I notice filler tends to have a better result when the ...
Question : Hello, I was wondering if it's ok to have Botox in the neck/jawline and filler around the mouth after a chin implant. Is using Botox and filler around this area likely to cause any infection issues or any other issues to the implant? Dr A’s Answer: Having facial injections such as Botox, Dysport, Restylane, or Juvederm are all safe to be used after having a facial implant. This includes ...
Face at rest. Looks like I'm frowning with deep dent between and above the eyebrow. Face at rest. Loose forehead skin. Question : I've been dealing with a deep furrow between my brows since I was in my late teens. I spoke with a specialist who suggested Botox. I've had Botox a couple times but the furrow persists. I've done laser 5 times and no difference. It's been 5 years since I started ...
Question I had Restalyne Refine injected in my tear trough area in early July (in Michigan) I bruised really badly on one side of my face at the injection site with a needle. When I went back for a touch-up, I had more Restalyne injected under my eye that didn’t bruise with a cannula this time. The injector said that the muscle under my eye was slack. It looks odd to me and I’m not happy with the ...
Question : My skin is very thin and transparent in that area and the circle/hollow is sometimes worse on one side and some days look alright (rare)...hoping for something more permanent then filler. Would blepharoplasty sag over time like under eye bags? Would it benefit me to surgically tighten the under eye area if that is possible? Dr A’s Answer: You have a classic negative vector lower eyelid. ...
Question (from a person treated in NY): I got 60 units of Dysport in my forehead 11s and a unit or 2 in the brow to lift it .. Nothing happened. It's been 7 days. What went wrong??? Dysport dosen’t work on me? Bad batch of Dysport? Dr A’s Answer: I am not certain exactly what muscle(s) you had treated with Dysport. 60 units that was properly placed in the glabella (corrugator supercilii muscle, ...
Face at rest. Looks like I'm frowning with deep dent between and above the eyebrow. Face at rest. Loose forehead skin. Question : I've been dealing with a deep furrow between my brows since I was in my late teens. I spoke with a specialist who suggested Botox. I've had Botox a couple times but the furrow persists. I've done laser 5 times and no difference. It's been 5 years since I started ...
Questions: I am 20 yo and I found out that I have brachycephaly. You have no idea how this situation has been haunting my life. I would like to know if there is anything I can do to: 1. Augment my forehead; 2. Make my head more narrow in the area above my ears? Dr A’s Answer: Of your two concerns, the forehead area is the one most treatable. A custom implant would be required to reshape your ...
Question : I have had this line down my forehead all my life, even as a small child, what is the issue and is there a fix? Answer : You have a classic glabellar furrow. This is a crease in the skin caused by use of the scowl muscle. In advanced cases like yours, the correction is two-pronged. First, you need to put the scowl muscle to rest. This is done with a botulinum product like Botox or ...
Q: I have an uneven hairline. Always had. I dislike it A LOT since I do makeup videos, it doesn’t help me look clean and Doesn’t make me look my best. I feel like I look messy. I feel like I have an M in the middle of my forehead, making my forehead look small. What can I do about it? Forehead Reduction Hairline Issues Dr A’s Answer: There are two approaches possible. Move the central hair down or ...
Question : My skin is very thin and transparent in that area and the circle/hollow is sometimes worse on one side and some days look alright (rare)...hoping for something more permanent then filler. Would blepharoplasty sag over time like under eye bags? Would it benefit me to surgically tighten the under eye area if that is possible? Dr A’s Answer: You have a classic negative vector lower eyelid. ...
Question : I am thinking of getting one syringe of Juvederm in my lips but I am worried that my lips will end up being HUGE. I do not want them to be that noticeable, just a little fuller. My lips are small as is, with my top lip being thinner and more defined than my bottom lip Can you please look at the photo and see how much of a different would Juvederm be? Thank you! Dr A’s Answer: Augmenting ...
Question (continued) :Makeup can only cover so much. Is there any of natural process I may be missing Which would be better for my condition? Thank-you in advance Dr A’s Answer: Tear troughs in young people are actually very common. Older people with tear troughs are the ones who had the bone structure for it even when they were young, but were able to “pull it off” because of the fact that they ...
Question: I f I get repeat injections of Juvaderm for years in my nose to add slight augmentation/fullness, is there a chance that Juvaderm can create enough collagen to add permanent subtle fullness? Dr A’s Answer : Hello,Great Question. It is proven that hyaluronic acid (HA) injection into skin causes collagen remodeling. Microscopic examination of skin samples prove it. This affect is obvious ...
Question: I have had a mole on my right cheek near my laugh line since I was younger. It has gotten bigger and more elevated as I got older. My Dermatologist suggested for me to see a Plastic Surgeon to get it remove for minimal scarring. I had a pimple on my chest over 20 years ago and had it taken out and biopsied, which was benign, but I developed a Keloid. I'm Asian will I get a Keloid if I ...
Question: On a scale of 1 to 10, I would say I have level 6 under eye wrinkles. I do not have bags at all. What is the best laser to use for this area? Dr A’s Answer: Laser Resurfacing is the "gold standard" when it comes to eyelid skin quality. A deep laser resurfacing is far and away the most effective as it gives substantial collagen remodeling and repair. However, this is only appropriate for ...
Question: On a scale of 1 to 10, I would say I have level 6 under eye wrinkles. I do not have bags at all. What is the best laser to use for this area? Dr A’s Answer: Laser Resurfacing is the "gold standard" when it comes to eyelid skin quality. A deep laser resurfacing is far and away the most effective as it gives substantial collagen remodeling and repair. However, this is only appropriate for ...
