Maximize your Botox and Filler

[Botox®](https://aedit.com/procedure/botox) and [soft tissue fillers](https://aedit.com/procedure/dermal-fillersinjectables) have gained immense popularity over the years. The two accounted for nearly 60% of all minimally-invasive cosmetic procedures in 2020 — and there’s good reason for it. Relative to other, more invasive, cosmetic surgeries, [Botox®](https://aedit.com/procedure/botox) and [dermal fillers](https://aedit.com/procedure/dermal-fillersinjectables) are much more affordable, require significantly less downtime, and carry fewer health risks. That being said, there is one major drawback: the results are temporary. Fortunately, there are certain behaviors and habits that we can introduce — or eliminate — to get the most out of our treatments.

So, what can you do to widen the gap between dermatologist visits? Read on for tips and considerations to maximize your [Botox®](https://aedit.com/procedure/botox) and [dermal fillers](https://aedit.com/procedure/dermal-fillersinjectables).

## **How Long Do Injectables Last?**
For better or worse, injectables like Botox® and dermal fillerswear off over time. Botox® typically lasts three to six months and most dermal fillers last around six to 12 months. There are a number of factors that play into the longevity of the injections —  some in our control and others not. The location of the injection is a key factor for how long the injectable will last. In general, muscles that are used more frequently will break down the toxin or filler at a faster rate. Muscles around the forehead, eyes, lips, and mouth are typically more active and, as a result, Botox® and filler may fade away more quickly when targeting those areas. Our metabolisms are another factor that impact injectable lifespan. Having a strong metabolism is a blessing for a number of reasons, but not when it comes to Botox® and dermal fillers. A fast metabolism can break down the toxin and filler  at a higher rate.

“Making sure the patient is the right candidate and accurately determining which injectables to do and where is highly important to ensure best results,” says [Amanda Doyle, MD](https://aedit.com/provider/amanda-doyle-md-31526), a board certified dermatologist at Russak Dermatology in NYC. “Going to a board certified dermatologist and / or plastic surgeon is likely to yield the best outcome. Even with the right doctor and right injections, if you have a fast metabolism, it’s possible that the treatments may not last as long.”

For patients who want longer-lasting results, the release of DAXXIFY™, a new anti-wrinkle injection and Botox® alternative, may be a better option once it’s commercially available in 2023. DAXXIFY™’s effects have been shown to last six to nine months, making it an appealing option for those wanting fewer injections. According to [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526), maintenance for DAXXIFY™ looks similar to Botox® and other neuromodulators like [Dysport®](https://aedit.com/procedure/dysportr) and [Xeomin®](https://aedit.com/procedure/xeomin). Whether it’s DAXXIFY™, Botox® or filler, the following expert advice is sure to help you get the most out of your treatment.

## **Expert tips on how to maximize Botox®  and filler injections**


### **Be extra attentive the first 24 hours**


Given the hefty price tag, the last thing you want to do is disrupt the injections as they make their way through the face. With that in mind, it’s best to leave the targeted area stationary and isolated to prevent the injections from dissipating. NYC-based board certified dermatologist [Brendan Camp, MD](https://aedit.com/provider/brendan-camp-md-34645), warns against lying down for at least four hours post procedure to avoid diffusion of the product. Further, [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) says facial massages, exercises with inversions, like yoga, and hats or headbands are all a no-go for at least the first 24 hours. Washing your face within the first day is doctor-approved, but you’ll want to be extra gentle and wait at least a few hours after the treatment. 

### **Avoid sun Damage**

It’s no secret that the sun’s harmful rays can cause skin damage in the form of redness, discoloration, and wrinkles. While it’s always important to protect the skin from ultraviolet (UV) rays, it’s even more pertinent for those undergoing dermal filler treatments. Research has found that the sunlight’s UV rays can degrade the hyaluronic acid found in fillers. [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) explains that unprotected sun exposure can stimulate enzymes in the dermis, which contributes to the breakdown of normal skin and injected hyaluronic acid. Not only would unprotected sun exposure decrease the lifespan of the fillers and demand more frequent injections, but [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645) says it can also continue to cause fine lines and wrinkles and a need for a higher dosage of neurotoxins to relax the skin.

### **Manage Stress**

We know, easier said than done. We’re not suggesting you need to eliminate stress completely, but it’s beneficial to work on stress management — if not for your mental and physical health, then for your Botox® and filler. Increased stress can trigger the release of the hormone cortisol which has been known to sometimes reduce our own body’s ability to produce hyaluronic acid. “When this happens, volume loss may become even more noticeable more quickly even when hyaluronic acid filler is part of the regimen,” says [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526). Further, stress can cause us to inadvertently change our facial expressions and recruit more muscles between our eyebrows and around our eyes. When muscle movement is increased, [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526) explains that the effects of the toxin injections may not last as long. Consider incorporating a stress-relieving activity, like yoga or meditation, into your daily routine. 

### **Skip the high intensity workouts**

High intensity workouts may be good for your overall well-being, but they’re not good for the longevity of your Botox® or filler. Exercise can stimulate your metabolism which, in turn, increases the rate at which the neurotoxins and fillers are broken down. “If someone is committed to making their aesthetic investment last as long as possible, it is recommended to integrate more low and moderate intensity workouts into their routine,” says [Dr. Camp](https://aedit.com/provider/brendan-camp-md-34645). The takeaway? Next time you’re thinking about attending your gym’s HIIT class, consider a long-distance run instead.

### **Keep a healthy wellness routine**
Practicing healthy habits is another critical piece to maximizing Botox® and filler injections. While the treatments help reduce the signs of aging, they have their limitations. Botox® and dermal fillers won’t clear up your skin’s complexion, but maintaining a healthy lifestyle sometimes can. Sugar and unhealthy fats can cause inflammation, breakouts, and uneven skin while inadequate hydration can lead to dry skin, eczema, and discoloration. Maintaining a good skincare routine, refraining from smoking, and limiting alcohol consumption can also lengthen the results of fillers and Botox®.

### **Integrate hyaluronic acid into your skincare routine**

Botox® and dermal filler can do wonders when it comes to smoothing out fine lines and rejuvenating the skin, but to achieve even better results, [Dr. Doyle](https://aedit.com/provider/amanda-doyle-md-31526) recommends pairing with hyaluronic acid serums and Revision Revox. The hyaluronic acid helps support and hydrate the skin and the Revision Revox can mimic the toxin injections by softening fine lines and wrinkles. Adding these two products into the mix can improve the results of the filler injections and make your skin look even more flawless.




Expert Opinion

What can you do to widen the gap between dermatologist visits for your Botox® and filler injections? Read on for tips and considerations to maximize your results.

How to Maximize Your Botox and Filler Injections

shutterstock 1593164065

From chemical peels to pimple patches, here are expert-approved breakout banishers.

Dermatologist-Approved At-Home And In-Office Acne Treatments

8 Dermatologists Share Their Favorite In-Office And At-Home Acne Treatments

brian-asare-RxVfMN7xyno-unsplash

It goes without saying that looking at a photograph is not the same as seeing something in real life. A two-dimensional snapshot simply cannot capture the nuance of a three-dimensional world, yet selfie and [social media culture](https://aedit.com/aedition/march-2020-study-shows-relationship-between-social-media-cosmetic-surgery) too often fails to respect that important distinction. Whether it’s through makeup, lighting, or face tuning apps, the photos that fill our feeds are not necessarily indicative of reality. But, increasingly, people are turning to cosmetic treatments to recreate a specific aesthetic that might look great in a picture but doesn’t translate to a natural-looking appearance in person because it lacks the movement and expression we expect to see. This is where an additional dimension of beauty – one that accounts for life in 2D *and* 3D – comes into play.

Recently, we hosted an Instagram Live with [Julius Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon in Chicago and creator of [Aforé Beauty](https://www.aforebeauty.com/), to learn more about his concept of “four-dimensional beauty” and how it influences his approach to aesthetic medicine to achieve the most natural and holistic results for his patients. Watch the entire conversation below or read on for a breakdown of five key takeaways.

<a href="https://www.youtube.com/watch?v=6QcFwi8ptxQ" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://www.youtube.com/watch?v=6QcFwi8ptxQ</a>

## **1. Defining Four-Dimensional Beauty**
Dr. Few has been in practice for over two decades. While the original outpost of [The Few Institute](https://www.fewinstitute.com/) is in Chicago, he has a satellite office in Los Angeles where he tends to some very famous faces. As he explains, treating public figures has taught him a lot about our understanding and perception of attractiveness. “One of the things that struck me was how I could see a household-name celebrity, who, in a photograph or in a movie, looked a certain way and by all accounts was attractive,” he shares. “But you saw them in person and they went to even a more dramatic and more appealing level.” 

It’s that dichotomy between what he calls the “in-person encounter” and the “print version” that led him to formalize the idea of four-dimensional beauty. “What that represents is the concept that we deal with the three dimensions we all know – length, width, and distance – and the fourth dimension is time and moments in time,” he explains. “We're not talking about days, hours, minutes – we're talking about microseconds of movement and what is communicated both in terms of verbal and non-verbal communication.” 

While there are extreme examples of people overdoing it, even just a little too much filler or neurotoxin can look off if it impacts the natural movement of the face, he says. “That really is what four-dimensional beauty represents – that transition from moment to moment in interpersonal interaction that can either make or break a moment,” he shares. 

## **2. Photo vs. Video**
Even if your in-person schedule is not quite back to pre-pandemic strength, days spent in Zoom meetings, scrolling through TikTok, or rolling your eyes at Instagram’s ever-conspicuous push for video content are a reminder that we do, in fact, live in a three-dimensional world. The best way to look your best IRL is to consider how the result of whatever you are having done is going to impact your features and expressions. 

Dr. Few says the onus is on the provider to properly assess the patient. “Probably the most important thing that any cosmetic plastic surgeon, dermatologist, or provider of any kind really needs to hone in on is the idea that you have to look at animation during that in-office visit,” he shares. One way to educate the patient and further drive home the point is by supplementing traditional [before and after photos](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery) with video. “I've started to incorporate more and more videography into the assessment, so I can show people,” he says. “I do believe that's going to become the norm in many ways.” 

With the ability to put a smartphone with a 4K camera into the palm of anyone’s hand, all providers need to do is standardize their lighting setup and positioning (à la traditional B&A photos). Dr. Few and his team recently [published a study](https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojac002/6515787?login=false) in the *Aesthetic Society Journal* based on the clinical results of using the [Aforé Beauty CR Emulsion](https://www.aforebeauty.com/products/cr-emulsion) – a serum that blends 0.2 percent retinol, [cannabidiol (CBD)](https://aedit.com/aedition/cbd-beauty-skincare-wellness-benefits), peptides, and hyaluronic acid to improve skin tone, texture, and hydration – that included a dynamic video component. “It gave us a platform to develop the videography assessment tool, which is in its infancy,” he says. “We're still working on it in terms of validating and putting it together, but we're well on our way.”

Long term, Dr. Few sees video as “a great equalizer” that will foster transparency. “There will be more and more of a demand for influencers and the like on social media to have videography versus a static picture,” he notes. “What different people got away with just because they had a great 2D picture, that's not going to be good enough.”

## **3. The Rise of Prejuvenation**
It’s usually easier to prevent something than correct it, and that is certainly true of age-related skin and aesthetic concerns. There is a lot to be said about rejuvenating procedures, but, in the last decade, the conversation has expanded to include the idea of ‘[prejuvenation](https://aedit.com/aedition/i-was-practicing-prejuvenation-before-it-was-a-trend)’ (i.e. preventative treatment). “I kind of came up with that term ‘prejuvenation’ at a multi-specialty meeting probably 10 or 11 years ago,” Dr. Few shares. “The whole concept came up during a panel because, at that time, I was just starting to really kick into taking care of a lot of models and actors, and that group really was keen on the idea of avoiding the knife.” Instead, they were interested in less invasive solutions that they could start earlier in life to potentially delay or eliminate the need for more invasive measures down the line. 

But it’s not just celebrities who want to get ahead. Dr. Few says he has long had patients who are predisposed to deeper frown lines or have a family history of jowling and want to address them as early as possible. “You can preempt that whole phenomenon just by simply targeting that area when it first starts to form, and then you hold it in suspended animation,” he explains, adding that it’s not about stopping the clock or dramatically altering someone’s appearance. “I believe if you try to take that given point where things are transitioning in maybe not the most positive way and hold it, well then that’s mission accomplished,” he says. “You've now made somebody achieve their goal of looking naturally beautiful and aging in the most graceful way, which, in my opinion, is the way to go.” 

Returning to those four dimensions of beauty, it’s all about enhancing what is already there in the most natural way. “It's not about aging ungracefully or in any artificial way or even not aging at all,” Dr. Few explains. “To me, where the artistry of cosmetic medicine and surgery comes through is in creating subtle contrast.” For example, “you have somebody who maybe has gray hair but, at the same time, has a youthful kind of very subtle cuteness that shines through,” he says. “That's their own individual expression.”

## **4. Blending Surgical & Non-Surgical Solutions**
Just because Dr. Few is a plastic surgeon doesn’t mean that every patient of his is going under the knife. “I am somebody who's kind of formed an expertise in both the surgical and non-surgical space – especially for facial rejuvenation and prejuvenation,” he says. In his view, it’s not so much surgical versus non-surgical but rather a continuum. “I try to position things in a way so that if somebody is not sure which direction they want to go, it's easier to do something that's a bit more temporary – that's non-surgical – that then can lead into a surgical option if that's what they want,” he explains.

Generally speaking, prospective patients fall into three categories: 

1. I definitely want surgery.
2. I definitely don’t want surgery – regardless of what I need.
3. I’m undecided and want to know my options.

After determining which bucket someone falls into, there are a trio of factors Dr. Few considers during a consultation to formulate a treatment plan: skin quality, volume loss, and facial laxity. “When you look at those three components, then I get to go into my toolbox and decide what are the options that work for it,” he shares. “For the skin, it may be different forms of resurfacing lasers, peels, etc., and then you look at non-surgical versus surgical lifting.” Seeing as he remembers the days when [Restylane®](https://aedit.com/procedure/restylane) was only one hyaluronic acid-based filler on the market, today’s innovation – especially in the non-surgical space – means there are now “more options than you could even hope to use.” As such, “it becomes much like picking the right paint brush for the component of the canvas you're painting on,” he says.

Finding the right balance between surgical and non-surgical has actually spurred hybrid solutions over the years. Dr. Few cites the evolution of the so-called [Nefertiti neck lift](https://aedit.com/aedition/where-to-use-botox-from-head-to-toe) as one such example. While injecting neurotoxin into neck bands can have a dramatic impact on texture and contour, the effect is temporary. For a longer-lasting result, Dr. Few developed a slightly more invasive neck band procedure. “That's where I can use a special needle that's called a no cord needle to actually go in and break up the bands of the muscle – much like the [Xeomin®](https://aedit.com/procedure/xeomin), [Dysport®](https://aedit.com/procedure/dysportr), or [Botox®](https://aedit.com/procedure/botox) would do – but it does it in a more permanent way,” he says. “You can marry these concepts, which is what makes it fun.”

