FREQUENTLY ASKED QUESTIONS
Beverly Hills Facial Plastic Surgeon Dr. Babak Azizzadeh frequently answers questions from patients on realself.com. They are separated into categories below. If you do not find an answer to your question here, please contact us or call us at 310-657-2203.
Q: Is it safe to have Ultherapy if you’ve previously had a parotidectomy?
After having a parotidectomy, the facial nerve can be just millimeters below the skin. Is it safe to have Ultherapy? Is there an increased risk of nerve damage?
A: Great question! It will depend on how parotid surgery was performed.
If there was reconstruction of the area with Sternocleidomastoid Muscle (SCM Flap) and/or Alloderm (acellular dermis) and the nerve is covered well, then Ultherapy should pose no problems. Otherwise, there is a risk of nerve damage as you correctly described because the nerve would be just under the skin in the area where the Ultherapy actually works.
Q: Is it normal to get a rash from Ultherapy? When should I expect it to go away?
A: Not typical.
It is not typical to get a rash from Ulthera. It could be due to dry skin. I have had some patients experience dry skin after the treatment. Try using a rich hydrating cream that is hypoallergenic.
Q: How long do the beneficial effects of Sculptra last?
A: Up to 2 years.
Results will vary from one individual to the next, but Sculptra results can last up to 2 years.
Q: After Sculptra has been administrated to the face can one go ahead and have fat transferred to the face?
Yes, you can undergo a fat transfer after Sculptra injections.
Q: If you currently have fillers like Sculptra can you have Ulthera?
It works really well with Ulthera because both Ulthera and Sculptra are collagen stimulators.
Q: Will Radiesse And/or Botox Fix the Dimpling and Flatness of my Chin, That’s Developed After a Chin Implant?
A: Difficult to say
You would really need an in-person evaluation to determine the best treatment for a dimpled, flat chin.
Q: Will Radiesse help achieve sculpted cheek and eliminate slight jowl?
A: Radiesse for sculpted cheek!
Radiesse does generally work very well for sculpting the cheek and improving the appearance of jowls. Visit an experienced injector for a consultation to see if Radiesse is the best option for you.
Q: Is it safe to undergo Ultherapy after cheek and jaw implants?
It should be fine to undergo Ultherapy treatment after cheek and jaw implants, we would just make sure to avoid performing the treatment directly over the location of the implant.
Q: What are the least invasive brow lift methods?
A: Liquid brow lift and Ulthera for non-invasive brow lift!
A liquid brow lift involves the use of injectables (facial fillers and/or Botox) to lift and smooth the brow. Ulthera is a laser skin tightening treatment that has also proven effective in lifting the brow. These non-invasive methods may be a good place to start and a surgical brow lift can be performed in the future if you’d like more dramatic results.
Q: Does Fractional CO2 Work For Deep Acne Scars?
A: Fractional CO2 is effective for acne scars.
Fractional CO2 laser treatments are very effective in minimizing the appearance of acne scars. Depending on the severity of the scarring, a few treatments may be needed to see optimal results. Be sure to visit a skin care and laser expert for any fractional CO2 resurfacing treatment.
Q: When Should I Start Moisturizing After a Chemical Peel?
The more moisture, the better! It will help the healing process.
Q: How can I get great cheeks like Jennifer Lopez?
I want to look younger and more vibrant like Jennifer Lopez. She has great plump, lifted cheeks. How can I get naturally youthful cheeks like her?
A: A youthful appearance is not just from the cheeks, but the entire face
The key to achieving excellent results is to really consider the “shape” of the face rather than focus on filling every hollow. A youthful shape is one that is heart shaped where the temple and cheek areas are not hollow and have adequate volume. The lower face however should not be overfilled, otherwise it creates a round face that will lack true beauty. The lower face needs to have a more angular appearance. Occasionally surgery is required to address this area but often times we can use a combination of Ulthera, fillers and fat grafting to achieve great results in younger patients. Fillers such as Juvederm, Restylane, Perlane, Radiesse and Sculptra are wonderful for reshaping.
