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I feel like I have very droopy cheeks at the corners of my mouth
Posted March 11, 2010 2:27 PM

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

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I've always had very thin lips and would like to do something to make them fuller
Posted March 10, 2010 5:10 PM in Dermal Fillers

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

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I had Restylane injected into my top lip
Posted March 09, 2010 2:21 PM in More Procedures

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 think 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 by Dr. Bustillo

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I'm 35 and interested in a lower eyelid lift
Posted March 08, 2010 12:07 PM in Eyelids Eyebrows and Forehead

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

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I had a facelift two weeks ago
Posted March 07, 2010 8:41 AM in Facelift

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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I have begun reading blogs about facelifts
Posted March 06, 2010 10:12 AM in Facelift

Question:
I have begun reading blogs about facelifts. Can you tell me what the Serdev Suture Midface Lift is? Is it safe and/or effective?

Answer:
The Serdev Suture midface lift is a type of midface lift that is performed by using sutures to elevate the malar fat pad. This is done in a minimally invasive technique, by passing the sutures through the skin and using them to elevate the tissues. My opinion regarding the use of sutures alone to elevate the facial tissues is that they do not work. Too often, I have seen patients that underwent these "lunch-time" lifts, which worked only for several days. Studies have been done and published which prove that these procedures do not work.

Posted by Dr. Bustillo

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At age 28, my skin has very little volume, and I am looking at getting a filler or facelift
Posted March 05, 2010 11:24 AM in Facelift

Question:
At age 28, my skin has very little volume, and I am looking at getting a filler or facelift. Which would you recommend, and would I be at risk for any complications later on in life?

Answer:
I think the answer is fillers, as you are too young for a facelift and facelifts do not add volume to the face. There are several fillers on the market that can be used to add volume. I look at several factors when choosing filler. The first is the location where the volume needs to be added and the second is the skin thickness. In general, I choose hyaluronic acid fillers, such as Restylane for mild to moderate nasolabial folds and the tear troughs. For thin skin and moderate nasolabial folds, I prefer the filler Perlane, which also a hyaluronic filler. For thick skin or cheek augmentation, I prefer Radiesse. This is a calcium-based filler, which works great in patients that need cheek augmentation.

Posted by Dr. Bustillo

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I am 43 and looking into a facelift
Posted March 04, 2010 6:04 PM in Facelift

Question:
I am 43 and looking into a facelift. I read an article that said that facelifts thin the skin and accelerate aging; is this true? Is there any way to prevent this?

Answer:
Over the past several months I have seen several patients, in their early forties that have asked me about undergoing a facelift procedure. While, I do not believe that age is the determining factor for a facelift, I do think that for most patients, this is a little early. My criteria for performing a facelift are really how the aging process has affected the particular individual. In any case, there are some, albeit very few, females in their early forties that need a facelift. In fact, most of these patients can be treated adequately with a necklift.

To answer the question about the thinning of skin and facelifting, I believe that having one facelift will not thin the skin. The thinning of the skin can occur when the patient has multiple facelifts. Again, another reason to wait having a facelift until you really need it.

Posted by Dr. Bustillo

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