## **5. The Benefit of ‘Stackable’ Treatments**
Long before the pandemic made the idea of [maximizing in-office time](https://aedit.com/aedition/best-aesthetic-procedures-to-combine-to-maximize-appointments) with your provider a must, Dr. Few was honing the technique of what he calls “stackable treatments.” “When I first came up with ‘stackable treatments’ as a concept, it was the combination of [Ulthera®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) and lasers and fillers – doing that all in one setting,” he shares. As he explains, the combination approach was, initially, “purely out of necessity.” “When I first started seeing patients in New York, I didn't have the luxury of trying to space it out over six months,” he notes. But then he realized the multimodal nature of the appointment was more than just convenient. “There's synergy in it,” he shares, that actually improves the results that would be possible with each treatment individually. 

But not all stacks need to happen at once. Lately, one of the popular pairings at his practice involves combining Dr. Few’s signature [thread lift](https://aedit.com/aedition/pdo-thread-lift-for-facial-rejuvenation) with [Sofwave™](https://aedit.com/aedition/sofwave-for-skin-tightening-collagen-production), a new non-surgical skin-tightening treatment that uses ultrasound waves to firm the skin, and [Kybella®](https://aedit.com/procedure/kybella) to address an array of age-related concerns in the lower face. “I'll do thread lifting, get a result, and then we can come back and do Sofwave™ to further enhance,” he explains. “It seems to really play on that matrix that has been created by the thread lifting.” But that’s not all. “If they still have a little bit of jowl fat, I can do a bit of off-label Kybella® injection to shrink it down,” he adds. “All of a sudden we're creating this approach that can deliver a progressive result.”  

Perhaps most importantly, this trio is not designed to create a trendy, overly snatched jawline. “Always bearing in mind four-dimensional beauty, we’re not trying to do anything just for the sake of a photograph on social media,” Dr. Few says. Instead, the procedures subtly-yet-substantially sculpt the lower face and neck for a more youthful countenance. The result: You’ll look like a rejuvenated version of yourself.

Board certified plastic and reconstructive surgeon Julius Few, MD, breaks down the concept.

A Guide To Four Dimensional Beauty For Natural-Looking Results

Why You Need A Four-Dimensional Approach To Beauty

shutterstock 1760754215

Hyaluronic acid-based fillers work somewhat like magic. Injecting them into the appropriate facial planes allows for deflated areas – such as the [cheeks](https://aedit.com/procedure/cheek-augmentation-with-fillers), mid-face, temples, and [lips](https://aedit.com/procedure/temporary-lip-fillers) – to experience an immediate improvement in volume and contour. Often, dermatologists and plastic surgeons veer on the conservative side and take a less is more approach when filling. After all, adding too much volume in any one area, at any one time can lead to an unnatural appearance. However, some patients require more volume than others, which may call for multiple syringes to achieve the desired effect.

Lately, we’ve talked a lot about [overfilled facial features](https://aedit.com/aedition/hyaluronidase-to-dissolve-dermal-filler), [filler migration](https://aedit.com/aedition/why-lip-filler-migrates), and [filler fatigue](https://aedit.com/aedition/dermal-filler-fatigue), which are just a few of the reasons why the concept of injecting large amounts of filler may sound scary. The truth is, in inexperienced hands, it can be. But, if you are working with a highly skilled injector who understands your aesthetic goals, it’s possible for the specialized technique to be both safe and effective. Here, top physicians break down everything you need to know about large-volume filler. 

## **Large Volume vs. Overfilling: What’s the Difference?**
The term ‘large-volume filler’ is relative. It depends on the treatment area and the anatomy of the patient. Generally, it refers to injecting more than the ‘typical’ amount of filler required for a noticeable change in the average patient, says [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a double board certified facial plastic and reconstructive surgeon in Arlington, VA. “I consider ‘large volume’ anything more than a single syringe (one cc) of filler,” he explains. For context, about five syringes of filler are needed to achieve one teaspoon's worth of volume, says [Joshua Zeichner, MD](https://www.instagram.com/joshzeichnermd/?hl=en), a board certified dermatologist in New York City. He adds that a typical ketchup packet contains about seven syringes worth of filler — just a little food for thought.

While large-volume filler equates to a larger, albeit appropriately used, dose, there is some confusion between it and [overfilling](https://aedit.com/aedition/how-to-correct-overfilled-facial-features). A clear distinction exists between the two:

- Overfilling refers to excessive and inappropriate filler placement
- Large-volume filler precisely injects more-than-average doses into the appropriate facial planes

Dr. Zeichner explains that, when placing more volume, the outcome is 100 percent determined by the skill and aesthetic of your injector. “It is no different than going to the museum and seeing a Monet versus a van Gogh,” he shares. “It's the same oil paint just used differently on the canvas.” If the injections are appropriate, the results should be natural and complement, not hinder the patient's appearance. “When the filler is not placed where it should be, patients often look odd or overfilled,” Dr. Zeichner adds.

We all know what an overfilled face looks like, and, unless that's the aesthetic you're going for, most people try to avoid it at all costs. For that reason, it's understandable why some patients get nervous that they will end up looking overfilled when their provider lays out four or five syringes of filler. Seeing a medical [tray of needles](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) does more than send off sirens that a substantial bill waits for you at the front desk. Dr. Zeichner says patients are more so afraid of looking overfilled and fake, than the price tag.

## **The Ideal Candidate**
Whether you need half a syringe or five ccs, a full assessment is vital before your provider injects a single drop of filler into your face. This includes studying the anatomy of the treatment area and its relationship to the rest of the face, in addition to learning more about your aesthetic goals. Not every patient needs the major volume technique, and the degree of evident aging determines who benefits from it and who doesn't. 

Typically, those with a significant [volume deficit](https://aedit.com/aedition/best-procedures-to-restore-facial-volume) and/or [asymmetries](https://aedit.com/aedition/cosmetic-procedures-for-body-asymmetries) are candidates for multiple syringes of filler. As such, age is not a factor when it comes to who can reap the benefits. More mature patients who require significant volume restoration and younger patients who mandate facial balance are often contenders, says [Michael Schwartz, MD](https://www.drschwartz.com/), a board certified plastic and reconstructive surgeon in Los Angeles. “Full facial balance restoration improves proportions and [creates harmony](https://aedit.com/aedition/facial-harmony-in-aesthetic-medicine) within the features instead of augmenting one area,” he explains. “It requires more product because we treat the face entirely to achieve natural results.” However, patients seeking intentional exaggeration of specific features that are not harmonious with the face's natural contours may not be well-suited for large volume injections, adds [Shirley Madhère, MD](https://elementsandgraces.com/about), a holistic plastic surgeon in NYC and founder of [Jet Set Beauty Rx](https://jetsetbeautyrx.com/).

Sometimes, it can be challenging for doctors to educate their patients on how much volume loss they have – and for patients to accept it – “but it is an important conversation to avoid potential disappointment, especially if a patient does not get the result they are looking for when using fewer syringes,” Dr. Zeichner explains. The last thing any provider wants is for a patient to invest in their face and not be happy with the results simply because there is a need for more product.

## **The Right Way to Do It**
What constitutes large-volume filler depends on each patient's face and how much filler they can safely benefit from, says [Kenneth Mark, MD](https://kennethmarkmd.com/), a board certified dermatologist with offices in New York, Aspen, and the Hamptons. Despite the volumizing benefits, he finds patients can be skeptical of substantial amounts of filler because of the suboptimal outcomes they’ve seen on social media from either too much of the wrong filler or poor injections in the wrong places. This rightfully creates legitimate concern amongst patients when they hear the words ‘large-volume filler.’

Using filler as an alternative to traditional cosmetic surgery procedures (like a [rhinoplasty](https://aedit.com/aedition/facts-about-liquid-rhinoplasty) or [chin implant](https://aedit.com/aedition/best-chin-augmentation-enhancement-procedures)) and in areas that require more noticeable correction (think: jawline, temples) call for larger volume – often two syringes of filler or more – says Dr. Cabin. “The nose and chin are unique in that fillers create changes in two-dimensional shape in the profile view, as opposed to three-dimensional facial volume change goals with other areas,” he explains. The chin typically requires one to four ccs of filler to create the necessary balance. When injecting insufficient amounts of filler, the results will not be noticeable and can even call unwanted attention to a specific feature.

In the hands of an expert injector who understands the nuances of filler and anatomy, using more than moderate amounts of product can create an aesthetically pleasing result, especially when the placement is deep. “It makes a big difference," says Dr. Zeichner, who regularly uses five or more syringes (often in a single session). “Most of my injections tend to be deep, down to the level of the bone,” he notes. This technique helps provide structure, support, and mattresses to lift and reposition the overlying soft tissue and skin. “If all of the injections are superficial, it weighs down the face and makes the patient look overfilled,” he cautions. Deep placement creates the opposite effect.

Deep injections also create a smoother appearance – sans bumps, lumps, and irregularities. Not injecting more robust fillers deep enough can cause superficial lumps, nodules, and a blue tinge to the skin, known as the Tyndall effect. “When injecting thicker fillers into the skin, it is important to employ a technique that places the filler in the layer of skin that is appropriate to accept the dynamic properties of that filler,” Dr. Madhère explains.

In the case of large-volume fillers, Dr. Mark likes to use a layering technique. Layering is just what it sounds like and consists of placing fillers in various depths of the skin and locations as needed over time. He says layering filler and staging it out over multiple sessions avoids overcorrection and provides natural-looking results. “Utilizing this method and pinpointing precise placement has allowed me to avoid complications and obtain optimal cosmetic results,” he adds.

Technique aside, injecting the right fillers in the right place is essential. Dr. Madhère says thicker hyaluronic acid-based fillers, like [Juvéderm® Voluma](https://aedit.com/procedure/juvederm) and [Restylane® Contour](https://aedit.com/procedure/restylane), occupy more space. But it's not just hyaluronic acid filler that fits the bill. Injectables that fill more robustly, including [Sculptra®](https://aedit.com/procedure/sculptra), which provides a scaffold for a volumizing effect, may be used. “Additionally, thick and long-lasting calcium-based [Radiesse®](https://aedit.com/procedure/radiesse) can also be used,” she explains. “So can [fat injections](https://aedit.com/procedure/facial-fat-grafting), but they involve a surgical procedure and additional costs.” No matter what filler you and your provider ultimately decide on, it's always important to find an injector that understands the differences between the products and where to place each one.

Just like every patient isn’t a candidate for large-volume fillers, not every facial feature should be treated with the technique either. The parts of the face that tend to respond well include the temples, cheeks, midface, and jawline. Dr. Madhère advises against using a lot of volume in the [forehead](https://aedit.com/aedition/cosmetic-forehead-procedures) and [eye area](https://aedit.com/aedition/under-eye-filler-pros-cons), as they can swell and cause undesirable puffiness.

## **One Session or Multiple: Which Is Best?**
There are plenty of patients that only need a bit of filler and respond well to an average dose. Yet, the ‘a little filler goes a long way’ rule doesn't apply to everyone. Dr. Zeichner says that “more filler goes a long way” for many of his patients. And, when there is a need for significant volume and it is within a patient's budget, he prefers injecting it all at once. “This means less anxiety over the visits and a single period of downtime versus multiple visits with potential bruising after each one,” he shares.

Some providers, meanwhile, choose to space out the injections. For example, Dr. Cabin rarely does large volume filler in a single appointment. Instead, he performs spreading out large-volume injections over a few visits because, as he says, there’s a greater chance of unnecessarily high levels of short-term swelling. “The filler tends to settle better when I inject it over several sessions,” he notes. “It settles and creates a more natural correction.”

[Swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) may be one reason to break the injections up, but there's also the potential for volumetric changes that patients don't know to account for. A filler may be a specific volume when it is going in and, most of the time, that volume increases since the product naturally pulls in water from the surrounding tissue (hence, post-treatment swelling). Some of this extra water can remain, causing what Dr. Cabin describes as a more considerable volume change than you would anticipate from the syringe volume alone. Volume fluctuations are another reason why some providers avoid injecting large amounts of filler at once.

## **How Long It Lasts**
The more product your provider injects, the longer it can take to break down and for the area to return to baseline. So, injecting more filler may equate to longer-lasting results, but there is a lot that goes into how long filler results last. “Longevity depends on several factors, including, but not limited to, the main ingredient, chemical composition, amount injected, and patient's metabolism,” Dr. Madhère explains. 

While injectable brands provide an average of how long each product lasts given its intended use (i.e. up to one year), those timeframes vary from one person to the next. “Everyone metabolizes fillers differently, so I like to start with full correction treatment and then follow-up with a [maintenance plan](https://aedit.com/aedition/how-frequently-to-get-non-surgical-cosmetic-procedures-like-dermal-filler-botox-chemical-peel) to keep the results up,” Dr. Schwartz says.

## **The Takeaway**
If your doctor says you'll benefit from multiple syringes of filler, it doesn't mean you will end up with an overfilled face that looks doughy or unnatural. In fact, some patients sport numerous syringes of filler, and no one but them and their injector knows. More often than not, it’s poor injection technique and improper placement that will land you in the ‘done and don't’ category. Ultimately, the decision is yours, but, with the help of an expert injector who understands how to use more robust amounts of filler to replace lost volume or correct asymmetry, you may be happier with the outcome. In the right hands, more can be more.

Dermatologists and plastic surgeons break down the benefits of injecting large volumes of filler for certain patients.

The Pros And Cons Of Large-Volume Filler Injections For Volume, Symmetry, Contour

Why Injectors Say Not To Be Afraid Of Large-Volume Filler

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There’s no wrong way to have a vagina – they’re all beautiful – but personal preference is just that, personal. [Vaginal rejuvenation](https://aedit.com/procedure/vaginal-rejuvenation-solutions) is the umbrella term that refers to an array of surgical and non-surgical solutions that can address both functional (think: urinary incontinence, vaginal dryness, vaginismus, etc.) and aesthetic (i.e. vaginal skin laxity, labia shape and size, etc.) concerns related to the vagina and the vulva as a whole.

For many women, conversations about sexual health primarily happen between friends, and they don’t necessarily center around things like appearance, hormonal changes (postpartum and [menopause](https://aedit.com/aedition/menopause-specific-beauty-skincare-hair-products)), or other functional concerns. If the discourse steers towards that topic, it’s often by comparison and without a clear solution. After all, not everyone is friends with medical and sexual wellness experts. 

That’s where we come in. We’re here to have that in-depth chat with a true expert in the field, [Usha Rajagopal, MD](https://aedit.com/provider/usha-rajagopal-md-1330), a board certified plastic and reconstructive surgeon and founder of [San Francisco Plastic Surgery & Laser Center](https://www.sfcosmeticsurgery.com/) who specializes in vaginal rejuvenation, to get clear answers to your ‘below the belt’ questions and learn more about the in-office procedures that exist to treat an array of [female sexual wellness](https://aedit.com/concern/female-sexual-wellness) concerns. 