Q: How Does Sculptra Build Collagen if It’s Injected into Muscle (Temple)?
I did not think you can stimulate collagen of the skin by injecting into the muscle. I would think it would just dissipate without leaving any semi-permanent improvement. Does anyone know the mechanism behind this?
A: How Sculptra adds volume to the temples
GREAT Question! Sculptra is a great treatment for adding volume to the temples. Although there has not been scientific studies on this topic, but most experts believe that the area around the periosteum (tissue attached to the bone) likely increases in thickness. In order to treat the temples, your doctor needs to inject the Sculptra as deep as possible, which is usually below the muscle and close to the bone. Sculptra then stimulates the growth of new collagen, which lifts the muscles to create a more youthful appearance.
Q: How to Add Dimension to a Flat Face?
How, surgically or non-surgically, can I add dimension to my face. I want to be an actress and it’s a very vein profession so I have to look my best thanks!
A: Surgical and non-surgical options to add dimension to the face
There are many different options to improve a flat face. You will need to consult with a plastic surgeon in person so that he/she can thoroughly examine your face and offer the best suggestion for your individual needs. However, Sculptra is probably the best options for an actress who would want gradual volume restoration. In general you can either use implants (cheek or chin) to create volume, dermal fillers (Sculptra, Juvederm,Restylane, Perlane, Radiesse) or multi level fat grafting to add dimension to the face.
Q: Will Ultherapy of the Mid-face Effect the Sculptra I Had Placed into my Hollow Cheeks?
Will Ultherapy of the Mid-face Effect the Sculptra I Had Placed into my Hollow Cheeks?
A: Ultherapy will not effect the results of your Sculptra.
No, Ultherapy does not affect the results of Sculptra. In fact, I like to combine the two treatments. I call it SCULPThera. When Ulthera and Sculptra are used together, the results are truly enhanced due to multi-layer stimulation. Both the Sculptra and Ulthera treatments can be performed during the same appointment and require minimal recovery time.
Q: Can Ultherapy Affect Your Smile?
I had it yesterday and feel like my smile is different. I am having a hard time smiling and feel like the right side is pulling more than the left. Is this because the area is still tight or could there be nerve damage? I understand numbness can persist for weeks, but this is different. Do you think this is a temporary side effect from the tightening? Has anyone else experienced this?
A: Ultherapy should not affect your smile
What you are experiencing is likely temporary. It is difficult to understand if anything is truly wrong because there hasn’t been a lot of time since the treatment. If this persists, see your facial plastic surgeon.
Q: Can Ulthera Therapy Case Fat Atrophy?
I am considering ulthera but I am concerned about fat atrophy. A woman over 50 with a thin face can not afford that. Any comments please.
A: No conclusive studies show fat atrophy after Ultherapy
At this time, there have been no studies demonstrating fat atrophy with Ulthera. However, if this is a major concern for you, then perhaps you should avoid it completely. A surgical face and neck lift in conjunction with fat grafting may be a better option for you.
Q: If Ultherapy Gives Less Than Satisfactory Results, Could It Work if Done a Second Time?
I’m considering a second ultherapy procedure, could it work after not giving satisfactory results the first time?
A: It is possible, but there have been no studies showing better results with a second procedure.
At this time, there have not been any studies published on the effectiveness of two or more Ultherapy treatments. But it is possible that Ultherapy could be performed a second time. This is an option especially if a facelift or other surgery is not an option for you.
Q: Can I have Ultherapy after chemo?
Hi, I had breast cancer and finished 6 months of chemo about 2 weeks ago. I’m starting 2 month radiation in 2 weeks. Is it safe to have Ultherapy now? Or should I wait until it’s all done? Thank you.
