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Posted on February 2nd
Question:
I’ve always had very flat cheeks and have envied those with nice high cheekbones. Would implants be a good way to improve my flat cheeks? Are there any other options like fillers?
Answer:
I treat flat and descended cheeks with either fillers or fat transfer. I do not use cheek implants because of the high complication rate. The fillers and or fat works so well and always have a natural appearance.

Posted in Miami injectable fillersMiami plastic surgeonMiami plastic surgery on February 1st
Question:
It seems like plastic surgery has moved toward less invasive procedures, more things like injectable fillers over surgical procedures like facelifts. Do you see this trend continuing?
Answer:
Injectables, such as botox and fillers are large part of an aesthetic practice nowadays. I believe that they can be used to treat the early signs of aging as well as some areas that are not treated with surgery. However, they are a compliment to surgery and do not replace it. For example, injectables do not treat the neck and jowls, which can only be improved with surgery.

Posted in Miami plastic surgeryMiami revision rhinoplasty on January 31st
Question:
I’ve heard revision rhinoplasty is most often performed as an open procedure. Is this true? Is it possible to undergo a closed procedure and minimize scarring?
Answer:
Revision rhinoplasty can be performed in an open or closed approach. The approach taken depends on your surgeon’s experience with either approach. There is not a significant amount of scarring associated with the open approach as compared with the closed. The only difference is the small incision used with the open and some additional swelling.

Posted on January 25th
Question:
Can malar bags be improved with an eyelid lift?
Answer:
An eyelid lift is a procedure that improves the contour of the lower eyelid area. It involves removing or rearranging the fat in the lower eyelid and then tightening the muscle and removing a small amount of skin. Malar bags are usually areas in the cheeks, not the eyelids, that retain fluid. This may be hereditary or caused by a diet high in salt that causes the body to retain fluid. These bags can be quite challenging to treat. Steroid injections can sometimes help the bags as well as a variety of other non-surgical options.

Posted in Miami fillersMiami plastic surgeonMiami plastic surgery on January 17th
Question:
What do you think are the best or most promising fillers currently available and what can they be used for?
Answer:
I believe there are two basic types of fillers on the market right now. The two groups are the hyaluronic acid fillers such as Restylane, Perlane, and Juvederm. The second class is the calcium hydroxyapetite, or Radiesse. I consider this last one a volumizer more than an actual dermal filler. I use this filler to add volume, much like I use fat in the operating room. My favorite area to use it is in the cheeks, where it adds volume and gives a nice cheek lift. The hyaluronic acid dermal fillers are great for the nasolabial folds, marionette lines and for the tear trough area just between the lower eyelid and the cheek.

Posted in Dermal Fillers on March 11th
Question:

I feel like I have very droopy cheeks at the corners of my mouth. Do any fillers work to provide a sort of cheek lift in this area?

Answer:

This is a common reason that people use fillers around the mouth. Patients usually ask me to improve the look and contour of this area. The lip corners are an area where several lines and folds unite. From above, the nasolabial fold ends on the corner of the lip. If this is prominent, it can make this area seem heavy and can hide the corner of the lower lip. In addition, the heaviness can translate to a downturned lower lip, making the patient seem sad. I treat this area with a combination of fillers and Botox. I start with filling the nasolabial fold to decrease its depth. I then use filler to fill and elevate the lower lip corner. The last step is to place a small droplet of Botox on the lower lip muscle to relax it. The relaxation of this muscle helps to elevate the lower lip just a little bit. The result is a beautiful lower lip and a happy patient!

Posted by Dr. Bustillo


Posted in Dermal Fillers on March 10th
Question:

I've always had very thin lips and would like to do something to make them fuller. What are the best fillers for adding volume to the lips and how long do the results last?

Answer:

My favorite filler for the lips is Restylane. I think it works very well and gives a very natural look when placed in the right location and amount. I like to add a thin strip to the border all around the upper and lower lip. I then place a moderate amount in the inside of the upper and lower lip. This allows a moderate amount of eversion, or turning out of the lip. When done in a moderate manner, the lips can be filled in a very natural way. The procedure is done in the office and usually takes 10 minutes to perform. Topical anesthesia cream is applied to the lips and then the Restylane is injected. One recent innovation is the addition of lidocaine local anesthetic to the Restylane. This has reduced the discomfort associated with the injections a great amount.

Posted by Dr. Bustillo


Posted in More Procedures on March 9th
Question:

I had Restylane injected into my top lip and, as a result, I had developed a granuloma. I'm looking to have a touch-up procedure done and would like to know if there is anything that I can do to prevent this from happening again.

Answer:

Well the first thing I will tell you is that it is highly unusual. So unusual, that I highly doubt that you actually had Restylane placed in your lip. While it is possible that you did develop a granuloma with Restylane, it is highly unlikely. I would go back to the physician or person that placed the injection and discuss this with him or her. Granulomas are typically associated with silicone or biopolymer injections. The other thing to ask yourself and the person who injected it is whether it was an actual granuloma. Was it maybe a small hematoma that developed? This is much more likely if it was actually Rastylane that was injected.


Posted in Eyelids Eyebrows and Forehead on March 8th
Question:

I'm 35 and interested in a lower eyelid lift. I read somewhere that some types of Injectables can be used as a sort of non-surgical lower eyelid lift. Is this true? I think it was Restylane that I saw used. How effective is this?

Answer:

You read correctly. When patients begin to show signs of aging in the lower eyelids, they can sometimes be treated with facial fillers. The eye is located in a socket, which houses the eye. There is orbital fat that surrounds the eye and protects it from it actually hitting the bony socket. With time, the fat begins to bulge out underneath the eye. This is seen as "bags" underneath the eye. Initially, when the "bags" begin to develop, fillers can be used to "camouflage" the "bags." The filler is placed through the skin and placed on the orbital bone. The procedure takes about 10 minutes to perform and most patients are very happy with the result. I prefer to use Restylane in this area. The results last approximately 7 months. Posted by Dr. Bustillo


Posted in Facelift on March 7th
Question:

I had a facelift two weeks ago. Everything seemed to go well except that I've been having horrible headaches ever since. Is this something to be concerned about or will they go away on their own? And how long will I have to live with them?

Answer:

Well, I am sorry that you are going through this. This is highly uncommon and not  associated with a facelift. The one exception is if you had a browlift.  Browlifts can sometimes be associated with  headaches. However, you make no note of having had a browlift with the facelift  in your question. I will therefore recommend that you pay a visit to your  primary care physician. It is possible that your headache be caused by  something else than the surgery.

Posted by Dr. Bustillo


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