## **1. It’s Not Just One Procedure**
First things first, the term ‘vaginal rejuvenation’ doesn’t refer to any one thing. “Vaginal rejuvenation is really a combination of vulva rejuvenation along with vaginal rejuvenation,” Dr. Rajagopal explains. Translation: there are options. We break them down below:

### **Surgical Solutions**
- **Labiaplasty**: “To improve the aesthetic appearance of the labia minora and labia majora, we offer a [labiaplasty](https://aedit.com/procedure/labiaplasty),” she shares. The surgical procedure can benefit those experiencing discomfort during exercise, urinary tract infections, painful intercourse, and other physical activity. The surgery can be performed alone or as part of a [mommy makeover](https://aedit.com/concern/mommy-makeover).
- **Monsplasty**: For those who have excess skin and/or fat in their upper pubic area that is impacting their quality of life, Dr. Rajagopal recommends [monsplasty](https://aedit.com/procedure/monsplasty) (a.k.a. mons pubis reduction or pubic lift). It can involve liposuction (to remove fat), surgical excision (to remove skin), or a combination of the two. 

### **Non-Surgical Solutions**
- **Emsella®**: “[Emsella®](https://bodybybtl.com/solutions/btl-emsella/) consists of high-intensity focused electromagnetic stimulation (HIFEM) that is similar to MRI magnetic technology,” Dr. Rajagopal explains. “It stimulates and enhances the function of the pelvic floor muscles.” She says the treatment is ideal for those experiencing urinary incontinence and/or an inability to achieve strong orgasms. The non-invasive treatment (you sit on a chair-like device that stimulates the muscles) calls for six 30-minute sessions in a three-week span.
- **Botox**: Yes, you read that right, Botox for vaginal health. The neurotoxin is used off-label for the treatment of [vaginismus](https://aedit.com/aedition/botox-injections-for-vaginismus), a medical condition that causes involuntary vaginal muscle spasms that can make inserting tampons and penetrative sex painful —  if not impossible. Botox is injected into the bulbospongiosus muscle (i.e. the muscle that surrounds the opening of the vagina) to relax it and relieve the spasms.
- **Infini™ RF**: If a surgical labiaplasty isn’t for you, Dr. Rajagopal says “you can also have just a labia majora reduction with [Infini™ RF](https://aedit.com/procedure/infini-rf).” When used on the vulva, the RF microneedling treatment can firm the tissue of the labia majora to enhance its appearance and even tighten the vaginal canal after natural childbirth. “We call it a vagi-facial,” she notes.
- **Laser Therapy**: Dr. Rajagopal uses [FemiLift®](https://almainc.com/products/femilift), a fractional C02 laser, to treat patients with vaginal dryness due to age and vaginal atrophy (a condition that can cause painful intercourse). The [intravaginal laser](https://aedit.com/procedure/vaginal-rejuvenation-with-laser-energy) is inserted into the vaginal canal (she assures us the treatment is much more tolerable than it sounds). Some patients enjoy the benefits after the first appointment, but Dr. Rajagopal recommends three sessions in three months for best results. 
- **PRP**: To improve pleasure, the so-called [O-Shot](https://aedit.com/procedure/oshot) injects platelet-rich plasma (PRP) into numbed areas of the vagina, clitoris, and labia to heighten orgasms and improve sexual wellness. For some, the effects are immediate, while an initial series of treatments may be needed for others. Results can last three to six months.

## **2. It’s Highly Customizable**
The vulva is made up of multiple organs – including the vagina – and just about all of them can be addressed. While vaginal rejuvenation is often talked about in relation to childbirth, hormonal changes, genetics, and even stress can impact both the form and function of the genital area. “There can be functional issues that may interfere with her lifestyle and how much pleasure she gets out of sex,” Dr. Rajagopal shares. “There can also be aesthetic issues that she may want to address and that’s what we offer.” 

Many of the procedures listed above can be combined to create a treatment plan that best addresses a patient’s unique anatomy and goals. Consulting with a board certified plastic surgeon or gynecologist who specializes in vulva rejuvenation is the best way to learn more about your options.

## **3. Candidates Vary** 
As with any procedure, those interested in vaginal rejuvenation should consult with their provider to ensure their preferred procedure(s) is right for them. As we mentioned, treatments that address vaginal health and appearance aren't one-size-fits-all, nor should they be. “With each treatment, we have an examination first to see who is a viable candidate,” Dr. Rajagopal explains. Topics such as medical history and overall health and wellness should also be discussed during the examination process. Women may also want to consider whether or not they are planning to have children or want to further expand their family. While some of these solutions treat sexual health concerns, others have the ability to be impacted or undone by pregnancy or childbirth.

## **4. Sensitivity Can Be Compromised** 
Although it’s uncommon, a decrease in sensation is always possible after cosmetic procedures – and vaginal rejuvenation is no exception. There is no surefire way to prevent this, though cosmetic gynecology performed by a highly skilled provider who specializes in the practice is the best way to ensure a safe and effective outcome. Prior to booking a procedure, be sure to use the [consultation process](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) to learn more about your provider. Research their credentials, review before and after photos, inquire about how often they perform the procedure(s) you are interested in, and even seek out patient testimonials to ensure you find the right fit. 

## **5. Recovery Is a Process**
The beauty of many non-surgical solutions (vaginal rejuvenation or otherwise) is that they come with minimal [downtime and recovery](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products). Even so, there may be some guidelines as to when certain activities, including sex, can be resumed. Be sure to ask your provider about any recovery protocols. 

Recovering from surgery is a bit more involved. Depending on the procedure, a few days to a week of downtime may be needed. Side effects of most vaginal rejuvenation surgeries include swelling, bruising, and discomfort. Infection is a greater risk due to the nature of the area, so practicing good hygiene after surgery is key. Those who have vaginal rejuvenation as part of a [larger mommy makeover](https://aedit.com/aedition/mommy-makeover-recovery-healing-process) will need to factor in the recovery of the other surgeries as well. 

## **The Takeaway** 
From genetics to age to childbirth, there are a wide variety of reasons you may be interested in vulva rejuvenation. For too long, women haven’t had reliable resources to learn more about their options. It’s time to change that. “It has been taboo to speak on female genitalia, while men’s concerns aren’t,” Dr. Rajagopal says. “They have medication to help with erectile dysfunction and aesthetic surgeries to improve the appearance, so I think the time has come for women to feel confident with that area.” Hear, hear!

Female sexual wellness is too often spoken of in hushed tones, but we’re going ‘there’ to answer the questions you have about vaginal rejuvenation.

What To Know About Vaginal Rejuvenation, According To A Plastic Surgeon

5 Things You Need To Know About Vaginal Rejuvenation

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Dermatologists weigh in on the safest solutions for acne, melasma, stretch marks, and more.

How To Treat Acne, Melasma, Stretch Marks, Spider Veins, And More During Pregnancy

Exactly How To Treat 5 Common Skin Conditions During Pregnancy

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Pregnancy causes many changes to the body, some which reverse naturally and others that require a little extra help. If you wish to achieve your pre-baby body or sculpt and contour your new physique, a [mommy makeover](https://aedit.com/concern/mommy-makeover) may be the ultimate amalgamation of procedures to do just that.

The term ‘mommy makeover’ is a catch-all for correcting any changes to a woman's body after childbirth, says [Lauren Chmielewski, MD](https://aedit.com/provider/lauren-chmielewski-md-143), a board certified plastic and reconstructive surgeon in New York City. A traditional mommy makeover typically involves a tummy tuck, liposuction, and breast surgery (breast augmentation, breast lift, or [both](https://aedit.com/aedition/combining-breast-augmentation-with-breast-lift)). Yet, today's mommy makeovers are more inclusive than ever. More women are opting to add [additional procedures](https://aedit.com/procedure/mommy-makeover-solutions) that include fat transfer to the breasts, vaginal rejuvenation, Brazilian butt lifts (as is found in the so-called ‘[hourglass mommy makeover](https://aedit.com/aedition/hourglass-mommy-makeover-with-bbl)’), and even arm and thigh lifts.

Just as important as finding a plastic surgeon who can achieve the results you're after is to understand (yourself) the ins and outs of the highly involved surgery and what the recovery entails. Although most mommy makeover patients are thrilled with the outcome, getting there is not always easy. Often, the [mommy makeover recovery process](https://aedit.com/aedition/mommy-makeover-recovery-healing-process) is downplayed – especially on social media. Therefore, patients need to have realistic expectations when it comes to the steps they need to take to achieve optimal outcomes, says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a board certified plastic and reconstructive surgeon in Lone Tree, CO. “Proper healing requires planning and attention to detail, like attentive wound care, compression, restriction of various activities, and careful attention to what you eat,” he shares.

Generally speaking, three weeks of taking it very easy is recommended, but that’s not always feasible – particularly for moms with young children. The more time you can take to recuperate, however, the better, since bleeding, breakage of internal sutures, and the opening of wounds are possible if you try to do too much too soon, cautions [Mark G. Albert, MD](https://aedit.com/provider/mark-albert-md-77), an NYC-based board certified plastic and reconstructive surgeon.

There's plenty to know about a mommy makeover that all too often flies under the radar. Whether you are in the [research phase](https://aedit.com/aedition/best-questions-to-ask-before-a-mommy-makeover), considering booking, or getting ready for recovery, we tapped top surgeons to get their expert tips on preparing for and recovering from the surgery. Here are 10 things to know before getting a mommy makeover.

## **1. Numbness Can Last Months, If Not Longer**
It's not uncommon for the skin to feel numb for months (even upwards of a year) after the [tummy tuck](https://aedit.com/procedure/abdominoplasty) portion of a mommy makeover. It is a normal – albeit disconcerting – part of the overall [healing process](https://aedit.com/aedition/tummy-tuck-recovery-healing-process), and there's no need to worry about a lingering lack of feeling. It is related to trauma to the nerve endings and swelling. During an abdominoplasty, your surgeon lifts and removes excess skin to tighten the abdominal wall and muscles. “In doing this, we cut the small nerves to the skin, and it takes time for these nerves to grow back to the skin surface,” Dr. Albert says. As a result, there can be little or no feeling through the abdomen during the regrowth period. It's a waiting game as the nerves repair, reconnect, and regenerate independently.

Usually, this process takes a few months, and Dr. Albert says it is incredibly uncommon for someone to have permanent numbness after the procedure. “Any numbness generally subsides as the swelling goes away, which can take up to six to 12 months before completely returning to normal,” Dr. Chmielewski adds. However, some patients never regain 100 percent sensation, and some degree of numbness may always exist in the abdominal area. So, if you feel the urge to scratch an itch with little relief, that’s why. 

## **2. Walking – Even Around the House – Is Difficult at First**
Getting up and mindfully moving is essential in the first few days after a mommy makeover since gentle movement promotes circulation and proper blood flow. Dr. Chmielewski says walking helps lower the chance of developing a blood clot or deep vein thrombosis (DVT) after surgery. Many plastic surgeons advise purchasing a walker (do this [before surgery](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products) and have it ready to go when you get home), since mobility is somewhat limited and the extra support is helpful. 

If you find it difficult or painful to stand upright, it is due to the newly created tightness in the core. Any discomfort is temporary. Some surgeons instruct their patients to walk hunched over with the help of a cane to prevent [unnecessary strain](https://aedit.com/aedition/how-to-reduce-tension-scarring-after-cosmetic-surgery) on the stomach incisions, which can force them open. But not every surgeon takes this approach nor agrees with it. “I find this unnecessary and believe it creates more back pain than one would have from the procedure alone,” Dr. Albert shares. “Therefore, I encourage my patients to sit and stand upright and be up and walking the day of the procedure.”

To make sure you keep moving, you’ll want to create a simple walking schedule and have a family member, friend, or partner make sure you stick to it. “Walking for 10 minutes every two hours while awake is a great way to ensure you’re getting enough movement in,” Dr. Chmielewski shares. As for when your movement will feel less encumbered, Dr. Buford says patients usually walk fully upright by week two or three.

## **3. The Shape & Position of the Breasts Will Evolve**
If you opt for [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) to correct deflation, decreased volume, or droopiness, don’t freak out if you don’t like how your new breasts look the first time you see them. Your first impression will not be your last. The breast implants usually sit very high on the chest [following a breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants). To help the implants settle into place, Dr. Buford recommends his patients wear a breast band and perform breast implant massages. This settling process (sometimes called ‘drop and fluff’) generally resolves over the coming months. 

It's also normal for the breasts to feel tight and swollen initially. But as the tissue stretches and relaxes and the implants soften up and descend the chest over the next few months, they begin to take their final shape and become more symmetrical and natural looking. “This is a completely normal part of breast augmentation with or without a breast lift,” Dr. Albert says.

## **4. An Electric Recliner Will Make Standing Up & Sitting Down Easier**
Post-mommy makeover, patients may find it cumbersome to get in and out of bed or a chair. That's why some plastic surgeons recommend recovering in an electric recliner, which makes sitting and standing much easier on the body. [Resting in a reclining position](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures) (you can sleep in one at night, too) helps take the pressure and strain off the abdominal wall, which is important since unnecessary stress or a pulling feeling can cause an incision to open.

If you don't have a recliner, you may want to purchase one or borrow one from a friend or family member. If an electric recliner is out of the question, consider using a wedge pillow for additional back support when sleeping or resting and use a small pad or lumbar support under the knees for extra support. Learn more in our [guide to post-op pillows](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing).

## **5. Your Plastic Surgeon Can Remove an Existing C-Section Scar**
If you delivered your baby via c-section, it's okay to have a mommy makeover once your doctor deems you ready for surgery. However, one of the most commonly asked questions among c-section patients is if a secondary scar is necessary. In most cases, creating a tummy tuck incision below an [existing c-section scar](https://aedit.com/aedition/invasive-non-invasive-procedures-to-fix-appearance-of-c-section-scar) (they're shorter and smaller than abdominoplasty scars) removes the original one. “Many patients have existing scars from previous procedures on the abdomen,” Dr. Chmielewski says. “So, depending on the operation, it is usually possible to have a tummy tuck and use these scars.”

There are some instances where you may not be able to trade a c-section scar for the [hip-to-hip tummy tuck scar](https://aedit.com/aedition/scarring-after-body-plastic-surgery), like if the c-section scar is too low. “When this is the case, it may not be possible to have the abdominoplasty scar placed below the C-section scar,” says [Adam Schaffner, MD](https://aedit.com/provider/adam-schaffner-md-33), a double board certified facial plastic and reconstructive surgeon in NYC. 

## **6. A Compression Garment Will Be Your New Favorite Accessory**
When you wake from surgery, you'll be wearing a tight-fitting [compression garment](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) in at least one area. Although it is uncomfortable, it helps limit swelling in the abdominal area and promotes healthy healing. Dr. Buford calls compression “a necessary evil,” adding that “it can mean the difference between an amazing result and a ho-hum outcome.” He also says that compression enhances local lymphatic drainage and reduces the risk of fluid collections ([seromas](https://aedit.com/aedition/risk-of-seroma-after-cosmetic-surgery)) beneath the skin.