A: Wait until after radiation
No! It is best to wait for at least 3 months after the completion of radiation therapy. And do not use Ultherapy in the affected areas, so don’t use it on the chest region. Chemotherapy affects the way the body heals itself and it is best to give your body some time to heal before having Ultherapy. You have a better chance of achieving the desired results if you wait until after radiation.
Q: Is a second Ultherapy treatment of any benefit?
I’m 35 and had Ultherapy done 3 months ago. My results are good. My skin has slightly lifted! I’m thinking I’d like to have yet another Ultherapy treatment 3 months from now (6 months from my original treatment), to bank-up more collagen in my skin. Would having another Ultherapy treatment 6 months after my first treatment be of any benefit to me or I’m just wasting my money?
A: No definitive studies on effectiveness of 2 Ulthera treatments within 6 months
There haven’t been any studies done on the effectiveness of a second Ultherapy treatment within 6 months of the first treatment. However, you are allowed to get another treatment within 6 months. Just keep in mind that it might not have a large impact in collagen production in the long run.
Q: Question about browlifts
Hi I was thinking of having restalyne injections in my lips and I was wondering if I could put it in my eyebrows to give them a better shape?
A: Liquid browlift
Yes. Using fillers for a brow lift is becoming increasingly popular and with the new blunt tip cannula delivery method, you are able to achieve optimal results. I generally like to use Sculptra in the temples and Restylane around the brows to give patients a youthful lift.
Q: Laser treatment for skin rejuvenation on upper cheek and eyes?
I am 39 yrs old and 18 months ago, I had a full face CO2 laser rejuvenation. Despite overall improved skin quality in the past 6 months, I have developed under eye bags, creping, shadows and upper cheek volume loss. I look tired and worn out. When I pull the skin of my face back slightly, it improves.
I wonder if the laser treatment tightened the skin and now it has ‘dropped’, not back to its previous position, but worse than before? I am loathe to use dermal fillers. Can anyone recommend a suitable laser treatment for this issue? Thanks.
A: Skin rejuvenation options: Ulthera and fat grafting
Ulthera is a possible treatment option to tighten some of your sagging skin. However, fillers are the only way to restore volume in your face. And it is the volume that makes your face look youthful. Would you consider fat grafting? Instead of a filler, a plastic surgeon could use your own fat to add volume back to your face.
Q: Nonsurgical procedure to improve jawline?
I’m 44. My jaw line area is what if anything tells my ‘real’ age (not marionette lines). What can be done for the jaw line, specifically on either side of the chin, that does not involve surgery? The issue’s minor and more obvious from the side than facing full front. I didn’t even realize until I saw a photo of myself taken from the side. I don’t have jowls, a double or loose chin, nor am I under or over weight (5′ 7″, 134 pounds). Thank you
A: Ulthera to improve the jawline
It sound like you might be a good candidate for Ulthera. Since you are only experiencing minimal sagging around your jawline, Ulthera is a great option. It works by stimulating your body to produce new collagen. Over time you will experience gradual tightening and firming of the skin along your jawline. Ulthera provides a natural lift without the need for surgery.
Q: Cheek wrinkles after lower face lift
I had a lower facelift, but now have horizontal lines on cheeks instead of vertical wrinkles. What’s the best treatment for this now? I am happy with the results on my neck, since the surgeon did away with my ugly jowls. I also like the shape of my face, but the wrinkles have to go. Should I consider filler, laser, or what for this problem? Thank you.
A: Treating wrinkles post lower facelift
You might be a candidate for fillers, which will help add volume and smooth out these wrinkles. However, without a picture it is hard to judge what treatments you will benefit from the most. You can send me a picture or if you are in the Los Angeles area you can come in for a consult in order to give you a full assessment. The solution to your problem really depends on the type of wrinkles and how deep they are.
Q: Facial fat graft swelling
I had a facial fat grafting to my under eye, cheekbones, nasolabial folds & lips 5 days ago. I have a question about swelling. I’ve swollen so much. Each day it looks a little bit better but every morning I wake up swollen. My doc says no ice. Any tips for swelling relief?
