Dr. Dean Kane Q&A – What can I do to speed up healing and reduce swelling after surgery or injectibles?

Q. What can I do to speed up healing and reduce swelling after surgery or injectibles?

A. We are very pro-active when it comes to nutritional suggestions to help our patients have minimal bruising, inflammation and swelling from both non-surgical rejuvenation procedures using Botox/Dysport, Sculptra, and fillers like Restylane and Juvederm as well as all our face and body cosmetic procedures. We also feel strongly that without a good diet high in protein, vitamins, minerals and anti-oxidants, the recovery periods will be prolonged and healing delayed.

From a homeopathic approach we highly recommend that our patients eat fresh pineapple several days before their procedures, the day of and following. The Bromelain in fresh pineapple has been shown to have great anti-inflammatory properties that helps to reduce the bruising of the face and body. In addition we recommend arnica montana in pill form and gel form the day of the procedure and following. Again this homeopathic products have tremendous anti-inflammatory effects on the body.

On a daily nutritional basis, I recommend to our patients what I do for myself and my wife, Lauri. We are a believer in the low carb diet with moderate to large amounts of protein 3 times a day along with a strong anti-oxidant diet of fresh vegetables. For breakfast we try to not only get our protein, but our anti-oxidants by having a green protein shake. Lauri mixes up a cup of fresh spinach, half a carrot, a small tomato, a quarter of a green apple with 2 scoops of vanilla protein powder with water in a blender or nutra-bullet. In addition we add in a liquid form of Vitamin D and Calcium into our shakes. This is a super healthy way to start your day with great vitamins, minerals and anti-oxidants. Lunch and dinner always includes salads, veggies and a protein food (fish, chicken, tofu, turkey).

When we do any cosmetic procedures, we are strong believers in how diet affects the healing process. Lack of protein and poor nutrition will lead to break down of tissues in the healing phase. We go over diet very seriously with all our patients prior to any cosmetic surgical procedures and always encourage a high protein diet especially for our, breast lifts and reductions, tummy tuck and body lift procedures and even face and neck lifts that require all those building blocks from protein to heal the large surface area created by surgery. For our liposuction patients, Lauri, who has degree in nutrition, will discuss diet and lifestyle changes to help patients lose weight and maintain their surgical results. Lauri will do the same with our CoolSculpting patients, while non-surgical, also need to understand that without changing diet and exercise no procedure will get the desired results.

Visit our website: www.DrDeanKane.com  or call our office at 410-602-3322 for additional information.

I had Restylane for my under eye hollows in Aug & unhappy with the result. Should I get it corrected by adding some more?

Question from Jacksonville, FL: This is just a follow-up from my previous post..I think that the Restylane wasn’t injected in the right dermal plane and made the hollows worse. I regret getting it done as I only have minor under eye hollows to begin with..Going back to my ps is not an option at the moment, due to financial restraints and distance – he’s in CA and I’m in FL. I am hoping someone here could recommend a ps close to North FL who is familiar with cases like mine. Thank you!

 Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:

Injectibles under the eyes for hollows and wrinkles are very challenging and require a very skilled injector! Your injector must understand the anatomy of the eyelid and cheek, the pros and cons of the different injectibles, evaluate your unique variations and have the skill level to try to achieve your desires.
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Consider:

• ​Skin tightening with ZO Obagi Skin Health and Peels
• ​Laser and Light therapies
• ​Deep fillers along the bone
• ​Sculptra
• ​Surgery
• ​There are too many options and considerations to offer you without a proper exam.

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Word of mouth followed by responsible social media like RealSelf should direct you to a well experienced Board Certified Plastic Surgeon or other expert injector to help you.
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I wish you the best!

Dr. Dean Kane

Center for Cosmetic Surgery and Medi-Spa

www.DrDeanKane.com 410-602-3322 DeanKane@DrDeanKane.com

How long after having Juvederm do you need to not massage or rub the area?