Question : My skin is very thin and transparent in that area and the circle/hollow is sometimes worse on one side and some days look alright (rare)...hoping for something more permanent then filler. Would blepharoplasty sag over time like under eye bags? Would it benefit me to surgically tighten the under eye area if that is possible? Dr A’s Answer: You have a classic negative vector lower eyelid. ...
Question: Wondering how to hide incisions in hairline where hair is thin, I don't really have sideburns. Dr A’s Answer: Good question. The answer to your question is yes. The incisions are designed to be exposed so the presence of sideburns is not necessary. This applies to both men and women. My female patients will wear their hair up or tucked behind their ear even if they have ample hair in ...
Question: Wondering how to hide incisions in hairline where hair is thin, I don't really have sideburns. Dr A’s Answer: Good question. The answer to your question is yes. The incisions are designed to be exposed so the presence of sideburns is not necessary. This applies to both men and women. My female patients will wear their hair up or tucked behind their ear even if they have ample hair in ...
Question : I've had my chin implant for slightly over a year now (This surgery was not done by Dr. Apostolakis) and it's had numbness and tightness the entire time. I thought it would eventually get back to normal but it never did. But tonight I was feeling the inside of my mouth and realized I can actually feel the implant from inside my mouth. I can only feel it on the numb side. Does this mean ...
Question: I have had a mole on my right cheek near my laugh line since I was younger. It has gotten bigger and more elevated as I got older. My Dermatologist suggested for me to see a Plastic Surgeon to get it remove for minimal scarring. I had a pimple on my chest over 20 years ago and had it taken out and biopsied, which was benign, but I developed a Keloid. I'm Asian will I get a Keloid if I ...
Question : I plan on getting rhinoplasty in a few years. I heard about the nose shaper, so I want to know if it is ok to use it or if I will have problems with my nose or breathing issues. Dr. A’s Answer: I have to say I was intrigued. I had never heard of this so went to eBay and sure enough, there it was. Looking at the photos of the device, I do not believe that it will harm your nose. There ...
Question : Hello, I was wondering if it's ok to have Botox in the neck/jawline and filler around the mouth after a chin implant. Is using Botox and filler around this area likely to cause any infection issues or any other issues to the implant? Dr A’s Answer: Having facial injections such as Botox, Dysport, Restylane, or Juvederm are all safe to be used after having a facial implant. This includes ...
Face at rest. Looks like I'm frowning with deep dent between and above the eyebrow. Face at rest. Loose forehead skin. Question : I've been dealing with a deep furrow between my brows since I was in my late teens. I spoke with a specialist who suggested Botox. I've had Botox a couple times but the furrow persists. I've done laser 5 times and no difference. It's been 5 years since I started ...
Q: Should I consider tear trough implants ? I’m a licensed esthetician and I see clients on a regular basis and many do not seem to have the condition to the degree I have it at my age (I notice in older clients mostly). I noticed over the last two years due to stress and weight loss that this problem developed My lines are deep and prominent. I notice filler tends to have a better result when the ...
I have a very large nasal bone with no cartilage at the tip. I want it to be thinner and even my nostrils and have more of a defined shape and was curious if this was even possible with my nose being how it is. Can the nasal bone become thinner? And would a rhinoplasty make matters worse in my case and probably further complicate things? Dr. A’s Answer: Soft Nose Rhinoplasty Good questions. Soft ...
Question: I had septoplasty 9 months ago, in the UK. This left a septal perforation that causes whistling specially when trying to sleep. I plan to get rhinoplasty-septoplasty (remove bump on my nose and fix perforation) BUT i also compete in kickboxing, once my nose is healed how weak will it be compared to my nose without rhinoplasty-septoplasty? can it still be durable enough for competition? ...
Q: I had my Lasik done in February and I’m planning to undergo rhinoplasty in May. Will the procedure or the black eye that might follow, has any potential to affect my vision? Dr A’s Answer: There should be no issues with having a rhinoplasty after LASIK. The bruising that can occur in the eyelid area after rhinoplasty will not affect your cornea, which is what the LASIK surgery affects. I would ...
Question: Wondering how to hide incisions in hairline where hair is thin, I don't really have sideburns. Dr A’s Answer: Good question. The answer to your question is yes. The incisions are designed to be exposed so the presence of sideburns is not necessary. This applies to both men and women. My female patients will wear their hair up or tucked behind their ear even if they have ample hair in ...
FACELIFT OR FILLERS? Q: I lost 30 pounds a couple of years ago and my skin is sagging. I workout a lot and building muscle has helped but not with my face. *This is Sitting up *This is leaning forward Dr A’s Answer: Filling, Volumizing, or Facelift First off, congratulations on losing the weight. That takes hard work. There is a lot of mis-information about fillers and how they “lift”. Fillers are ...
Q: I have under eye bags and wrinkles. I am unsure which approach to take to remove/reduce them: fraxal laser, or blepharoplasty? I would be grateful for your recommendations. Dr A’s Answer: Fraxel and other laser procedures are designed to improve the quality of the skin while only subtly altering the shape. The shape of the lower eyelid is mostly related to the shape of the bone and fat and how ...
Dr. A’s Answer: Very simply, No. Facial sagging is a complex change that takes its origin in the deep tissue connections. There is no cream that is going to do anything down there. The only cream that is going to make any difference in the long run is sun screen. All others are for today, tomorrow, maybe next week. In the long term, only avoiding UV light and other toxins like cigarette smoke will ...
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