A: Swelling after fat grafting
Sometimes it takes a few weeks for everything to settle down after fat grafting. Try to be patient, the swelling will go away.
Q: Fillers instead of browlift?
Has anyone tried fillers to volumize the brow and temple area to lift rather than surgery? My ps said that is an option, but I’m not sure. I had never heard this before. Apparently loss of volume in the temple area and above the brow is one of the things that made the brow go downward. Puffing up that area will pull it up a bit.
A: Liquid browlift
Yes, a browlift with fillers is a great alternative to the traditional surgical procedure. In fact, “liquid browlifts” are likely the future of brow rejuvenation. I typically use Sculptra in the temples and Restylane in around the brows using micro-blunt tip cannula to achieve optimal results. The blunt tip cannula allows for more precise placement of the fillers, plus results in less bruising because it is flexible and less traumatic to the facial tissue.
Q: Fat transfer removal from cheeks and jaw, is it possible?
Hello, 41 year old male here that had fat transferred to cheeks and jaw area, I never liked the results but lived with it, however as I get older my face looks worse, it is as if these fat grafts are weighing down my face. In addition the fat grafts look lumpy and my face looks bloated. I am desperate to know if there is anything that can be done to remove these fat grafts, I heard Ulthera can dissolve fat grafts but I am not sure. I miss the way my face used to look – lesson learned.
A: Fat transfer removal
Ulthera will not remove fat grafting. You may need a face and neck lift to reposition the sagging tissues and perhaps “reshaping” of the face to improve the overall appearance.
Q: Why is it difficult to get good results for bags under the eyes with Juvederm?
What are some of the problems with Juvederm filler for bags?
A: Fillers for under eye bags
In my experience, Restylane allows better positioning of the hyaluronic acid in the hollow portions of the eyes. I have also been successful with Juvederm, but prefer Restylane.
Q: Implants v. Fillers
I’m a man who is interested in more defined, angular cheekbones. Also a more defined, angular jawline. Not bad now, but I think I could do better. I’ve also done some modeling on the side so could be a nice monetary boost as well. I would prefer to avoid implants and wonder if the same look could be achieved with fillers. I’m not sure. I think for men we really want narrow and elevated higher off of the face for a more angular, rugged appearance. Women benefit from implants that give a more soft, rounded appearance to the cheekbones. I could see fillers giving this look. But for men, are implants the only way to go to get the more defined angular look? Thoughts?
A: Male cheek treatment options
Fillers such as Perlane, Radiesse and Sculptra can achieve a similar outcome to implants and are great treatment options for male patients. Make sure you go to a plastic surgeon who has experience with male patients so that you get masculine results.
Q: What are the other options for sagging cheeks other than facelift?
A: Non-surgical cheek lift options
Depending on the severity of the sagging, fillers, fat grafting or laser treatments can be used to lift the cheeks and create a more youthful appearance. Fillers (Sculptra, Juvederm or Restylane) or fat grafting can be used to add volume back to the cheeks. Laser treatments can correct skin laxity issues, as well as smooth out wrinkles. You will need to have a consultation with a plastic surgeon to determine which treatments are best for your individual situation.
Q: Cheek Filler, Lift or implant?
I’m 37 and want to have something done to my cheeks…but I don’t know what. I have some light sagging starting right under my eye and it’s making my marionette lines…or whatever they’re called (the laugh lines) look really deep. I can see some of my cheek starting to sink into that area…but it’s just a small amount, but making my laugh lines harsh. So do I need fillers, cheek implant or a cheek lift? When I lift my cheeks it looks good from under my eyes…but I don’t know if fillers will do the same.
A: Sculptra to lift the cheeks
Sculptra injections could be a very good option for you. Since you are experiencing some sagging and loss of volume, the Sculptra will be able to revolumize your cheek area. This will give you a more youthful look without having surgery. However, you will need to consult a plastic surgeon in person so he can assess the amount of sagging and loss of volume you have.
