Is there a limit as to how many Botox injections one can safely have?

Question:
I’ve been having Botox injections for 5 years now. Is there a limit as to how many injections one can safely have? I’m just wondering if I will face any special risks after having these injections for so long.

Answer:
There have not been any studies indicating that long-term Botox use is detrimental. You can have some muscle atrophy over time but if the Botox is stopped the muscles will regenerate. The atrophy of the muscles is usually not noticeable by observation of the patient’s face.

Posted by Dr. Buckingham

What can I do to get rid of nasal veins?

Question:
I’ve begun to notice some ugly veins on my nose. Is this related to rosacea? What can I do to get rid of them?

Answer:
Vascularity of the nose can be an indication of acne rosacea or can occur as an isolated entity. The best treatment for broken capillaries or dilated veins of the nose is a KTP laser. This procedure is performed in the office with immediate results and limited down time. The process which formed the dilated veins or capillaries will continue however and they are likely to recur as years pass. Usually a patient will get 2-4 years results.

Posted by Dr. Buckingham

Is IPL a good treatment for aging skin?

Question:
Is IPL a good treatment for aging skin? I’m in my early 40s with some minor wrinkles and sagging and texture irregularities.

Answer:
IPL is a good treatment for skin pigmentation and vascularity. It may provide some dermal thickening but is not a treatment for sagging, textural irregularities or wrinkles. Another laser treatment such as fractionated carbon dioxide laser was reviewed and is laser a better for fine lines and wrinkles. Sagging tissues may be better treated with volume augmentation using fillers such as Restylane and Juvederm or possibly the patient’s own fat. More significant sagging is better addressed with surgical intervention for instance limited incision facelift.

Posted by Dr. Buckingham

Can facial wrinkles be removed with laser skin resurfacing?

Question:
If I look up close at my face in the magnification mirror, I see fine wrinkles almost all over my face. Are these tiny wrinkles the type of wrinkles that laser resurfacing erases?

Answer:
In general, I would recommend not utilizing a magnification mirror to analyze your face. A better option would be to analyze the face in the mirror from 2-3 feet. This will give you a better impression of the true aging characteristics of your skin. Wrinkles which are visible in this manner can be easily treated with laser resurfacing techniques. There is a host of available treatments in fact to help fine lines and wrinkles and only a consultation will determine which procedure is most beneficial for an individual patient.

Posted by Dr. Buckingham

What filler is best for improving the area under the eyes ?

Question:
What filler is good for improving the area under the eyes or the tear troughs?

Answer:
Different fillers can be used under the eyes and in the tear trough areas. These would include Restylane, Juvederm, Radiesse and even Sculptra. Sculptra however should be used with significant caution in the thin skin around the eyes. Additionally, Radiesse can be massaged into the tear trough area, but direct injection may cause visible lumpiness. Both Juvederm and Restylane are great alternatives for the lower eyelid however Juvederm attracts greater quantities of water and so therefore may cause puffiness in a greater percentage of individuals. We prefer to use Restylane in the lower eyelids as we feel that it provides the softest results without the disadvantages Juvederm presents. For the same reasons we prefer Juvederm as the hyaluronic acid in the perioral area. The other advantage of hyaluronic acid is that they may be reversed by an injection of an enzyme. This adds an additional level of safety for their use of the periocular area.

Posted by Dr. Buckingham

What’s the best way to evaluate performed facelifts from a surgeon?

Question:
What should I look for when looking at before and after pictures of a potential surgeon to perform my facelift?

Answer:
One advantage of the internet is that it allows the patient to examine the physicians before and after results. What appears to be a good result to one patient may not appear to be that way to another. In our practice, we strive to provide significant benefit for the patient from the preoperative to the postoperative photograph, while creating a natural result that cannot be detected as cosmetic surgical intervention by looking at the postoperative photo alone. We do not want anyone to look at our patient postoperatively and know that they have had cosmetic surgery. If you compare their postoperative result to their preoperative photo however, there should be a significant difference. Patients who are looking for these types of results will be attracted to our website and facility. A patient looking for a surgical result that appears more “operated”, may seek a surgeon who has before and after photos demonstrating that type of result.

Posted by Dr. Buckingham

What is a Botox brow lift and how effective is it?

Question:
What is a Botox brow lift and how effective is it?

Answer:
A Botox brow lift is where Botox is injected into the upper portion of the muscle which surrounds the eye to relax its depression of the brow. Relaxation of this muscle allows the brow to elevate slightly due to contraction of the forehead muscle. The results are subtle but the patient may obtain 1-2 mm of brow elevation with this technique.

Posted by Dr. Buckingham

Is IPL a type of laser resurfacing?

Question:
Is IPL a type of laser resurfacing? What exactly does it do and what can it treat?

Answer:
IPL is technically not a laser as it is a filtered band width of many wavelengths of light and not a single wavelength like a laser. It is a useful tool for treatment of diffuse redness of the skin and pigmentation. It will not help with wrinkles to a noticeable degree.

Posted by Dr. Buckingham

Can the size of my nostrils be reduced?

Question:
I like everything about my nose but my nostrils which I think are too big. Can this alone be changed through surgery and how?

Answer:
The size of the nostrils can be altered alone with surgery. The procedure is referred to as an alar base reduction. Depending on the cause of the nostril size this procedure might involve an incision inside the nostril only, outside only or a combination of the two.

Posted by Dr. Buckingham