QUESTION from Australia, AU: Ive had Juvederm on my mouth lines, nasal lines and some on my frown lines. The dr said that I need to avoid pressing too hard for around 2 days when I cleanse my face and I should avoid having any kind of facial massage for the next two weeks. Is this right?

 Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:

Any injectible has the ability to migrate or move initially following injection particularly with massage. I recommend to my patients that they may cleanse their face but avoid massage for 2 full days. Thereafter the gel will be more settled and fixed to the surrounding tissues. You may then gently massage using a lymphatic or squeegee technique to even out any swelling.
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​Always return to and follow the directions of your injector. He /she was the one that performed the injection and should know what is best for you.
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​All the best!

Dr. Dean Kane  Center for Cosmetic Surgery and Medi-Spa

www.DrDeanKane.com 410-602-3322

DeanKane@DrDeanKane.com

Will Sculptra still give me a natural look?

Question: I am thin, and have age related volume loss in my face. Will Sculptra still give me a natural look?

 Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:

Sculptra in my hands has been sensational for thin patients. ​​Sculptra in its newest formulation has provide even firming of the facial skin without the over-filled effects seen with fillers. Fillers are necessary if you need a fuller cheek or lips.  For lines, passive wrinkles and folds, Sculptra firms the dermis naturally by stimulating fibroblasts to create the components of youthful skin: collagen, hyaluronic acid and elastin.

It takes 6 weeks to feel the initial effects of a thickening process to the facial skin and by 3 to 6 months following no less than 2 sessions of 2 vials each, the patient and comparative photos show remarkable results.
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​Many of our patients well perform fillers for instant gratification and return for Sculptra for a more natural firming and elastic like shrinkage of the tissues. This is not filling and is not muscle relaxation but a natural, rejuvenation of thinner to thicker, firmer more resilient skin resistant to wrinkle formation and fine lines.
​​Once this minimally invasive procedure has achieved its desired effect, you can continue to stimulate the the dermis using other non-invasive techniques such as ClearLift, and retinoids to further deliver its effects at the dermal level.
​​Please proceed to a Board Certified Plastic Surgeon or other well experienced expert injector with many hundreds of Sculptra patients for your best results.

All the best of luck.

Dr. Dean Kane Center from Cosmetic Surgery and Medi-Spa www.DrDeanKane.com

410-602-3322 DeanKane@DrDeanKane.com

Is there an effective non-invasive treatment for paradoxical hyperplasia?

Question from London, TX:

I’m suffering from paradoxical hyperplasia after CoolSculpting and would like to know: 1) if invasive therapy is the only solution? (if so, what your recommendation would be) 2) If other types of non-invasive techniques can also be equally effective? (e.g. treatments which use ultrasound technology to melt away the fat such as Liposonix/ultrasound cavitation) 3) if exercise &diet alone can deal with reducing the size of the abdomen? (it doubled in size after the CoolSculpting treatment!) Thanks

  Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:

So sorry this has occurred to you! Paradoxical Hyperplasia following CoolSculpting is uncommon. It is my belief that inflammatory removal of fat cells occurs as well as the proposed apoptosis. This occurs during surgical procedures such as liposuction and tummy tucks as well leaving a firmer, fibrous tissue replacing the lost fat.  ​​I recommend time and deep scar massage initially. Patients who lose weight during the time of focused fat reduction from CoolSculpting do better.

​It may take a year or longer until the changes have settled as any procedure that creates heat or traumatic injury such as ultrasound or radio frequency procedures, liposuction or tummy tuck during the healing process may also add to the lumpy scarring. At that time you may consider these other procedures but only with the evaluation and recommendations of a Board Certified and well experienced Plastic Surgeon.
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​I hope this has helped. All the best!

Dr. Dean Kane

Center from Cosmetic Surgery and Medi-Spa www.DrDeanKane.com

410-602-3322 DeanKane@DrDeanKane.com

Is this a RUDE question to ask your surgeon?

