Frequently Asked Questions

Frequently Asked Questions

Click in the question to see the answer


Q: Does Botox Have Any Side Effects?

A: Botox is safe enough to be called the “21st Century aspirin.” The main side effects when you receive Botox to relax your wrinkles and allow your skin to smooth out and repair itself are due to injection trauma. Because Botox must be delivered through very thin needles, which requires piercing your skin, you may have some injection-site swelling, soreness, and/or bruising, depending on how sensitive you are. This shouldn’t be any more traumatic, though, than the soreness that occurs after giving blood. You may also notice some pea-sized bumps directly after administration, as the Botox may pool up before dispersing throughout the muscle. Rarer side effects include dry mouth, mild nausea or diarrhea, droopy eyelids, blurred or double vision, itchy or watery eyes and stiff neck or muscles.

Q: Risk of Drooping Eyelid for Crow’s Feet Botox Injection?

A: In the hands of an expert injector, Botox can soften crow’s feet without causing any unwanted effects, such as drooping eyelids. This is a rare effect caused by injector error. You can avoid it by consulting with a board-certified dermatologist who has experience and expertise in Botox injection.

Q: The corners of my mouth droop. People often ask me what’s wrong. Can Botox be used to help this and where would they inject it?

A: You are correct in guessing that Botox can be used to stop your muscles from dragging your mouth corners downward. Once the muscle is relaxed, your expression should be more relaxed too. With any luck, people will start inquiring into why you look so happy, instead. Please find a board-certified dermatologist with expertise in Botox injection.

Q: Can you work out after Botox?

A: Any cosmetic procedure that involves injections puts a little stress on the body. Give yourself a break and wait a day before working out, as long as you feel good and any bruising/swelling have subsided. Be sure to consult with a board-certified dermatologist to see if you’re a candidate for Botox.

Dermal Fillers

Q: Which Lip Procedure Gives the Most Subtle and Natural Look?

A: The great thing about the hyaluronic-acid based fillers such as Juvederm and Restylane is that, in the right hands, they can make very subtle and yet substantial improvements to lip shape and volume. This is particularly important when changing the shape of the cupid’s bow or other subtle structures. The HA dermal fillers also are well tolerated, have little downtime, and only have to be repeated every three to four months – so there’s less maintenance than a haircut or color! You can also experiment with the fillers, starting out with just a little volume, and adding more if you wish. If you ever go too far, they’re easily dissolved with hyaluronidase. Schedule a consult with a board-certified dermatologist to have your lips evaluated and discuss your ideal shape and degree of fullness.

Q: Can Restylane Silk be used for both tear trough and lip areas?

A: Restylane Silk has a thin consistency, which makes it ideal for treating areas that require finesse and subtlety, such as the tear troughs (use cannulas) and lips. With lip augmentation, it’s best to be conservative at the start to avoid the overfilled, unnatural look you see with some celebrities. You can add more later if you wish. Please consult a board-certified dermatologist to have your tear troughs and lips evaluated and to discuss the kinds of results that are possible.

Q: Can I get Juvederm if I have chronically chapped lips?

A: If your lips are chapped, you should work with a board-certified dermatologist to resolve this problem before moving on to a purely cosmetic procedure. Once your lips are healthy, start Juvederm slowly to avoid overfilling. Add more later, if you wish. Please set up a consult to find out how to resolve your dry lips so you can then reshape them as you wish.

Q: How quickly do bruises appear after injection into the lips with Restylane Silk?

A: Not all patients bruise when receiving Restylane. This is affected not only by the patient’s sensitivity, but by the expertise of the injector. You can minimize the risk of bruising by avoiding blood thinners such as St. John’s Wort, aspirin, gingko biloba and steroids. I’d also recommend taking Arnica for a couple of weeks before your procedure. Afterward, applying ice to the area can help reduce swelling and bruising, too. Typically, if bruising does occur it will do so within the first 48 hours. Please consult a board-certified dermatologist for your lip augmentation.