Dr. Albert says that patients know that any compression will stop as soon as they remove the garment, and they will get swollen again. “Typically, patients use the compression garment I give them in the OR for about a week and then switch to a tighter compression garment as the swelling subsides,” he notes. Every plastic surgeon has their recommendation for the length of time that patients should wear compression garments, and most stay in one for at least the first six weeks post-procedure. Throughout that process, you can size down as [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) resolves to retain some degree of compression until you reach your final shape and size. If you do not wear a compression garment or have a manual [lymphatic drainage massage](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery) performed, it may lead to prolonged swelling.

## **7. Make Sure You Are Done Having Children**
While there is nothing stopping you from getting pregnant again after a mommy makeover, it certainly will [impact the results](https://aedit.com/aedition/how-pregnancy-affects-cosmetic-surgery-results). “The idea is to make your stomach as flat as possible and the skin as tight as possible, which can stretch again if one has another child,” Dr. Albert says. Dr. Chmielewski agrees and usually advises her patients to wait until they are finished having children to proceed with a mommy makeover. “Cosmetic surgery is an investment, and patients should be at or close to their goal weight for the results to be long-lasting and achieve the best results possible,” she says.

Moreover, getting pregnant following a mommy makeover may have implications on the way the body responds to pregnancy. “If a tummy tuck is performed in which the rectus muscles are tightened (plicated), a woman will likely feel a tighter sensation than prior pregnancies,” Dr. Schaffner says. “There is the theoretical risk of restricting the growth of the fetus.”

## **8. You’ll Need a Laxative (or two) to Get Things Moving Again**
A mommy makeover requires [anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), and the trade-off for comfort during surgery is constipation in the days following it. For this reason, a laxative is a must for your post-recovery shopping list. Any over-the-counter laxative will do, but, if you’re taking one that you have never used before, it’s best to test it three to five days before your surgery to make sure your body responds well. This way, you can get an idea of how fast-acting it is and any potential side effects. Another way to ensure a smooth transition following surgery is to eat plenty of fiber-rich foods while recovering, which always helps make the bowel movement process a little easier.

## **9. Pay Attention to Your Diet During Recovery**
You are what you eat, especially when in recovery mode. The food you consume while at home recouping from a mommy makeover should be fiber-rich and anti-inflammatory to promote healing. Dr. Buford says surgical nutrition is where patients and many practitioners fall short. But, if you keep to a healthy and clean diet before surgery (along with regular workouts), your recovery will likely be easier and faster — and you'll feel pretty good, too.

Protein is also crucial for recovery. A diet that lacks enough protein may lead to poor wound healing and a lack of energy, Dr. Schaffner says. Steer clear of salty foods, which can cause unnecessary water retention. The same goes for soda and processed and fried foods. They offer no nutritional value, but these inflammatory foods can lead to prolonged swelling. Learn more in our [guide to what to eat before and after cosmetic surgery](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery). 

## **10. You May or May Not Need Drains**
For years, drains were one of the downsides of a tummy tuck. Patients don't like emptying them, and their removal can be uncomfortable. Today, not every plastic surgeon uses drains, and it all depends on your provider’s technique and preference. As Dr. Schaffner explains, progressive tension sutures minimize the need for drains. “We also use medications before and after surgery (such as gabapentin, Celebrex, and Tylenol) and during surgery (such as long-acting anesthetics) to [minimize the need for opioids/narcotics](https://aedit.com/aedition/opioid-free-plastic-surgery-pain-management) and shorten recovery times and minimize the development of complications,” he adds. Drainless tummy tucks make the recovery process a bit easier with [better scarring](https://aedit.com/aedition/how-to-reduce-tension-scarring-after-cosmetic-surgery), too.

## **The Takeaway**
From what procedures to get to how much childcare to arrange, we know there is a lot to consider before, during, and after a mommy makeover. To help, we’ve got all the resources you need to simplify the research process:

- [7 Questions To Ask Before Booking A Mommy Makeover](https://aedit.com/aedition/best-questions-to-ask-before-a-mommy-makeover)
- [Expectation vs. Reality: Recovering From A Mommy Makeover](https://aedit.com/aedition/mommy-makeover-recovery-healing-process)
- [Is The Hourglass Mommy Makeover The New Mommy Makeover?](https://aedit.com/aedition/hourglass-mommy-makeover-with-bbl)
- [What Happens When You Get A Breast Lift After Breastfeeding](https://aedit.com/aedition/mastopexy-breast-lift-after-pregnancy-breastfeeding)
- [Here’s What You Need To Know About Repairing Diastasis Recti](https://aedit.com/aedition/diastasis-recti-repair-abdominal-separation-post-pregnancy-weight-loss)
- [How To Improve The Appearance Of A C-Section Scar](https://aedit.com/aedition/invasive-non-invasive-procedures-to-fix-appearance-of-c-section-scar)
- [How Pregnancy Affects Cosmetic Procedure Results](https://aedit.com/aedition/how-pregnancy-affects-cosmetic-surgery-results)

From there, a consultation with a board certified plastic surgeon who specializes in mommy makeovers will allow you to develop a treatment plan that best aligns to your lifestyle and aesthetic goals.

Hint: It involves so much more than just a little nip and tuck.

What You Need To Know About A Mommy Makeover, According To Plastic Surgeons

10 Things To Know Before Getting A Mommy Makeover

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Lip augmentation via hyaluronic acid-based fillers can [add volume](https://aedit.com/concern/lip-size) and/or [enhance the shape](https://aedit.com/concern/lip-shape) of the lips to create a pout that best flatters your face. It’s a quick and temporary procedure (results last six to 12 months) with minimal downtime (save for a bit of swelling and bruising) that can immediately and dramatically improve the smile and the overall proportions of the face. But no aesthetic treatment is without [risk](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), and lip enhancing procedures via filler are under more scrutiny than ever before for migration – or what TikTok calls “the filler mustache.” And the number of videos about fillers seemingly moving out of place proves it's more common than many of us realize. 

In these clips, [lip filler](https://aedit.com/procedure/temporary-lip-fillers) patients show how the product has moved into a space in the lips near the white roll (the small white line at the top of the lip) due to poor injection technique, too much product, the lip's natural anatomy, or the wrong filler. The effect can happen in other areas of the face too – like [under the eyes](https://aedit.com/aedition/under-eye-filler-pros-cons) – but the lips are especially prone to experiencing this spreading effect. Once the filler shifts out of place, the lip (often the top one) appears duck-like or distorted, which is a look no one wants.

If you’re questioning whether your filler is migrating, here’s everything you need to know to look for and how to restore a more natural-looking appearance.

## **Why Filler Migrates**
Hyaluronic acid-based fillers are gels with a liquid-y formulation. The basic rules of science tell us that any liquid can move. However, migrating filler isn't necessarily an immediate effect. Instead, it’s one that happens gradually over weeks, if not months or even years. All ‘temporary’ fillers aren't necessarily temporary, and some mysteriously stay in these particular areas, says [Paul Jarrod Frank, MD](https://www.instagram.com/drpauljarrodfrank/?hl=en), a board certified dermatologist and founder of PFRANDMD in New York City. The filler can move in virtually any direction, although it usually transpires more in the upper lip because of constant movement and motion (think: smiling and talking). As a result, there can be a strange appearance to the upper lips with visible product sitting in the area right above the lip, which causes it to protrude outward.

When fillers shift out of their intended place, the result is unnatural-looking lips that jut out or look fuller in unexpected areas, says [Samuel Hahn, MD](https://aedit.com/provider/samuel-hahn-md-20403), a double board certified facial plastic and reconstructive surgeon in Cockeysville, MD. The displacement also often gives the appearance of bulging or excessive fullness above or below the pink portion of the lip called the vermillion border, which causes a prominent shelf or unnatural roll. In addition, some types of filler are more apt to push up into that white space than others.

So, how can someone know if their fill has migrated or if it's just a case of bad lip injections? First, look at the border of the lip and if it lacks a crisp perimeter between the lip edge and above or below the lip border or a distended area across the upper lip cutaneous (vermillion border and philtrum), says [Madhuri Chadha, MD](https://drmadh.com/), the founder of Chadha MD Aesthetics in Beverly Hills. “This is what gives the effect of 'trout pout,’” she adds. Other indicators to look for include the appearance of prolonged swelling or difficulty closing the lips. If the white part of the lip looks like a duckbill, then the filler has shifted and it's not over-projection, adds [Ava Shamban, MD](https://aedit.com/provider/ava-shamban-md-2325), a board certified dermatologist in Santa Monica, CA.

Filler can migrate for one or more reasons. The most common include: 

### **1. Bad Placement**
Migrating filler can happen when injectable products are placed into the wrong plane. As Dr. Hahn explains, a thin plane – known as the pars marginalis and pars peripherals – separates the lip muscle (orbicularis oris), and injecting it into the wrong plane can allow the filler to move. By placing more product into the lip, the path of least resistance for the filler is into the lip's peripheral tissues, leading to a deviation, he adds. Therefore, the depth of the filler placement and the [needles used](https://aedit.com/aedition/guide-to-needles-used-for-cosmetic-injectables-botox-filler) are essential to a successful outcome.

Depending on where the filler is injected, it can “migrate” into the white roll and even further into the cutaneous or white lip, Dr. Shamban says. “So, the truth is, the product doesn't usually ‘migrate’ but results outside the area, which is more about not placing it into the tissue at the location or depth it should be,” she explains.
 
Injectors use many techniques to inject the lips depending on the look a patient wants, their natural lip shape and volume, and the inherent structure of the lips. Some buzzy injection techniques, like tenting and [Russian lips](https://aedit.com/aedition/biggest-non-surgical-aesthetics-trends-of-2022), which create more volume in the middle of the lips for a heart-shaped appearance, promise to limit the incidence of displaced filler. However, there's no foolproof method other than being mindful of how and where to place the product. “The result of lip injections is directly related to the technique and the original shape and size of the lip,” Dr. Shamban notes.

### **2. Over-Injecting**
Filler migration can also occur by [over-injecting](https://aedit.com/aedition/dermal-filler-fatigue) the lips. Movement can happen if too much filler is placed at once. Though no set amount causes a migrating-like effect – even small amounts can shift – it's best to stage out significant volume enhancement over time. But, as Dr. Frank explains, the features on the face are not that different than something like our shoe size. You can only fit so much into a specific space. “People expect to do more with filler than can be accomplished with their natural anatomy,” he says. “[Overfilled](https://aedit.com/aedition/how-to-correct-overfilled-facial-features) lips, nasolabial folds, and cheeks are due to overaggressive filler.”

Injecting too much product into the lips forcefully stretches them out to accommodate the additional volume. Since the tissue can’t hold the filler properly, it starts getting into the neighboring areas. Injectors can control how much filler is going into any area, which is why it’s essential to take a less-is-more approach. Dr. Shamban says that using specific techniques, like microdosing the lips over several appointments, allows the product to adapt to the tissue. “We can assess the lip architecture to improve the look and appearance of size and shape or build the structure around the lips for more of a 3D appearance without overfilling the lips,” she shares.

### **3. The Wrong Product**
Not all fillers are the same, and using the wrong product can allow it to shift beyond the placement area. Your injector must use the appropriate filler to ensure that it stays put. For starters, only hyaluronic acid-based fillers belong in the lips — never [Radiesse®](https://aedit.com/procedure/radiesse) or [Sculptra®](https://aedit.com/procedure/sculptra). When it comes to HA, “there is no best hyaluronic acid filler, but there are ones that are more amenable to certain areas of the face to reduce lumping, bumping, and migration,” Dr. Frank notes. 

### **4. Inflammation**
Inflammation can occur as a natural response to injecting a foreign substance into the face. While an inflammatory response isn’t as common as poor technique or too much product as the reason behind filler that extends beyond the lips, it can happen. “There can be temporary inflammation, swelling, or a [hematoma](https://aedit.com/aedition/risk-of-hematoma-after-facelift) at the injection site,” Dr. Shamban says. Additionally, “it can also be attributed to a patient's reaction or an allergy to a filler, although this is rarer and an autoimmune response,” Dr. Chadha adds.

The bulging effect is most evident when smiling or puckering the lips, but it can also be noticeable when the mouth is at rest. Some patients complain of a stretched-out feeling accompanied by discomfort depending on where the filler has moved. Although drifting filler is often more cosmetic than anything, Dr. Chadha says it’s important to address it quickly if [certain symptoms](https://aedit.com/aedition/risk-of-vascular-occlusion-after-dermal-filler) are present. “Look for changes in color, skin-blanching, pain, increased pressure, and continued swelling, all of which can cause concern and should be addressed by a medical professional,” she says. If the provider is not well trained, practicing proper protocol, or ensuring a sanitary environment, Dr. Shamban says infection is also a concern. 

## **How to Fix Migrating Filler**
There are two ways to fix migrated fillers: 

1. Dissolve them with hyaluronidase
2. Wait for them to break down and dissipate on their own

For a number of reasons, the former is usually preferred. Dr. Frank says the best way to deal with migration is to dissolve the filler with [hyaluronidase](https://aedit.com/procedure/hyaluronidase) (an enzyme that breaks down hyaluronic acid gels). In just a few hours, hyaluronidase softens the filler and returns the lips to a more natural shape, projection, and size. Not all of the filler necessarily needs to be removed. If it's just one area that shows signs of migration, it can be spot treated. Depending on the amount of movement, the lips may need to recover before injecting them again (if you decide to) to prevent it all from happening again. For most, that’s a four- to six-week process. Patients that opt to dissolve and refill their lips need to go slow and avoid overfilling, “as this will open up the previous tissue planes that allowed for migration,” Dr. Hahn cautions.

Filler will naturally degrade for patients who do not wish to [dissolve with hyaluronidase](https://aedit.com/aedition/hyaluronidase-to-dissolve-dermal-filler). Needless to say, this is a much longer process because the body may not entirely break down all of the product in the lips. It can take, on average, anywhere from six to 12 months to dematerialize. Going this route doesn’t mean every last drop of filler will be gone. 

Migrated filler can be a one-off experience for some people and a constant problem for others. “That means you may have to consider not treating that area with filler,” Dr. Frank says. “There are people who have a naturally higher propensity to migration due to their anatomy.” You may also want to look for a better-trained provider, as Dr. Shamban suggests. “Sometimes, the area around the lip needs to be filled for structure rather than the lip itself,” she notes. A skilled injector can make significant differences and improvements with the proper support structure.

## **Can Filler Migration Be Prevented?**
There is no perfect solution, but the best way to make sure that lip filler stays where you want it to is to be injected by a highly skilled provider who specializes in the procedure. “Generally, be concerned about your provider's experience level,” Dr. Shamban says. “The best practice is to do your due diligence and research your injector.” That includes their training and [body of work](https://aedit.com/aedition/importance-of-before-and-after-photos-in-plastic-surgery). “Their aesthetic approach and results should be individualized and aligned with your look and aesthetics,” she notes. 