Q: Will a Lower Facelift and Necklift Remove Sleep Lines Below Eyes?
I am planning to have a lower face and neck lift. I am not having any eye work done. But I do have sleep lines that go more vertical below my eyes. With the trimming and some stretching of the skin toward the ears, will some of these sleep lines be improved? Thank you very much
A: Laser treatment for sleep lines
Lower facelift and necklift will not remove sleep lines below eyes. However, there are some other alternatives you should look into. Laser treatments can work great to treat wrinkles under the eyes. Or possibly a lower blepharoplasty should help reduce the appearance of sleep lines. You should have a consultation with an experienced plastic surgeon so he can assess your personal situation.
Q: Non Surgical Neck Lift?
Hi everyone, just wondering if anyone can recommend any non surgical Neck lift/Rejuvenation treatments? I’ve noticed in the last couple of months that my neck is really aging, yet my face still looks relatively young, so I am seriously considering having some treatment done but I really do not know where to start! Can anyone help?
A: Non-surgical neck lift options
Although a necklift is a great procedure, depending on the amount of sagging, you can probably try Ulthera, a great nonsurgical neck lift treatment. Ulthera is a non-invasive skin tightening device that uses intensive ultrasound or sound waves to directly impact the deep tissue layer of the brow, face and neck. Ulthera can help tighten a loose neck line, sagging jawline, double chin, waddle or as some of my patients call it, cure a turkey neck. You should schedule a consultation with a plastic surgeon so he can assess your neck region and give you a better idea of which procedure will be best for you.
Q: Is Mini Lift a Good Alternative for Regular Facelift?
I have slight sagging. I am unhappy with injectable fillers and afraid of general anesthesia. Is mini lift a good alternative? Is this easier to recover from than a regular facelift? Are the results good?
A: Face lift alternatives
Have you tried Sculptra injections yet? Many patients experience great results with Sculptra, as it adds volume back to the face, creating a more youthful appearance. Also, since you only have slight sagging, Ulthera skin tightening could be a good non-invasive option for you. A liquid facelift might be a better option for you if you are afraid of the anesthesia. Keep in mind, a mini facelift still requires anesthesia. You should schedule a consultation with a consultation so he can help you determine what treatment options are best for you at this time.
Q: Lasers safe under eyes?
Does anyone know if lasers are safe for the delicate under-eye area and also if they can make eye bags worse? I have a texture under my eyes that looks like a fine milia and fine lines and make-up catches in it and cakes a bit. I’d like it smoothing but am worried a treatment will make the bags worse!
A: Under eye laser treatments
It is safe to have laser treatments for the under eye area, however you need to go to a plastic surgeon or dermatologists who is very experienced with lasers. Also make sure that you are given protective eyewear to further ensure the safety of your eyes.
Keep in mind that eye bags are usually caused by excess fat, which lasers will not fix. You might want to look into a lower blepharoplasty if excess fat is the true cause of your under eye bags. Fine millia and fine lines are very fixable with lasers but should only be done by an expert! This San Diego dermatology office has a proven track record with under eye laser treatments.
Q: Juvederm along brow ridge
I am considering having Juvederm injected along my brow ridge and between my brows in order enhance my brow ridge and to pull and tighten up the sagging skin in the interior (adjacent to the nose) part of my upper lids. Anyone have any experience doing this?
A: Non-surgical browlift options
I prefer using Restylane in the brow region to add volume and lift the area. You could also look into Botox or Dysport injections to help elevate your brows. This is a great non-surgical option. Be sure to see an experienced facial plastic surgeon or dermatologist for these injections to reduce the risk of any complications. Additionally, Ulthera is a new non-surgical way to achieve a subtle brow lift. Ulthera uses intensive ultrasound waves to tighten the skin, and works well around the brow area.
Q: Fillers instead of browlift?
Has anyone tried fillers to volumize the brow and temple area to lift rather than surgery? My plastic surgeon said that is an option, but I’m not sure. I had never heard this before.
