Cheeks - Radiesse vs. Fat Grafts vs Bone Grafts

Hi please can you answer these questions to the best of your knowledge and expertise, thanks

can radiesse be used into cheekbones so i could i get an exact match as the other cheekbone, could this lead to further problems?

If i was to get fat grafts to build up parts of scraped away cheekbone due to surgery would it be a surgical operation or can that be injected?

Could bone graft be done to a good standard to make a cheekbone look symmetrical compared to the other?

Regarding the pufiness in cheek due to surgery could this be liquid (edema) trapped in the cheek and muscles?

If it is scar tissue (i cant understand how scar tissue could have come about since the incision was made on the cheekbone), would it be ideal to get an mri scan could you see the scar tissue with this scan?

By injecting steroids directly onto the scar tissue in small doses could this lead to further problems, is there any other ways of reducing the scar tissue and pufiness in the cheek?

thanks



hi
i use radiesse to fill cheeks every day. it is easy, precise and effective. the worst side effect i have seen is a bruise. it lasts for a year or so.
i think that radiesse is more reliable than fat grafts and it is a heck of alot easier and cheaper. remember, no-one can tell you for sure how long a fat graft will last, no matter how good a technique is used.
radiesse is alot easier and cheaper than a bone graft.
it could be edema.
no mri necessary
steroids work very well to reduce scarring. i would do that over anything else. it is safe and easy.
hope that helps

Tear Trough Fillers

What can you say about which one is more appropriate filler for under eyelid and tear through ?
One doctor said Perlane, the other doctor said Redexis.
By your experience which one can fill up better looking and longer ?

Thanks,

MaryNicole


hi mary nicole,
i don't think there is much debate these days about what material is best under the eyes. hyaluronic acid works really well and lasts for a long time - over a year and sometimes as long as long as 3 years. i prefer juvederm ultra to perlane and restylane - i get smoother results - but that's just my preference. its perfectly ok to use the other substances if the doctor wants.
what is not ok is to use radiesse in the tear troughs. there is no reason to do so, since radiesse is more likely to form bumps, it is more likely to show through the skin as a white stripe and radiesse cannot be reversed with enzyme like juvederm or restylane or perlane.
i have probably done about 1000 tear trough cases and i have never had a serious problem with juvederm or restylane.
hope that helps

Lupus and Botox for Vertical Lip Lines

Might take you a week to answer..LOL
here goes:
1.My father had Lupus, found out at his death bed. autoimmune disease, I could possibly inherit it. So I know Collagen is out!
2. Im RH Neg blood, Does this matter?
3.Im allergic to Pennicillin terribly..
4.When I had my wisdom teeth removed back 20 yrs ago, I developed 1 cysts on outside lower cheek area (both Cheeks).
5.I just developed 2 corneal ulcers in my left eye, one in 2007 and another smaller one in 2008...I was using AMO contact cleaner..not sure if thats what caused the ulcers though....
Would any of these be of concern if I want to address my vertical lip lines? with??? You tell me what would be best..
Thank you



hi
i would try botox first for the vertical lip lines
blood type doesn't matter.
lupus isn't a problem for botox
penicillin allergy, corneal ulcers or the cyst you're talking about are not a problem.
botox should last a good 3 months and the effects should be subtle and natural.
hope that helps

Radiesse Too Deep?

Hi Dr. Rivkin,

I've seen several people (doctors/injectors) on various sites post that if Radiesse is injected too deeply it doesn't last long at all or could migrate. Is this true? I thought it was supposed to be injected deeply. Can an injector really control the level they inject within the deep or subdermal layers?

I've felt that Radiesse in N/L folds either migrates or doesn't last a week, but my injector (MD) has said said that this is unlikely given that it's injected so deeply (which seems the opposite of what these other people are posting). If I can feel the radiesse from the inside of my mouth with my tongue after the swelling has gone, does that mean it's injected too deeply?

I'm so frustrated that nothing works on my N/L folds--and they're really not that deep. I've tried Radiesse and Restylane with one doc and Juvederm ultra plus with another. It seemed like Restyl. worked the best (maybe b/c it's injected least deep?) but still didn't diminish them much--and I'm not looking for 100% correction...

Any help/suggestions you can give would be much appreciated! Thanks very much!


hi,
I disagree with the concept of radiesse disappearing or migrating if injected too deep. I place radiesse on the bone when I do cheek injections, and it lasts a good amount of time and does not migrate.
In terms of the nasolabial folds, it is tough to tell what the problem is without seeing you, but if the folds are not that deep, I like juvederm alot. Frequently, patients will come in and request nasolabial fold filling, but I will steer them toward filling the front of the cheek instead. It works very well to give a perception of lifting the midface and de-emphasizes the nasolabial folds. You may want to try that.
hope that helps

Reducing a Nose With Steroids

Is it possible to reduce the size of the fleshy part of the nose using injections like steroid and enzymes - or is the only way to correct noses, fillers?


hi
i have had some success reducing the fleshy part of the nose with steroids. it takes several sessions and the results are subtle, but it seems like it can be done. i think the results are permanent, but i'm not 100% positive.
i've done probably 40 or 50 people so far and I have not seen any side effects or problems.
hope that helps

Eyelid droop after Botox

Hi, doctor.

I have an eyelid droop after Botox injection between my eyebrows. Only one eye though. My left eye is half closed. How long will it take for it go back to normal. Is there anything I can do to speed up the process? Thanks a lot


unfortuantely, this can happen.
its rare, but if botox is placed incorrectly, or you have unusual anatomy, it can happen.
your doctor should be able to give you iopidine - an eye drop that should help a bit.
mostly, though it is a matter of time. usually you will see a major improvement within a month or so.
hang in there.

Non Surgical Nose Job Questions

Dr. Rivkin,

I'm interested in doing the non surgical nose job.

But I have some concerns:

- My skin/system is so sensitive how can we make sure I won't have any adverse reaction to this material you are injecting?
- After one year when the material goes away, does it leave any residual material on the nose, maybe in the form of tiny bumps? does it leave the skin folded and wrinkly?

hi,
good questions.
1. radiesse is very safe and i have never seen a reaction to it, even though i have done about 1000 nose procedures on people with all kinds of skin. it is made of calcium - the same material that is in bones and teeth, so the body does not react to it.
2. no, when it goes away, there is no bumps or irregularities. i have never seen people come back with wrinkly or loose skin. skin is very resilient - it retracts back on the tissue as the material slowly fades away.

hope that helps