While [choosing the right provider](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) is, first and foremost, key to a successful outcome, there are other factors to be aware of when it comes to minimizing the potential for filler migration:

1. **Understand what your injector is putting into your lips.** The only appropriate type of filler to inject into the lips is hyaluronic acid-based product, like those within the [Juvéderm®](https://aedit.com/procedure/juvederm) and [Restylane®](https://aedit.com/procedure/restylane) families. Although many different injectable brands exist, only HA fillers are safe for this area. Biostimulatory injectables, including Radiesse® and Sculptra®, do not belong in the lips.
2. **Appropriate filler viscosity plays a role.** Using the wrong filler in the wrong plane of the lips can cause the product to shift. “The viscosity and density of the filler are important,” Dr. Hahn says. “In general, less dense, less viscous fillers are less likely to migrate.” Only your provider (not you) will know what filler best suits your lips.
3. **Take a less is more approach.** If you want fuller lips than what genetics blessed you with, a slow and steady approach is always best. “It is better to do little bits at a time rather than overstuff an area,” says Dr. Frank, who also suggests that injectors be attentive to make sure the [patients' expectations](https://aedit.com/aedition/how-plastic-surgeons-balance-patients-cosmetic-surgery-desires-and-safety) are appropriate. “Follow-up and retreatments are beneficial,” he shares. “It's also helpful to check in with patients every few months anyway to assess the work done whether they are getting refilled or not because even the best placement of filler sometimes does change in terms of positioning.”
4. **The injection technique is paramount.** Probably the most crucial rule for your injector must follow is product placement. Dr. Hahn says that while the amount of filler injected plays a role, technique and placement of the filler are equally important to avoid migration. For example, he says it's essential to inject filler close to or at the vermillion border, which precisely outlines the [cupid's bow](https://aedit.com/aedition/cupids-bow-cosmetic-surgery-fillers-for-lip-augmentation). Otherwise, the filler can migrate into the surrounding tissue. “In general, there is an increased chance for filler migration as you inject more filler,” he adds.

## **Beyond Filler**
If migrating filler becomes a recurring issue or you are looking to avoid the threat all together, there are other surgical and non-surgical lip-enhancing procedures to consider:

- **Lip Lift**: The trending [lip lift](https://aedit.com/procedure/subnasal-bull-horn-lip-lift) procedure is a permanent way to enhance the lips. The procedure shortens the length between the upper lip and nose to show more of the pink part of the lips. Keep in mind that addressing the shape of the lips is more the objective here than adding volume, which your surgeon can accomplish by adding fat during the surgery. 
- **Lip Flip**: A lip flip utilizes neuromodulators (i.e. [Botox®](https://aedit.com/procedure/botox)) rather than filler (although many injectors choose to combine the injectables). Dr. Shamban says lip flips can be done in a similar but different way to improve lip size and shape. By relaxing the muscles around the lips, the lips flip (hence the name) out to make them a little poutier. The technique is also helpful for those with thin lips or a gummy smile.
- **Fat Transfer**: Autologous fat can be used to add volume and fullness to the lips when they’re inherently thin, prone to migrating filler, or just not as responsive as you’d like them to be to synthetic injections. [Lip augmentation with fat transfer](https://aedit.com/procedure/lip-augmentation-with-fat-transfer) is usually performed alongside other surgical procedures (like a [facelift](https://aedit.com/aedition/best-procedures-to-combine-with-a-facelift)), since liposuction on a donor site must first be performed to harvest the fat. After the initial absorption period, the results are long-lasting and  the shape and volume can be corrected. 

## **The Takeaway**
If you think your lip filler is on the move – be it days, weeks, months, or years after your injections – you may not be imagining it. Fillers that are incorrectly injected or not suitable for the lips can end up migrating outside the vermillion border, resulting in a ‘trout mouth’ or ‘duck lip’ appearance. While there is no surefire way to prevent this from happening, choosing an expert injector is one of the best ways to ensure an optimal outcome.

Dermatologists and plastic surgeons explain why your lip filler might be moving and how to correct it.

Why Lip Filler Migrates And How To Fix It

 Why Lip Filler Migrates And How To Handle It

carlos-martinez-jVHNm1Tf46Q-unsplash

The ever-popular [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (a.k.a. eyelid surgery or eye lift)  procedure corrects signs of aging on the upper eyelid, lower eyelid, or, in some cases, both, including loose skin, upper lid hooding, under eye bags, and more. Younger blepharoplasty patients (think: those in their [twenties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s) and [thirties](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-30s)) often undergo surgery to address and/or change the structure of the eyes. When asymmetries, lack of definition in the upper lid, and persistent bags are long-standing complaints, the procedure can be a long-term fix.

But not everyone is ready for, nor needs, an eye lift to improve the look of the eyes. That's why non-surgical treatment options like thread lifts, fillers, neuromodulator brow lifts, lash extensions, and even contouring makeup are considered the next best things. Here, we’re rounding up the top four ways to rejuvenate and enhance the look of the eyes – sans surgery.

## **1. Accentuate the Lashes**
One of the quickest and most painless ways to accentuate and enhance the appearance of the eyes is with [eyelash extensions](https://aedit.com/procedure/eyelash-extensions). By adhering the correct lash extension style to the eye, attention is drawn away from droopy or puffy eyelids for a more youthful and lifted appearance, says Clementina Richardson, a celebrity lash expert and founder of [Envious Lashes](https://www.enviouslashes.com/). Unfortunately, there are a lot of women walking around with thick, unnatural-looking extensions or without a design that complements the natural shape of the eye, which makes them appear heavy and even droopy. Richardson shares that for extensions to open up the eyes, you should ask for longer extensions in the center of the upper eyelid. “Stay away from longer ends, which pulls the eyes downward,” she notes.

Opening the eyes via lash extensions is an art, not a one-size-fits-all treatment – especially if the objective is to take years off and camouflage tired, sagging, or hooded lids ([check out our guide to lash extensions for monolids and hooding](https://aedit.com/aedition/lash-extensions-for-monolid-hooded-eyes)). “Lashes frame the eyes and can do a lot of good for people who want to add lift, volume, and texture,” she explains. “[They] act as an enhancement of your natural lashes.”

An almond-shaped eye is the most requested look. “When you have almond eyes, there is more versatility in shaping,” Richardson says. However, regardless of the shape of the eyes, a custom approach is always best. A universal tip: [Lash extensions](https://aedit.com/aedition/what-its-like-to-get-eyelash-extensions) should always boast a nice curl. When the extensions appear too straight or too long, they can pull down on the eyes. “This can make the eyes appear smaller and weighted,” she cautions.

### **Lash Serums & Mascara**
If lash extensions or false strips — we're into the reusable [Good Janes J-Lash](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fgoodjanes.com%2Fcollections%2Fmink-lashes%2Fproducts%2Fjlash), made from mink fur collected from shedding — aren't for you, there are ways to coerce the natural lashes to grow longer and thicker. A peptide-packed [lash growth serum](https://aedit.com/aedition/eyelash-growth-serum-benefits-safety-results), like the [Beverly Hills MD Lash Enhancing Serum](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fbeverlyhillsmd.com%2Fproduct%2Flash-enhancing-serum%2F) from board certified plastic surgeons [John Layke, DO](https://aedit.com/provider/john-layke-645), and [Payman Danielpour, MD](https://aedit.com/provider/payman-danielpour-md-797), will flood the lashes and follicles with the ingredient (each product has its own mix of ingredients, which can pair [peptides](https://aedit.com/aedition/guide-to-topical-peptides-in-skincare) with [hyaluronic acid](https://aedit.com/aedition/guide-to-hyaluronic-acid-in-skincare-dermal-filler), vitamins, and more). After consistent use for about 12 weeks, the lashes will appear noticeably longer, stronger, and more fluttery.

There are also [mascaras](https://aedit.com/aedition/best-lengthening-curling-volumizing-mascaras) that have nourishing ingredients within the formula to improve eyelash health. The [Freck Beauty Lashrocket Mascara](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Ffreckbeauty.com%2Fproducts%2Flashrocket-mascara%3Fvariant%3D41169332076730) pulls double duty as a mascara and lash serum in one thanks to its blend of powerful peptides that help weak lashes look and feel fuller and longer in about one month. It’s a buildable matte black formula that doesn’t clump or smudge. 

## **2. Fill in the Hollows**
When dark shadows and hollowing have you reaching for concealer morning, noon, and night, it may be time to consider [under eye filler](https://aedit.com/procedure/under-eye-filler). Injecting hyaluronic acid (HA)-based filler into the depressions where the top of the nose and orbital rim meet can be a game-changer for those who are concerned about the effect the tear troughs are having on their eye area as a whole. “Hollows can also make someone look older and more tired with a darker appearance due to a shadow effect,” says [Robert Schwarcz, MD](https://www.naturalfacedr.com/), a board certified oculofacial plastic surgeon in New York City. 

It's normal, with age, for the fat under the eyes to descend further down the face and for the bone or orbital socket to dwindle in density. These combinations, plus changes to the texture and thickness of the skin, make it more common for the signs of aging to quickly surface under the eyes and send patients running to their doctor's office to fix them. The way filler works in this area is pretty simple. The addition of volume plumps up the depressions to create a more pillowy and smooth appearance. The filler also plumps up the skin so that light can better reflect off the area. “Addressing the contour deficit fills the area,” Dr. Schwarcz explains. If the texture of the under eye skin is a concern, he suggests [microneedling with radiofrequency](https://aedit.com/procedure/microneedling-with-radiofrequency), [lasers](https://aedit.com/procedure/nonablative-laser-skin-resurfacing), and [chemical peels](https://aedit.com/procedure/medium-depth-chemical-peels).

HA-based filler isn’t the only injectable that can be used under the eye. [Angela Lamb, MD](https://aedit.com/provider/angela-lamb-md-34643), a board certified dermatologist in NYC, likes to mix filler with platelet-rich fibrin (PRF) in some cases. “If the problem is true volume loss, those are my go-tos,” she says. As she explains, under eye filler works better for correcting an indent or hollowness and perhaps a mild bag, whereas surgery is best suited for more prominent bags and redundant skin.

Often, it requires taking a holistic approach and considering all aspects of the face to create a natural and harmonious appearance. With age, the cheeks can start to sag, which causes ligaments in the area to pull down on the outer corner of the eye, says [Julis Few, MD](https://aedit.com/provider/julius-few-md-15580), a board certified plastic and reconstructive surgeon in Chicago. The strategic placement of filler can address this. “Returning the [cheeks](https://aedit.com/procedure/cheek-augmentation-with-fillers) to a more elevated position also lifts the outer corner of the eye so that it appears more like a cat eye,” he explains. And don't be surprised if your doctor also injects some filler into the [temples](https://aedit.com/aedition/cosmetic-forehead-procedures), which is a prime target area for volume loss. The brow's tail gets a little boost, too, to make the temples appear less sunken and the eye area smoother overall.

## **3. Don’t Neglect the Brows**
In situations where the [eyebrows](https://aedit.com/concern/aging-and-tired-eyes) are behind the changes to the shape and appearance of the eyes, addressing the positioning of the brows can make a world of difference. Over time, the tails of the brows tend to drop and fall downward, decreasing the distance between the upper eyelid and the eyebrows. In addition, a low brow position can add weight to the upper eyelid. In severe cases, it can encroach on the eyelid space, Dr. Schwarcz shares. There are both in-office and at-home solutions to address this:

### **Botox Brow Lift**
One of the best ways to give a visible – albeit temporary – lift to the brows is with the so-called [Botox brow lift](https://aedit.com/procedure/chemical-brow-lift). It involves injecting small amounts of neuromodulators (read: Botox®, [Dysport®](https://aedit.com/procedure/dysportr), [Jeuveau®](https://aedit.com/procedure/jeuveau), or [Xeomin®](https://aedit.com/procedure/xeomin)) to improve the position of the brows for three to four months at a time. To further complement newly lifted arches, many doctors inject the crow's feet and glabellar lines that form at the outer corners and in between the eyes to smooth the skin and make everything in the area appear refreshed and youthful. Keep in mind that using neuromodulators to lift the brow won’t do anything to address loose skin. 

### **Thread Lift**
The Botox brow lift is effective for achieving some lifting and shaping but is less dramatic than other options, like a [thread lift](https://aedit.com/procedure/thread-lift), Dr. Few notes. Thread lift procedures are pretty much downtime-free – save for some minor swelling – and involve placing absorbable sutures for an instant and long-term (they stimulate collagen over the coming months) lift in those with mild brow and eyelid sagging. “The threads go underneath the skin's surface to gently lift the area via small hooks that grab and hold the skin in place,” Dr. Lamb explains. Threads can also benefit those who are beginning to notice a ‘heavy’ forehead and drooping eyes and desire a little refresher before surgery down the line. 

Precise placement of threads can help hoist the outer part of the brow, making the outer corners of the eyes appear more lifted. “I like to use threads in an upside-down ‘U’ configuration going up to the hairline to lift the outer corner of the outer third of the brow,” Dr. Few says.  As he explains, this technique helps remove unwanted hooding of the upper eyelid while gently elevating the outer corner of the eye and brow. In these cases, neurotoxin injections are necessary to relax the forehead muscles and reap the full benefits of the threads. “Otherwise, the threads will pull through the tissue and cause the brow to drop again,” he notes.

Doctors can also use threads to tweak the shape of the eyes, but it doesn't always need to result in the now-popular [fox eye look](https://aedit.com/aedition/canthoplasty-canthopexy-eyelid-surgery-for-fox-eye-trend), a term that Dr. Few coined years ago during a lecture. “The goal should not be a hyper-elevated, unnaturally appearing cat look, but rather a natural elevation that enhances the appearance of the brow and upper eyelid,” he says. “The threads should create a pleasing appearance while being more exotic in a younger person and restoring natural positioning in someone experiencing age-related changes.” This is why selecting the right provider to perform the procedure is of the utmost importance — you want their before and after results and overall aesthetic to match the look you are trying to achieve. 

Keep in mind that while threads can provide some improvement, the skin in the brow and upper eyelid area is sensitive and thin. During the first few days, it may look pleated or bunched up due to overcorrection. “Surgery is the gold standard and would be my first choice for anyone wanting a predictable, long-lasting result,” Dr. Few says. Non-surgical solutions, like the combination of threads and neuromodulators, last about six to 12 months and require maintenance to retain the results. Since the benefits are relatively temporary, it’s essential to have realistic expectations and understand what threads can and cannot fix, Dr. Lamb says.

### **Makeup**
Brow powders and pencils can be just as important as doctor-administered treatments. With age, the brow hairs tend to become patchy and thin, and their once-crisp arch melts into an unorganized silhouette. Yet, redefining the arch with expert shaping ([check out our tips for how to shape your brows at home](https://aedit.com/aedition/how-to-shape-tweeze-define-eyebrows-at-home)) and filling them in with a good brow product ([we’ve rounded up the best powders, pomades, pencils, and gels](https://aedit.com/aedition/best-eyebrow-pomades-powders-pencils-gels-tools)) can make a significant difference. “The eyebrows lend structure to the face and frame the eyes, and, when properly filled in, they can create the effect of a brow lift," says Dani Kimiko Vincent, a celebrity makeup and brow artist and founder of [KIMIKO](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.google.com%2Furl%3Fq%3Dhttps%3A%2F%2Fwww.kimikobeauty.com%2F%26sa%3DD%26source%3Ddocs%26ust%3D1649198110615954%26usg%3DAOvVaw3AG3e_Yk13aNbSFMC5ngPD). 