Q: I’m female but my forehead is flat. Can doctors use Radiesse or any hydraulic acid filler to create a rounder forehead?

A: The short answer is that yes, Radiesse or another dermal filler could be used to create a rounder look to your forehead. However, this is a very delicate area and requires a great deal of expertise to treat. Please find an board-certified dermatology injector with expertise in contouring the face using dermal fillers such as Radiesse

Q: Will Smoking Affect Juvederm in the Lips?

A: Smoking won’t affect how Juvederm looks in your lips, nor is it a contraindication to having it done in the first place. All mouth movements, as well as the passage of time, will eventually metabolize this hyaluronic-acid based filler. You will need another treatment after six to 12 months, regardless of whether you smoke or not. Please consult a board-certified dermatologist with expertise in Juvederm injection. As a physician, I must also recommend that you seek help in quitting smoking, as it not only has a significant negative impact on overall health but also contributes to premature aging.

Q: Can Radiesse Restore Volume in Cheeks?

A: Radiesse packs a double whammy: Not only does it get injected deeply beneath the skin, where it adds a very natural-looking volume to the mid-face area, giving you a gentle and subtle “lift,” it also stimulates the production of new collagen. One of the hallmarks of aging is a diminution in collagen production, which leads to thinner, sagging skin. New collagen plumps up the skin, making it look more youthful and fresh. Talk to a board-certified dermatologist to find out how Radiesse can rejuvenate your face.

Q: Radiesse or Fat Transfer for Veiny Hands?

A: I love Radiesse because it not only fills out volume in the hands and face that has been lost to aging, but it also boosts the production of rejuvenating collagen! The skin on the backs of the hands, like the skin on the neck and eyes, tends to be very thin and loosely attached, making it most susceptible to age-related changes. Radiesse plumps the hands again with an aqueous gel, making them look years younger in just one treatment. While the gel will dispel and be eliminated from the body, the rejuvenating collagen is left behind. The presence of Radiesse also stimulates the production of new collagen, which will help maintain your benefits for about six months. Radiesse can also be layered with other dermal fillers, such as Juvederm and Restylane, for optimal results. Talk to a board-certified dermatologist who has expertise in restoring volume to the hands.


Q: Is PicoWay laser effective on blue ink?

A: Blue ink can be removed with PicoWay’s 1064 nm wavelength in Fitzpatrick skin types I-VI. Please be patient. It will take at least five or six sessions to remove your tattoo. Colored inks are more resistant to being broken down and dispersed than black ink. That’s why your black ink is fading more quickly. The blue should fade with further treatments. Please be sure to use a board-certified dermatologist to remove your tattoo.

Q: How should I remove my hand tattoo completely and how safe would it be?

A: If you would feel better removing it, the only way to proceed is with laser tattoo removal. I recommend PicoWay, as it is very effective at fractionating ink into very small particles that will then be safely removed by the body. Tattoos usually take at least five sessions to fade completely. Luckily, you seem to only have black ink, which is the easiest to remove. Here is a video that explains a little more about how PicoWay works:

Q: I have a tattoo on the web of my hand and I wanted to get a excision. I have had three treatments with laser and I still don’t see a big difference. Would excision work for my tattoo?

A: You didn’t mention what type of laser was being used for your removal, but I would recommend PicoWay. Three sessions are not enough to remove a tattoo. It usually takes at least five or six sessions before you get the results you want, but it may take up to seven or eight or more. As long as the tattoo is starting to fade, the laser is working. I would not recommend excision in your case. Please discuss your progress with a board-certified dermatologist.

Q: White Outline On Tattoo; Can I Still Get It Removed?

A: The PicoWay fractionated laser is a safe way to use high-power energy to break up and remove tattoo inks of various colors. Black is the easiest to remove. You don’t mention if you want the white dots removed also, but if so PicoWay can handle those, too. Please talk to a board-certified dermatologist with many years’ experience with successful tattoo removal; you will probably require at least five sessions.