I’ve always thought of myself as looking younger than everyone else, but now I can’t deny that I am aging.  I used to be one of those women who swore that she would never have plastic surgery and I equated it with all of those movie stars who were full of themselves. Lately, however, I have been thinking that I don’t want to live my life watching myself age and looking sad and tired.  I notice that I am not going out as much as I used to because, quite frankly, I don’t feel that I look as good as I used to.  I don’t want to have any signs of plastic surgery.  What do you suggest that I can do that is small and will make me feel like I am somewhat in control of this aging process?

The first thing that happens in aging is that our facial expression changes.  This has an affect not only on how people perceive us, but also how we perceive ourselves.   In some instances we are perceived as looking sad.  This is because the eyes and mouth are areas of expression on the face that the aging process changes first.  For example as the cheek falls the lower eyelid appears longer and fat pads then appear which makes eye look saddened.  So doing a lower eyelid lift will take care of the extra skin below your eyes.  Lifting the cheek can make a big difference in how people perceive you as you get older. As women in particular get older, the corners of the mouth will turn down.  A simple procedure like adding a filler to fill in the corners of the mouth and some of the lines around the mouth will make you appear not only well rested, but also more friendly.  To make you appear that you have more energy, we can also lift the upper eyelid which will make you look less tired.  


What is the difference between Botox and fillers?

Botox reduces muscle movement, but does not fill in volume from where it has been lost as part of the normal aging process.  The areas where we lose volume as we get older are the lips, corners of the mouth, nasolabial folds, the area in front of the jowls, and sometimes the cheeks.  This usually starts to occur by your early 30’s.  Candidates for fillers are people who want to optimize their appearance with very little downtime and want to just refresh their look.  I’m a believer in enhancing, but not distorting someone’s natural beauty.  Our goals are NOT to make you look like the Housewives of Beverly Hills.  Different fillers are made of different substances which last differing amounts of time.  Juvederm will last about 4 – 6 months, Radiesse consistently lasts for a year, but for the longest lasting results I prefer fat injections.  By harvesting your own fat from a different part of your body, we can address even the deep lines.  The best thing about fat implantation is that it is a permanent result.


How do you do your Botox?  I used to think that all Botox was the same until I had it done in Ohio.  When I get my Botox with you, I get a nice brow lift and you turn the corners of my lips up.  My results also seem to last longer when you do my Botox.  Are they using different stuff, or are you putting it in differently?

I give more units of Botox per treatment, but placement is also very important and can determine how your face looks after injection.  There are many types of Botox on the market right now, but I still think that the Allergan brand provides the longest lasting results.


My girlfriend gets Botox from you and looks flawless.  I look like I’m always mad and people are constantly asking me what’s wrong.  I know I need Botox, but I’m afraid and I really don’t know why.  Can you tell me more about it?

Botox is a substance that works primarily by reducing muscle movement.  Once it’s injected directly into the muscle there is no allergic potential because it is not a protein.  Wrinkles are caused by muscle movements which make lines appear on your face as a direct result of those repeated movements.  Reducing muscle movement prevents those lines from being made in the future, and it will relax current muscle, which will smooth out your skin.  The areas Botox can be used on are frown lines, around your eyes, for the lines around your mouth and chin, for raising your brow, for turning up the corners of your mouth, and for softening the bands in necks.  People are sometimes hesitant because they don’t want to do Botox every three months, but they will still get improvement even if they do it once every six months or once a year.  Some people don’t like putting anything foreign into their bodies, but Botox has a long and safe history of use in the aesthetic world.


Why is it that when I get Juvederm up North it only lasts about 3 months, but when I am down here and you do it, it lasts for over 6 months?

Sounds like you need to spend more of your time down here, must be the weather back home.  Seriously, what many people don’t realize is that Juvederm comes in four different types.  There are some which are tighter cross-linked which will make them last longer – this is the type that I prefer for my patients.  Another important consideration is the depth and position of the Juvederm.  If Juvederm is placed too deeply, it will be absorbed faster.  When placed correctly, Juvederm can help to significantly reduce lines around the lips, nasolabial folds, and the corners of the mouth.  I also pay attention to the cheek volume which is a very important part of anti-aging treatment.


I was looking at some photos with my daughter the other day and I was amazed to see how much thinner my lips are now compared to when I was younger.  What is the best way to fix this problem without looking like Angelina Jolie?

There are three options to replace the lost volume in your lips:  short term fillers, long term fillers or permanent fillers.  Short term fillers consist of Juvederm which lasts 4-6 months.  Radiesse is a long term filler that lasts one year.  Fat Implantation is a very popular choice because it is a permanent solution and is excellent for turning up the corners of your mouth.


I have heard about stem cells for anti-aging.  Does it work and do you do the procedure?

Stem cell therapy is a very fascinating frontier in medicine still in its infancy.  The basic concept of stem cell therapy is that each stem cell can fortify and increase the growth of nearby cells thus improving the healing and aging process.  The majority of stem cells for the healing process are taken from the bone marrow.  The stem cells for cosmetic procedures are taken from fat since each fat cell has a stem cell within it.  This is why we perform fat injection to the face to restore volume:  the stem cells will not only stimulate healing and restore youth, but will also increase blood flow to the area.


My skin has been looking older and older in the last few months.  I happen to be blessed with a husband who has magnificant skin, but I on the other hand, got my mother’s complexion.  What can I do in a pinch to make myself look better?

Microlaser peel is a possibility for you because it has very fast healing time and can reduce most of your pigmentation spots.  Another benefit is that it can also reduce pre-malignant areas which can make your skin healthier.  Pore size can be reduced and fine wrinkles can be eliminated.  Microlaser peels have a very fast healing time of about three days.  Many of our patients will typically combine the laser peel with fat injections.  The benefit of fat injection is that it can restore lost volume while the micro laser peel can tighten loose skin resulting in a great overall natural result.



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“Your perception of yourself often determines how you live your life. This is reflected not only in your personal self confidence, but your social interactions. Interestingly, you will find that how people perceive you is only an added bonus.”

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