To create the illusion of a more lifted brow, start by filling in the upper outer arch instead of the front of the brows. “This will concentrate the filling in the area that lifts the brows and draws them up and outwards for a more open eye,” Kimiko Vincent explains. Avoid drawing down at the end of the brow. “You’ll want to keep the front of the eyebrows light and always feather the product through with a spoolie brush to blend and soften,” she shares. The trick here is to use a soft yet precise brow pencil, like the [KIMIKO Super Fine Eyebrow Pencil Automatique](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fkimikobeauty.com%2Fcollections%2Fbrows%2Fproducts%2Fsuper-fine-eyebrow-pencil-automatique), so that the product looks natural and not colored in or penciled on. Finally, set the brows with a long-wear gel, like the [KIMIKO Brow Sensei](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fkimikobeauty.com%2Fcollections%2Fbrows%2Fproducts%2Fthe-brow-sensei).

## **4. Use the Right Eye Makeup**
Applying the right eye makeup – using appropriate colors and proper technique – adds visible contrast and draws attention to the eyes. Everyone's eye shape is unique and, while there are specific ways to enhance different shapes, this basic principle always applies: bring light forward and recede what's dark, Kimiko Vincent says. Similarly, using liner and mascara to [lift the eyes](https://aedit.com/aedition/face-lifting-sculpting-makeup-tips) is a universal solution.

When using makeup to enhance the eyes and make them look more youthful, Kimiko Vincent says to concentrate darker shadows on the lash line and towards the outer sections of the lid. “Sometimes, I contour with shadow to help the eyes appear more doe-eyed and, when necessary, I'll use a lighter shade of shadow on the lid so that they don't appear as sunken,” she shares. One thing to be aware of is mixing crepey skin with shimmery shadows, which has the potential to accentuate laxity. Instead, a matte neutral shadow, like the ones in the new [GXVE by Gwen Stefani Eye See in Color Clean Multidimensional Eyeshadow Palette in Simple Kind of Life](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.sephora.com%2Fproduct%2Fgxve-by-gwen-stefani-eye-see-in-color-clean-multidimensional-eyeshadow-palette-P481997%3FskuId%3D2568152%26icid2%3Dproducts%2520grid%3Ap481997%3Aproduct), is a better option.  

If a sagging upper lid is bothersome, focus on using darker shadows and placing them on the upper, outer portions of the eyelids. “From there, use lighter colors in the inner and middle sections of the lids,” Kimiko Vincent explains. She also recommends applying eyeliner on just the top lid and keeping the liner's tail (the end) lifted.

The classic cat eye is a favorite for creating a lifted outer corner. To do it, Kimiko Vincent recommends using liquid liner, pencil liner, or a deep eyeshadow and a smudger brush or tool. “A kitten eye starts from the center outwards and is slimmer than a traditional cat eye,” she explains. “You can subtly extend the inner corners with eyeliner to add a more feline eye shape.” Shadows are also helpful in contouring the eyes. Again, keep the darker tones towards the outer portion of the lid and concentrate mascara on the outer portion to draw the eye shape up and out.

Speaking of mascara, don't forget about the lashes. Kimiko Vincent says to curl the eyelashes first because “the eyes always benefit from a lift.” It makes them “appear instantly more youthful,” she adds. Before [swiping on mascara](https://aedit.com/aedition/mascara-tips-from-celebrity-makeup-artists), layer on a lash primer for extra volume and staying power. Then, coat the lashes with a volume and lengthening formula. Kimiko Vincent says to focus on lifting the lashes while sweeping on the mascara, paying extra attention to the outer corners of the eyes.

## **The Takeaway**
While a [blepharoplasty and/or brow lift](https://aedit.com/aedition/combining-blepharoplasty-and-brow-lift) may be the gold standards for rejuvenating the upper third of the face, they are not for everyone. Whether you are looking to delay going under the knife or are not a candidate for surgery, there are minimally invasive solutions and even at-home makeup tips that can refresh the lids, brows, and lashes.

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

From Botox brow lifts and under eye filler to eyelash extensions and mascara, experts share their tips for enhancing the eye area.

Non-Surgical Eye Rejuvenation: In-Office Procedures And Makeup Tips For Eyelids, Lashes, Brows 

How To Enhance And Rejuvenate Your Eyes Without Surgery

shutterstock 597048095

Whether you call them cold sores or fever blisters, those who have experienced a herpes simplex virus (HSV-1) infection can feel their Spidey senses tingling before the effects even show. Oral herpes can be somewhat painful, though it’s mostly the connotation and aesthetic impact that leads many to cancel plans, feel shame, or turn to makeup as a means of covering up. 

According to the National Institutes of Health (NIH), about 90 percent of people have been [exposed](https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2/oral-herpes) to the HSV-1 virus by age 50, with 50 percent to 80 percent of adults in the United States believed to have oral herpes. All of this is to say that cold sores are quite common, but that doesn’t make them any less annoying to live with. Fortunately, they can be nipped in the bud if you strike the iron before it’s hot, and that’s what we’re exploring here today. From early treatment to medical care, here’s what the experts have to say about treating, preventing, and managing cold sores.

## **Understanding Cold Sores: Symptoms & Triggers**
Regardless of how you get the virus – be it through accidentally sharing utensils or a kiss – the small, fluid-filled clusters can happen to anyone at any age. More often than not, they are harmless. “It's important to remember that the majority of people have been exposed to herpes simplex, often in childhood,” says [Daniel Belkin, MD](https://www.nydermatologygroup.com/doctors/dr-daniel-belkin/), a board certified dermatologist at New York Dermatology Group in New York City. “So, a breakout may very well be a recurrence and unrelated to the most recent contact.” As he explains, HSV-1 is what typically infects the mouth area, while HSV-2 usually affects the genitals and is not as prevalent.

Cold sores can crop up for a variety of reasons. “Anything that impacts the immune response in the skin or creates injury in the skin can cause a breakout,” Dr. Belkin shares. While that sounds broad, those who’ve experienced a cold sore know how tricky it can be to understand the trigger. “[Sun exposure](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage) can reduce the immune response in the skin and cause a breakout,” he explains. “Illness can reduce the immune response in the skin and also cause a breakout, giving us the names ‘fever blister’ and ‘cold sore.’” An outbreak can also be from conditions that impair the skin barrier, such as [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) (more on that later). Lastly, Dr. Belkin notes that cosmetic facial treatments can play a role, too. “Especially around the mouth, [filler injections](https://aedit.com/procedure/dermal-filler-and-injectable-solutions), [lasers](https://aedit.com/aedition/guide-to-ablative-laser-skin-resurfacing), and [microneedling](https://aedit.com/procedure/microneedling) can cause breakouts,” he adds. 

The symptoms of cold sores evolve over their lifespan. Early on in the process, many feel “redness, pain, swelling, and blistering,” says [Amy Spizuoco, DO](https://aedit.com/provider/amy-spizuoco-19341), a board certified dermatologist and founder of True Dermatology in NYC. An HSV-1 outbreak can last anywhere from three days to a week with no indication of how big it will be. As a result, the earlier you notice the warning signs, the better. Our experts say that as soon as the swelling and tingling appear, the clock is ticking to address it.

## **How to Treat Cold Sores**
There is no cure for HSV-1, but there are some treatment options that can treat symptoms and mitigate flareups. They include: 

### **Prescription Medication**
“The best way to treat a cold sore is to have some oral medication on hand and take it as soon as you have the feeling that a cold sore is coming,” Dr. Belkin shares. “When done this way, all you need is a day of medication, and then you are done.” Dr. Spizuoco says oral acyclovir and valacyclovir are both effective. 

If you don’t have a prescription at home already, we know that squeezing in a trip to the doctor may be difficult – but it’s likely worth the effort. “Unfortunately, I don't think anything over-the-counter is very effective, and I would recommend seeing a physician to get a prescription of oral antivirals to have on hand if you are someone who gets frequent cold sores,” Dr. Belkin explains. While he notes that OTC Abreva (docosanol) “can’t hurt” and may “shorten healing time by half a day or so,” he says it is “not super effective.”

For those who can’t get ahead of the cold sore, Dr. Spizuoco has good news. “In office, the blisters can be lanced or injected with cortisone to speed up the resolution,” she says. 

### **At-Home Remedies**
Dr. Belkin explains that, when it comes to at-home cold sore solutions, “there aren't any.” Many try cold compresses to soothe pain, but you should proceed with caution. “Using irritants to try to clean or dry the area will just lead to further breakdown of the skin and prolong healing time,” he warns. “Once the virus is no longer active, keeping the eroded area moist with Vaseline or Aquaphor can help it to heal.”  

For at-home prevention, leading a healthy lifestyle may seem like a vague task, but [adequate sleep](https://aedit.com/aedition/impact-of-beauty-sleep-on-skin-health-nighttime-skincare-products), a [healthy diet](https://aedit.com/aedition/best-diet-for-healthy-beautiful-skin), and taking steps like wearing a [lip balm with sunscreen](https://aedit.com/aedition/best-lip-balms-with-spf) can help reduce the chances of a cold sore from developing in the first place. 

### **Avoid This**
Certain behaviors may be done with the best intentions but are blindly slowing the healing process, while others may be unknowingly triggering infection. Either way, here are doctors’ orders for what not to do: 

1. **Using Too Much Makeup**: “Cold sores are hard to cover up because they are textured, but I don't see a problem with dabbing on some foundation,” Dr. Belkin says. While a little can be great, layering too much (with [dirty brushes](https://aedit.com/aedition/how-to-clean-makeup-brushes-sponges)) can be detrimental. When applying, “wash your hands after, as cold sores are infectious and the virus can be spread to different parts of the face,” he cautions. To minimize its appearance or expedite the healing process, Dr. Spizuoco suggests [hydrocolloid patches](https://aedit.com/aedition/best-pimple-patches-to-treat-acne-breakouts-blemishes) to “conceal a cold sore.” Additionally, if lip gloss or lipstick is applied on the affected area, the product may be contaminated and lead to future breakouts.
2. **Eating That, Not This**: If you’re wondering if [diet](https://aedit.com/aedition/how-food-impacts-skin-aging) can impact the healing process, it absolutely can. Eat as cleanly as possible, and avoid spicy or acidic food and carbonated beverages. 
3. **Getting a Treatment**: This may seem self-evident, but it bears repeating: Aesthetic treatments, including [lip filler](https://aedit.com/procedure/temporary-lip-fillers), should be avoided until the skin is fully healed. “I would hold off on any of these if a patient had an active or healing cold sore,” Dr. Belkin advises. “Once the area is healed, we can proceed with treatment.” Even if you are not experiencing an active outbreak, share your medical history with your provider. “If a patient is prone to cold sores, I might administer some oral medication before the treatment for prophylactic purposes,” he adds.
4. **Sharing Utensils**: Sharing items that come in contact with a cold sore can lead to the other person getting the virus. For those concerned about when to share again, “cold sores are thought to be no longer infectious once the blistered or eroded skin is dried and crusted,” Dr. Belkin explains. But, to be safe, he recommends “waiting until the skin is re-epithelialized or healed over.” At that point, “the area may still be pink, but, if it feels like normal skin, it is fine to start sharing again,” he says.

## **How to Prevent Cold Sores**  
For many, prevention can mean leading a healthy lifestyle, but it's not a guarantee. As mentioned, there is no rhyme or reason as to what can cause an outbreak, but those who have the HSV-1 virus in their system will benefit from [regular exercise](https://aedit.com/aedition/best-fitness-classes-workouts-exercises-to-try-at-home), getting enough sleep, eating well, and taking care of themselves. 

For those with a weakened immune system or [eczema](https://aedit.com/aedition/comparing-eczema-vs-psoriasis), a diagnosis and tailored treatment will be beneficial for prevention, as this population may experience worsened symptoms. “The first breakout of cold sores is typically more severe than a recurrence,” Dr. Belkin explains. “If you think you may be having the first episode due to recent exposure, it would be a good idea to see a doctor to be evaluated and to be prescribed oral medication.” He emphasizes that “the sooner you start, the quicker the breakout will fade.” This, he says, minimizes “both embarrassment and the risk of [scarring](https://aedit.com/aedition/how-to-treat-every-type-of-scar).” 

## **The Takeaway**
Oral herpes might feel like an embarrassing condition that comes with social anxiety and some physical discomfort, but cold sores are common and can be addressed quickly with the right precautions. From medical intervention to rapid action, there are options for those with plans and no desire to cover up an unforeseen breakout. Consulting with a board certified dermatologist can help manage and treat current and future cold sores.

There’s never a good time to get a fever blister, but, when treated early, an outbreak doesn’t have to ruin your plans. 

Dermatologist Tips For Treating And Preventing Cold Sores

Your Guide To Treating And Preventing Cold Sores

shutterstock 731707603

We’ve talked about the [pandemic-related boom](https://aedit.com/aedition/post-covid-at-home-skincare-device-trend) of at-home beauty devices that can (to varying degrees) recreate the experience of professional treatments or, at the very least, help [maintain](https://aedit.com/aedition/maintaining-skin-with-devices-skincare-products-between-cosmetic-procedures) your results in between in-office appointments. But these gadgets and gizmos aren’t just for the face. [Body tools](https://aedit.com/aedition/best-at-home-body-devices) have seen a similar rise in popularity that shows no sign of slowing down, and infrared sauna blankets are perhaps one of the buzziest examples.

There is no denying that infrared sauna blankets are taking the internet and social media by storm, but we’ve been wondering: How do they stack up to the real thing? When you consider that the experience of a sauna (infrared or otherwise) has long involved a trip to the spa or gym where you physically sit in a room for an extended period of time, it can be hard to wrap your head around the idea that you may be able to recreate that experience anytime, anywhere with a relatively portable tool. 

To better understand the [benefits of infrared saunas](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941775/) and how at-home versions compare to the traditional experience, we’ve tapped two experts. Read on to learn more about the benefits of infrared sauna blankets and whether they are a worthwhile investment.

## **What Is an Infrared Sauna Blanket?**
In simpletest terms, an infrared sauna blanket is a tool that is designed to deliver the benefits of a traditional infrared sauna in blanket form. “Sauna blankets use infrared heat and work in the same way as an infrared sauna cabin,” says Lauren Dovey, the founder of [Heat Healer](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fheathealer.com%2F). 

For the uninitiated, infrared saunas (of any kind) differ from dry Finnish saunas in that they don’t heat the air. Instead, they use infrared lamps to warm the body. “Compared to a Finnish sauna, they are a more gradual and comfortable heat,” Dovey shares. When you enter an infrared sauna, you don’t feel hot right off the bat. As you spend time in an infrared sauna, your body will gradually warm. “This means most people can tolerate the heat for a longer period of time, which can extend the benefits they receive,” she notes.

While everyone responds to infrared saunas differently, Heat Healer says that, if you spend an hour in its [Infrared Sauna Blanket](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fheathealer.com%2Fcollections%2Fshop-now%2Fproducts%2Finfrared-sauna-blanket), you can expect to feel “warm and snug” during the first half hour before things to get a bit more “intense” during the second 30 minutes. The blanket, which uses far infrared light, can get up to 176 degrees Fahrenheit, though the brand recommends starting at 158 degrees and adjusting from there.