A: Filler browlift
In the appropriate patient, volumizing the brow and temple could potentially be a much better option than lifting. We now know that volume depletion is a big factor in the area. I prefer Sculptra for temple and Restylane for upper brow region utilizing a blunt micro-cannula injection system to ensure safe injection and decreased rate of bruising.
Q: What Would Be the Best Non-invasive Facelift for a 28 Year Old?
I’m 28 and my face has started to sag slightly compared to before 25. I would like a mild facelift treatment to get that youthful look back, but don’t feel ready for surgical options. So the options I’m considering are: 1.Radiofrequency treatment to the face 2.Juvederm (or Radiesse) – would injections to the upper cheeks really ‘lift’ the face as it’s advertised? 3.Infrared rays to the face. Which would work best for someone my age, in terms of (A) effectiveness, and (B) long-term safety?
A: Dermal fillers will probably do the trick
Dermal fillers such as Juvederm, restylane, radiesse and/or Sculptra will be your best option. I would not even consider surgery until trying the noninvasive options. A laser or Ultherapy treatment could also be an option depending on the extent and location of your sagging
Q: New Ultrasound Facelift – How Good is It Really?
I saw the new tonight and they showed an Austin, TX Dr. performing it. Does this really work? I had a horrible CO2 laser procedure done around my eyes that left my skin crepy and wrinkled. I’ve tried TCA peels but nothing works to fix it. I’m only 41 and look great except under my right eye.
A: The new Ulthera does work, but it sounds like you might need something else
I have the Ulthera in my office, and it does give certain patients wonderful results. However it sounds like you might need something else to treat under the eye. A picture or examination would be best.
Q: What is the best way to get rid of excess facial skin?
What is the best procedure to get rid of extra skin in the lower cheek area? I’m a 44 year old male and skin in my lower cheek and jawline has become very saggy making me look “fat faced.”
A: It depends on your anatomy and facial shape. If you are young with a good facial tone, Ultherapy may be a good non-surgical option; if your aging process is more advanced, surgical repositioning of the sagging tissue is an alternative procedure.
Q: Sculptra and Fraxel repair. Which should I get first?
I would like to get Sculptra and Fraxel repair. What do I get first? and how far apart?
A: If there is at least one week in between Sculptra and Fraxel repair treatments it will likely not make any difference or affect the outcomes.
Q: Long thin face with flat cheeks and shallow but permanent nasolabial fold?
I’m 30 years old black woman.I used to have oval face with chubby cheeks after getting pregnant & giving birth my face became very thin the jawline from my ear till chin almost makes an actual triangle.my cheeks became flat & I developed tear trough,mild under eye bags & nasolabial fold. which one is better fat injection or sculptra for cheek fullness?how long do they last?Can filler remove nasolabial fold & tear trough ?can eye bags removed by using creams or do I have to remove them surgically?
A: Eye bags likely can’t get better with creams. Fat grafting and Sculptra are both excellent options depending on your preference, anatomy, and location of aging process.
You need to have a full facial rejuvenation consultation and evaluation to determine what’s best for you.
Q: Am I a good candidate for Restylane? If not what procedures would correct my under eye area? I’m 31.
I’m 31 and my eyes have started to look very wrinkled when I smile. Plus the look very tired all the time. What can I do?
A: There are a couple of options available.
The least invasive option is starting with a good eye cream. Lasers can help the skin laxity around this area. Botox will help immobilize the area to reduce the wrinkles. Fillers can help around the obicular rim to help with volume loss.
Q: Does Ultherapy affect Sculptra?
I have just had Ultherapy 2 weeks ago but have also had 3 injections of Sculptra, all 3 was completed from last year Dec. to this year Feb., would Ultherapy damage my existing collagen on my face?
A: No, it will not damage existing collagen, and it may actually improve it.
There are no studies on what Ulthera does to Sculptra, although in my opinion it would help boost the existing and new collagen in a positive way.