## **The Benefits of Infrared Sauna Blankets**
“Infrared sauna blankets have multiple benefits for the skin and body, including improving complexion,” says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist and Mohs surgeon in New York City. The beauty and wellness benefits of infrared are generally the same whether you are in a sauna cabin or in a blanket. With that in mind, let’s take a closer look at what this technology can do for your mind and body.

### **Skin-Boosting Benefits**
From a skin perspective, “the heat from the blanket opens up pores and causes sweating, which releases toxins, bacteria, dead skin cells, and other impurities,” Dr. Engelman explains. All of that can help “you achieve clearer skin,” she adds. But that’s not all. “Infrared sauna blankets also improve circulation and slightly increase heart rate, simulating the effects of a light-to-moderate workout,” she shares. Such exercise “is known to have benefits for the skin,” she says, adding that “improved circulation may also help to boost collagen production.”

It should be noted that infrared light does not [damage the skin](https://aedit.com/aedition/best-skincare-to-treat-sun-damage) the way ultraviolet (UV) light does. “There is little risk of developing cancer as a result of exposure to the infrared rays in a sauna blanket,” Dr. Engelman says. “It is more likely that you will suffer adverse effects from dehydration or accidental thermal (heat) damage if your body is not used to the higher temperatures of the blanket.”

### **Health & Wellness Benefits**
We all know saunas have both mental and physical effects, and infrared saunas are no exception. “Other pros of infrared sauna blankets include elevated endorphin levels, lower stress levels, and a better night’s rest,” Dr. Engelman shares. Below are three of the most notable mind-body benefits:

1. **Mood Boost**: “Heat therapy sends signals to our brains to release feel-good chemicals including serotonin, endorphins, and dopamine,” Dovey says. For maximum effect, she advocates for “stacking” wellness practices like meditation and breathwork while in the sauna or blanket to “stimulate the parasympathetic nervous system” and encourage the body “to press pause on the release of stress hormones like cortisol and epinephrine.” The result? “This double whammy effect may help promote an even greater feeling of calm, focus, and peace,” she shares.
2. **Calorie Burn**: We know that infrared saunas can get your heart rate up, and Dovey says that, during a session with the Heat Healer blanket, you can burn up to 600 calories. “Heat therapy, like sauna use, can be a mimetic for exercise and has a similar effect on cardiac output, which means that – just like when you exercise – your body is also going to burn calories,” she explains. “This is what leads to longer-term weight loss.”
3. **Pain Relief**: Research has [found](https://pubmed.ncbi.nlm.nih.gov/21742283/) that infrared saunas can reduce muscle and body pain related to fibromyalgia, endometriosis, nerve conditions, arthritis, and more. “Because infrared saunas increase blood circulation, they can support the body to heal, particularly when repairing inflamed joints,” Dovey says. It can also be used as a recovery tool. “The infrared sauna is a great way to relax and ease sore muscles after a workout by increasing blood circulation and assisting muscle repair,” she adds.

## **Infrared Sauna Blanket Safety**
Infrared saunas and blankets are generally considered safe and effective, but there are a few things to keep in mind. “There is some risk relating to dehydration due to copious amounts of sweating while in the blanket and possible thermal damage if temperatures are raised too high for your skin/body to tolerate,” Dr. Engelman reiterates. To avoid this, she recommends drinking plenty of water before and after treatments and not falling into the trap of trying to do too much too soon. “If you’re a beginner to infrared sauna blankets, start at a lower temperature and shorter amount of time than recommended,” she says. By gradually working up to the recommended settings, you’ll avoid stressing out your body.

It goes without saying, but always be sure to follow the instructions to a T – from what you wear in the blanket to how much time you spend in it. It’s always best to consult with your healthcare provider before beginning a new therapy, and this is especially important if you are pregnant, under the age of 16, sensitive to heat, or have certain skin or medical conditions.

## **How Do Infrared Sauna Blankets Measure Up?** 
The most obvious benefit of infrared sauna blankets? They are significantly more convenient than the standard sauna cabin. “Sauna blankets heat up quickly, are cost-effective to run, convenient to have in your home, portable, and easy to store when not in use,” Dovey says. You also have a bit more flexibility when it comes to how you utilize your time during treatment. “A benefit we hear from our customers is that having your head out of the blanket makes it much more comfortable than a sauna cabin,” Dovey shares. “You can lay there and relax and listen to your favorite meditation, weekly podcast, catch up on that Netflix show you’ve been wanting to watch, or just sit in silence as the infrared heat works on your body.”

While they are an investment (the Heat Healer blanket retails for $568), the one-time outlay can turn out to be substantially more cost-effective over time – especially if you plan to use your blanket regularly. While you’ll enjoy pain relief and relaxation (mental and physical) immediately, you’ll need to develop a consistent routine to reap some of the other results. “For longer-term benefits such as weight loss, cardiovascular health, and collagen production, it is recommended to use at least three times a week for 30 to 60 minutes a session,” Dovey notes, adding that you should limit usage to no more than an hour a day.

The net-net: If you are ready to build infrared therapy into your wellness routine, an infrared sauna blanket from a reputable manufacturer can be a wise – and *very* convenient – investment. 

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Two experts break down everything you need to know about the skin, health, and wellness benefits of at-home infrared sauna treatments.

The Benefits Of At-Home Infrared Sauna Blankets For Skin, Health, Wellness

Are At-Home Infrared Sauna Blankets Too Good To Be True?

shutterstock 1760659916

It’s believed that about 7.5 million Americans have psoriasis and another 32 million or so have eczema. That combined population is likely used to experiencing dry and scaly patches, which is why it can be easy for the untrained eye to misidentify the two. “Eczema, or atopic dermatitis, and psoriasis are both very common skin conditions that are often confused by non-dermatologists,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a board certified dermatologist and founder of Washington Square Dermatology in New York City. “They are both red, dry, scaly and often itchy, so they can look similar to non-dermatologists.”

To the trained eye, however, that’s where the similarities between eczema and psoriasis usually end. In order to give your skin the care it needs, a proper diagnosis from a board certified dermatologist is key. To give us non-dermatologists a better understanding of the ins and outs of eczema and psoriasis, we’ve tapped two top physicians for their expert insight.  

## **Eczema & Psoriasis 101**
Both eczema and psoriasis are skin conditions that, in some instances, present similarly. According to [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a NYC-based board certified dermatologist, they can appear as “red patches and plaques” on the skin, but “the causes, triggers, appearance, and treatment may differ between the two conditions.” In terms of similarities, eczema and psoriasis “are both conditions that reflect inflammation in the skin,” she shares – though “they occur for different reasons and can appear differently on the skin.” In terms of visible differences, Dr. Jaber says “psoriasis is typically more thick and scaly than eczema,” while eczema is often itchier than psoriasis.

With that in mind, let’s take a closer look at each:

### **What Is Eczema?**
Also known as atopic dermatitis, [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) “describes a condition when the skin becomes red, itchy, dry, and, sometimes, flaky,” Dr. Garshick shares. It is often genetic in etiology (if your parents had eczema, you likely will, too), and it “commonly appears in babies or early childhood,” she adds. While Dr. Jaber says that it “can improve as you get older,” it is “often seen in patients that also have allergies and asthma.” 

Eczema can affect any part of the body, but Dr. Jaber says it is more common “on areas that rub” such as “the inner elbow, behind your knees, neck, and arms, and legs.” Generally speaking, eczema is due to inflammation of the skin and is often triggered by irritants and things that dry out it out like harsh soaps, detergents, chemicals, clothing with a rough texture (think: wool), and stress. While we might think of cold winter climates as a culprit, warmer weather can exacerbate the condition, too. “For some people, intense heat and humidity can also aggravate the skin,” Dr. Garshick says. That includes hot showers.

**Your Eczema Cheat Sheet**

### **Causes & Triggers:**
- Inflammation 
- Genetics
- Environmental factors
- Stress

### **What it looks like:**
- Dry, itchy areas of skin
- Patches of red, gray, brown, or purplish skin 
- Affected areas can also be bumpy or uneven

### **Associated conditions:**
- Seasonal allergies or hayfever
- Asthma
- Family history

### **Common treatments:**
- Moisturizing, fragrance-free beauty routine 
- Lifestyle changes (i.e. shorter showers, humidifiers, etc.)
- Biologic medications

No two eczema experiences are the same. In mild cases, there may be just a bit of redness or flaking. In more severe instances, the skin can thicken, be very red, and peel. At its worst, it can put the skin at risk for superficial infections. Treatment can range from over-the-counter skincare to prescription medication depending on the severity.

### **What Is Psoriasis?** 
[Psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis) is “an inflammatory skin condition that is characterized by red, scaly, well-demarcated plaques with silvery scales that can occur anywhere on the body,” Dr. Garshick explains. Unlike eczema, “psoriasis usually starts in adulthood and rarely occurs in children,” Dr. Jaber notes. Studies show there may be a hereditary component, and it can be associated with diabetes and heart disease. The average age of onset generally occurs at two different peaks. According to Dr. Garshick, the first is 15 to 35 years old and the second is 55 to 60 years old. 

Common areas that are affected by psoriasis include the scalp, elbows, knees, lower back, nails, hands, and feet. “Psoriasis tends to affect the extensor surfaces, such as the knee and elbow, and can be associated with joint pains and psoriatic arthritis,” Dr. Garshick shares. Flare-ups can be brought on by a variety of factors. “Psoriasis is often triggered by changes in the season, stress, alcohol, and skin trauma,” Dr. Jaber says. It can also be exacerbated in the aftermath of infections like strep throat, he adds. 

**Your Psoriasis Cheat Sheet**

### **Causes & Triggers:**
- Injury (think: insect bites, sunburn)
- Certain illnesses & medications
- Temperature changes
- Smoking & alcohol consumption 

### **What it looks like:**
- Red or pink plaques
- Raised rash with scales
- Clearly defined patches

### **Associated conditions:**
- Psoriatic arthritis
- Certain autoimmune conditions, including Crohn’s disease
- Type 2 diabetes

### **Common treatments:**
- Topical steroids
- Vitamin D analogs
- Narrowband phototherapy
- Lifestyle changes (i.e. diet, stress, etc.)

Eczema and psoriasis are similar in that every case is different. The condition usually manifests in unpredictable cycles that alternate between periods of few to no symptoms and more intense flare-ups. For some, psoriasis is a mostly cosmetic concern. But, for others, it can cause discomfort (physical and mental) and impact quality of life.

## **Diagnosing Eczema & Psoriasis**
If you are experiencing patches of scaly skin, the best way to determine whether you have eczema, psoriasis, or another skin condition is to schedule an appointment with your dermatologist. “In addition to the locations involved, associated symptoms, and the characteristic appearance, the most definitive way to distinguish the two is with a skin biopsy,” Dr. Garshick says. While the latter may be the most definitive, it’s not foolproof. “There are scenarios when even that is not conclusive to differentiate the two,” she admits.

When it comes to the physical exam, there are some specific indicators to keep an eye out for. “Eczema tends to be more ill-defined in the edges, while psoriasis is more well-demarcated,” Dr. Garshick explains. “Psoriasis is also known to experience the Koebner phenomenon, which is the appearance of new skin lesions in areas of skin trauma or injury in otherwise healthy appearing skin.”

Diagnosis may, however, be a little more nuanced on the face. Dr. Garshick says that it can sometimes be “challenging” to distinguish between eczema and psoriasis on the face – though “there are some hints based on location.” Because people with eczema tend to have more [sensitive skin](https://aedit.com/aedition/difference-between-sensitive-vs-sensitized-skin) in general, it “tends to favor the area around the eyes and mouth” and can be “more pronounced in areas of the face where the skin is thinner,” Dr. Garshick shares. This is not usually true of psoriasis. “On the face and scalp, some individuals can experience an overlap of psoriasis and seborrheic dermatitis (dandruff), which can affect the hairline, forehead, and eyebrows,” she adds.

## **Treating Eczema & Psoriasis**
Not only can a dermatologist diagnose your skin condition, but they can develop a treatment plan for it, too. “A dermatologist can help guide you on how to distinguish psoriasis from eczema as well as the specific treatment course,” Dr. Garshick says. This may include over-the-counter and prescription skincare, oral and injectable medications, and in-office procedures. “While the types of treatments may be similar – as both can be treated with topical creams as well as light therapy and oral or injectable medications – the specific ways and medications to treat the conditions can differ,” she notes. “It is always important to see a dermatologist to determine the best treatment options for you.”

### **How to Treat Eczema**
There are many ways to treat atopic dermatitis, and many of them require little to no professional intervention. “I always recommend starting out with simple lifestyle changes,” Dr. Jaber says. These modifications include:

- Using a [fragrance-free](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin) soap
- Taking shorter, cooler showers
- Patting (not rubbing) your skin dry
- [Moisturizing](https://aedit.com/aedition/best-body-creams-lotions-balms-for-every-skin-concern) twice a day 
- Running a [humidifier](https://aedit.com/aedition/humidifiers-facial-steamers-for-skincare-dry-skin-acne) at home
- Avoiding fragrance & skin irritants 

With your skincare routine, it’s all about preventing [dry skin](https://aedit.com/aedition/how-to-treat-prevent-dry-skin-face-body-hands) and irritation, but know that these changes may not be enough for everyone. “If, despite this, you still struggle with eczema, see a dermatologist for topical prescription medications,” Dr. Jaber says. “There are both steroid and non-steroid topical medications that work very well for mild to moderate eczema.” From a prescription perspective, Dr. Garshick points to non-steroid anti-inflammatory creams like Eucrisa® (crisaborole) and Elidel® (pimecrolimus) and injectable Dupixent® (dupilumab). For some patients, light therapy may also be effective. In the most severe cases, Dr. Jaber says there have been “some amazing advancements” in the treatment of eczema with biologic medications. 

### **How to Treat Psoriasis**
Psoriasis flare-ups can be unpredictable, and, as Dr. Garshick shares, “treatments do not provide a permanent cure” and “there’s always the chance it can come back.” Even so, there are some lifestyle adjustments that can help manage and maybe even prevent relapses. They include eating a [well-balanced diet](https://aedit.com/aedition/best-diet-for-healthy-beautiful-skin), maintaining a healthy body weight, keeping stress levels in check as much as possible, and many of the eczema-prevention tips outlined above. “Since psoriasis has been found to be associated with other medical conditions, such as an increased risk of heart disease, certain lifestyle modifications, such as weight loss and exercise, can be helpful for those with psoriasis and has been shown to improve psoriasis skin severity,” she notes.

From there, a multi-modal treatment plan often works best. Both of our experts agree that topical steroids and/or topical [vitamin D](https://aedit.com/aedition/guide-to-vitamin-d-in-skincare-wellness) analogs, like calcipotriene, can be effective – especially in the treatment of mild psoriasis. For moderate to severe cases, narrowband phototherapy and biologic medications are often a solution. As Dr. Garshick explains, the latter are “injections that target the immune system” and “have been a great advance” in the treatment of psoriasis because they allow patients to see results and clearer skin “relatively quickly.”

In terms of at-home skincare, Dr. Garshick says exfoliating acids can help to smooth scaly skin. “As some of the plaques can be thick, it can be helpful to use [salicylic acid](https://aedit.com/aedition/guide-to-beta-hydroxy-acids-salicylic-acid-in-skincare)-based creams on the plaques to help exfoliate and eliminate the dead skin cells,” she shares. Oh, and then there is this piece of advice that is true of psoriasis and pretty much every other skin concern: Don’t touch it. “You don’t want to manually pick off the scales in psoriasis, as that can trigger more scales,” she warns.

## **The Takeaway**
If you have red, rough patches of skin that are not responding to your usual hydrating skincare routine, it’s time to visit the experts to figure out the root cause. Even an article as comprehensive as this one cannot replace the expert eye of a [board certified dermatologist](https://aedit.com/aedition/skin-care-questions-for-your-dermatologist) when it comes to diagnosing and subsequently treating both eczema and psoriasis. Once you know what skin condition you are dealing with, you’ll be able to establish a treatment plan – including the necessary lifestyle adjustments – accordingly.

To the untrained eye, it can be difficult to distinguish between the red, scaly patches of skin. Here’s what you need to know about the common skin conditions.

Eczema vs. Psoriasis: What's The Difference Between The Skin Conditions?

Eczema vs. Psoriasis: What’s The Difference?

AEDITION for men-min

Expert Opinion Collection | The AEDITION

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The Duchess of Cambridge’s nose. Penélope Cruz’s lips. Angelina Jolie’s cheekbones. Ask any plastic surgeon and, chances are, they've encountered any number of patients entering their office with pictures of those celebrity facial features. It’s certainly not surprising that people going in for cosmetic surgery would ask that the body part in question be made to look like that of a certain Hollywood star deemed “perfect.” But any surgeon worth his or her weight in [Botox®](https://aedit.com/procedure/botox-facial) will tell you that proportion — not perfection — is the secret to looking your best.

“In our social media culture, we definitely see patients coming in requesting this person’s nose and that person’s eyes. But I tell them that I’ll make you the best you," says board certified Philadelphia facial plastic surgeon [Jason Bloom, MD](https://bloomfacialplastics.com/). "It’s so important to have a conversation explaining why everything from the patient’s skin type and texture to their ethnicity dictates what will look right on them — not to mention the proportions of their face.”   

## **The Mathematics of Beauty**
While we're all familiar with the phrase "beauty is in the eye of the beholder," plenty of research has been done into what physical attributes so-called "beautiful people" have in common. The Ancient Greeks discovered the Golden Ratio of nature (which may or may not be able to be duplicated in the human body — though Leonardo DaVinci used the mathematic marvel when painting the Mona Lisa), and, needless to say, the interest in perfection has only spiraled from there.

Here's the thing: There’s a reason why Kate Middleton’s nose is so admired. With its 106-degree nasal tip rotation, the Duchess' sniffer is about as close to “mathematically perfect” (yes, you read that correctly) as it gets. [Research shows](https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/1883794) that noses angled between 104 and 108 degrees are considered the most attractive. Scarlett Johansson, Kate Beckinsale, and Jessica Biel are similarly #blessed with the ideal proportion, but that doesn't mean it's right for everyone.

Dr. Bloom explains that Kate's nose wouldn't necessarily flatter someone with thicker skin or more sebaceous glands. “[Rhinoplasty](https://aedit.com/procedure/ethnic-rhinoplasty) is certainly one surgery where you have to take these factors into consideration — on top of nose shape and facial symmetry,” he says. 

## **Proportion vs. Perfection in Cosmetic Surgery** 
In 2016, Amber Heard's face was found to be [91.85 percent accurate](https://www.londonfacialplasticsurgery.co.uk/facial-balance/) to the elusive Golden Ratio, followed closely by Kim Kardashian and Kate Moss. But taking any one of their features and putting them onto someone else's body wouldn't necessarily yield a desirable result.

“The key to facial beauty is proportions, not just particular features," says Nashville-based board certified plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649). "This means beauty is actually found in how various features relate and interact with one another on someone’s face. It's why big features like the eyes or cheekbones of Angelina Jolie work very well on her face, but would not on others.” 

Speaking of Jolie, her plush pout is a case study in proportion. According to a [study in JAMA Facial Plastic Surgery](https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/2601230), one-third of the fullness should be on the top lip and two-thirds on the bottom lip-chin area. 

“If you look at Angelina Jolie, her lips look perfect on her face because they follow this ratio,” explains Dr. Bloom. “So, when a patient says they just want their upper lip filled, I explain that it won’t look natural. They won’t look their personal best, if it’s not recreating that ratio. You often see when this goes wrong because that’s when people have duck lips.”

The ratios extend to the rest of the face, too. It may be hard to visualize, but, horizontally, the ideal width of a face is about five-eyes wide — meaning, if you measure your face across, there would be space for another eye between your two actual eyes and room for one more eye on each temple. 

Vertically, meanwhile, the face is divided into thirds, with an equal distance between the [hairline and brow](https://aedit.com/procedure/direct-brow-lift), brow and nose, and nose tip and chin. Rather than trying to recreate the alleged perfect face, a cosmetic surgeon can employ any number of tricks to add balance and, yes, proportion as needed. 

“If you have a surgeon who is focused on proportion, he or she can find ways to lengthen or shorten these areas using optical illusions,” says Dr. Bloom. For someone who wants his or her forehead to look smaller, Dr. Bloom can visually minimize the temples by injecting them with [filler](https://aedit.com/procedure/under-eye-filler). Conversely, if the bottom half of the face is too stout, filler may be injected into the chin to create length. 

## **The Takeaway**
All of this is not to say that you shouldn't arrive at your next plastic surgery consultation with inspo pics of your favorite celebs in tow. The visual cues can be a good way to show your surgeon your preferred aesthetic. But, ultimately, it is important to let your own facial structure — and your doctor — be your guide in creating a look that could only be yours.

When it comes to cosmetic procedures, it’s proportion — not perfection — that will ensure you look your best. Here, plastic surgeons explain why the key to a “perfect” face is all about balancing your features. 

Plastic Surgery Perfection vs. Proportion: How To Achieve The Ideal Look For You

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No longer exclusive to the dermatologist’s office, non-invasive procedures like injectables (i.e. [Botox®](https://aedit.com/procedure/botox-facial), [fillers](https://aedit.com/procedure/under-eye-filler), etc.) and laser treatments have made their way to plastic surgery practices as well. According to the [American Academy of Facial Plastic and Reconstructive Surgery](https://www.prnewswire.com/news-releases/aafprs-2018-annual-survey-reveals-key-trends-in-facial-plastic-surgery-300782534.html), four-fifths of all treatments performed by facial plastic surgeons in 2018 were cosmetic non-invasive (read: not surgical) procedures. So, why have so many plastic surgeons embraced non-surgical services? And, in turn, which procedures make perfect pairs?

“In my practice, non-invasive procedures are frequently done in conjunction with cosmetic surgery to improve the overall result or to provide a more efficient treatment plan for patients,” explains [Dara Liotta, MD](https://www.facialplasticsnyc.com/), a facial plastic and reconstructive surgeon in Manhattan.

One popular non-invasive and invasive cosmetic procedure combination in Dr. Liotta’s practice is the coupling of Botox® and [upper eye lifts](https://aedit.com/procedure/upper-eyelid-blepharoplasty) because "injecting while a person is sleeping keeps tension off the surgery incisions and improves the overall result." 

She also frequently pairs [lip fillers](https://aedit.com/procedure/temporary-lip-fillers) and [nose jobs](https://aedit.com/procedure/open-rhinoplasty). “Lip filler is often paired with a rhinoplasty because tweaking the lip shape helps balance the new proportions of the face," she shares. "Also, injecting around the mouth can be painful, so doing it while a patient is under anesthesia helps save her from extra discomfort."

[Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63), a Manhattan plastic surgeon and clinical assistant professor of surgery at Weill Cornell Medical College, has a similar approach. "Dermal fillers are painful, period," she says. "So, doing them when you are already under sedation is appealing."

Dr. Doft regularly incorporates injectable fillers into cosmetic surgery — even if the filler is not necessarily complementary to the surgical procedure (e.g. lip fillers with a [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-fat-transfer)). She also adds lip fillers and [PRP](https://aedit.com/procedure/acell-and-prp-injections-for-hair-loss) (platelet-rich plasma scalp injections that stimulate regrowth) to [facelift](https://aedit.com/procedure/deep-plane-facelift) surgery. “Many older patients who are ready for a facelift are often also suffering from thinning hair and lips," she explains. "So, many decide it is both efficient and painless to address them all at once."

Another popular "extra"? [Laser resurfacing](https://aedit.com/procedure/ablative-fractional-lasers).

Both Dr. Doft and Dr. Liotta say lasers are a go-to non-invasive add-on to plastic surgery procedures that already require a considerable recovery period (think: eyelid surgery or facelifts). 

“In addition to elevating the facelift result by improving the texture of newly lifted skin, lasering during surgery can save the patient extra downtime on the backend,” explains Dr. Liotta. “After surgery, most patients opt to stay out of sight for at least a week, so adding deeper laser resurfacing — which leaves the skin red and raw — saves the patient from two rounds of downtime. Post-op, they stay home and recover from both the surgery and lasering simultaneously.” 

But it's not always about minimizing pain or maximizing downtime. Some effective combos are more spa-like in nature.  

Dr. Doft says she frequently combines liposuction with a lymphatic massage — a non-invasive therapeutic treatment. “I work with an excellent masseuse who specializes in lymphatic drainage," she says. "I have found that having her massage a patient three to four times after [liposuction](https://aedit.com/procedure/laser-assisted-liposuction) makes the end result more uniform and it can significantly decrease post-op swelling, sometimes cutting recovery time by a third or even in half.” 

Multitasking is a marvelous thing.

Many plastic surgeons now offer non-invasive cosmetic treatments and often suggest complementing a surgical procedure with an add-on or two. So, what are the best combos? The AEDITION talked to the experts.

The Best Surgical and Non-Surgical Cosmetic Procedures To Combine

Better Together: The Best Surgical and Non-Surgical Cosmetic Procedures To Combine

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On rare occasions, cosmetic procedures may not yield the results you hoped for. And, while we are not talking about gross negligence, you may find yourself disappointed with the way things turned out. 

Perhaps a [rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty) slimmed your nose, but now you have a very pointy tip. Or, you had [liposuction](https://aedit.com/procedure/power-assisted-liposuction) on your muffin top but see only the slightest improvement, certainly not the slimmed waistline you anticipated. Simply stated: Whatever the cosmetic surgery—even common procedures like [tummy tucks](https://aedit.com/procedure/abdominoplasty), [breast augmentations](https://aedit.com/procedure/breast-augmentation-with-implants), [breast reductions](https://aedit.com/procedure/breast-reduction), or [facelifts](https://aedit.com/procedure/midfacelift)—the final result has fallen short of your expectations, and you want it fixed. 

## **What’s The Next Step?** 

“It’s important, first and foremost, to be patient,” says Wendy Lewis, an independent plastic surgery consultant known as [The Knife Coach](https://wendylewisco.com/home/). “Some patients look good at three weeks, others not until three months post-surgery, and, for some, your full result may not be apparent for six months.” 

Lewis advises that you wait for all the post-surgical swelling and bruising to go away before you start to fret over the outcome. “Sometimes it takes a few weeks or even months for everything to settle—and it’s only then that you can evaluate how things look.”

That said, if you are feeling anxious, speak up. “When you visit your plastic surgeon for follow-up care, it’s okay to voice your concerns to them or to the staff and say that you are feeling disappointed or worried. A [reasonable physician](https://aedit.com/aedition/how-i-found-my-plastic-surgeon-trust-your-gut) will want to address your concerns, walk you through the recovery process, and talk about the next steps, if necessary,” she says.

## **What Your Should Not Do** 

“Do not run out and ask a bunch of other cosmetic surgeons for a second opinion. There will, undoubtedly, be doctors who are happy to validate your concern and say they can fix it. But their motives may not be in your best interest,” cautions Lewis. 

A better strategy: Try, at least initially, to work with your original doctor. You’ve already invested time and money into that relationship, says Lewis, and they are, likewise, also invested in helping you feel satisfied with your surgery results. Give him or her a chance to work through your disappointment and offer solutions if your result really does merit fixing. 

Lewis also stresses the importance of remaining rational. “Don’t threaten and don’t storm in and demand your medical records – unless you are really ready to sever that relationship," she explains. "Once you take your records, you’ve escalated the situation and pretty much ensured your doctor cannot and will not help you. Now, you’re going to have to find a new doctor and spend more money to get what you want.” 

## **How To Get On The Same Page As Your Doctor** 

Ideally, you and your doctor will be on the same page well in advance of whatever cosmetic treatment or plastic surgery procedure you are planning to have done. To ensure you have found the right medical professional for you and your needs,  Lewis offers this advice:

### **Check Their Reviews**

While very negative reviews are to be considered, Lewis cautions that, sometimes, those comments come from an unhappy patient with a vendetta – especially if the rest of the reviews are overwhelmingly positive. Instead, it's the doctors that consistently receive mediocre ratings (think: three out of five stars or less) that should give you pause. 

### **Research Your Doctor’s Aesthetic** 

Look at the other people in the waiting room. Ask to see before-and-after photos – especially of people similar to you in age and general physical description. Take advantage of any technology that allows you to “see” your result using digital images. In some cases, you may even be able to try on a “nose” or the like that is constructed from a 3D printer. If, after these steps, you feel confident in the doctor’s skills, great. If, however, you still have mixed feelings, Lewis says to “ask him about what concerns you.” This is a good way to determine if it’s the doctor’s aesthetic you don’t like, or if your expectation of the plastic surgery is unrealistic.

### **Evaluate the Staff** 

You want a doctor that has a good relationship with his or her team – and you want to feel comfortable around them, too, because you’ll be interfacing with them quite a bit. Lewis says having two consultations to get a good sense of the doctor and staff is reasonable, and, if you’re still unsure, go for a third. “No reasonable doctor will deny a third visit," she says. "And, if he does, that’s a red flag.”

### **Don’t Rush** 

Ask every question that comes to mind. Don’t ignore your gut. “While many surgical procedures can be reversed or fixed, that’s not a solution you want to count on,” says Lewis. Revision surgeries, corrective surgeries, and other treatments are expensive and require additional downtime. Plus, you usually have to wait nine to 12 months, until your body has totally healed, before going under the knife again. 

## **When to Walk Away**

While all of this due diligence should lead to a satisfactory result, there may be rare instances in which your relationship with the physician is beyond repair. Lewis advises that if your doctor is not being reasonable, if he or she is not answering your concerns, or if you feel they are just not capable of giving you the result you want, then it may be time to move on. But taking your records and finding a new board certified plastic surgeon should be the last resort. 

For those who have not had surgery yet and worry about the risk of disappointment, Lewis offers this: “Most doctors want you to be pleased. And I found that, most of the time, disappointment is the result of miscommunication or unrealistic expectations, not the surgeon’s skill.”

If your cosmetic procedure falls short of your expectations and you want it fixed, this is what you need to know. 