Question from Spartanburg, SC: Docs say that a patient’s face must be carefully evaluated and matched to the “right” surgical technique. IF the PS exclusively does some variation of SMAS lifts should I think he never does the more challenging deep plane for HIS comfort or should I think that NO one showed up for whom a deep plane was the best option?

Answer from Dr. Dean Kane, board certified Plastic Surgeon from Baltimore:                                                                         It is not “rude” to ask the number and styles of facelift or the reasons why a surgeon uses the techniques he or she does for the surgery requested.

​Just as the surgeon should perform a proper evaluation of your past medical, surgical and social history to provide a proper plan to achieve your desires safely, it is in your best interest to find the surgeon whom matches your needs too.
​​Unless there is a specific reason to perform a more complicated procedure, the “twins facelift” study has determined that the difference and duration of various facelifts show nearly no difference.
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​Pick your board certified Plastic Surgeon and Facelift surgeon carefully.
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​All the best!

Dr. Dean Kane Center from Cosmetic Surgery and Medi-Spa www.DrDeanKane.com

410-602-3322 DeanKane@DrDeanKane.com

How long will my QuickLift Last?

Question from Amelia Court House, VA I’m a 52 year old  male who has minimal jowling and very little neck sagging. I just had a QuickLift down, I’m 5 days out. I have minimal swelling and bruising, I’m fair skinned. How long do you think this procedure will last? Any answers appreciated.

 Answer from Dr. Dean Kane, Board Certified Baltimore Plastic Surgeon:

This is the “age” old, $64 million question each facelift surgeon is asked at consultation; so it is a very good question!

​​The duration of a facelift is dependent on many unique factors:

1. ​ethnic background of the patient including the thickness of the dermis
2. ​prior care and weathering of the skin
3. ​amount of skin elevated and trimmed in the facelift
4. ​added lifts such as the neck, jowl, brow and forehead
5. the skills of the surgeon
6. ​skin rejuvenation procedures and care following facelift
7. ​and others.
8. 
   

In general, the less tissue lifted, the sooner the surrounding tissues will sag and the lifted tissue will relax once again. Rather than create a mis-conception that a quicker lift will heal faster and perform a similar end result to a traditional facelift; the patient and surgeon should identify those aspects of aging and create a surgical / non-surgical plan to manage the patients desire for improvement.
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​The dermis of the skin in patients of northern European heritage tend to be thinner and therefore relax younger than patients of “color” (African, Mediterranean, Hispanic, Asian origins).

​​More weathered or less cared for skin will have less elasticity at the time of facelift and age quicker thereafter.

​​What we can say is that a facelift allows the face to continue the aging process from a younger looking age.

​​Many studies have reviewed this question and the current consensus seems to be that a traditional facelift will “last” 7 to 10 years. Please anticipate less “duration” if you have had less of a facelift.

If you will consider many of the new rejuvenation techniques to continuously stimulate the skin to “anti-age” such as the weekly use of topical retinoids, weekly to monthly use of dermal laser, IPL and fractionated CO2 or erbium lasers, and/or Sculptra therapy; the texture of the skin will improve, firm and tighten. So if you have had a facelift, you can keep it looking younger, longer.

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​I hope this has helped you. All the best!

Dr. Dean Kane

Center from Cosmetic Surgery and Medi-Spa www.DrDeanKane.com

410-602-3322  DeanKane@DrDeanKane.com

Why is it taking so long to heal after facelift?

Question from New Orleans, LA: 30 days post op today. Slow healing, not a smoker! Did everything right then some. Ps not worried, but is there anything I can do to speed up the healing of left ear front? first pic is about 4 days ago. Does not hurt, ooze or burn. Still taking bromelain and vit c and now supplements. Am tired of hiding out. Scabs behind ears still too, left back better than right, but right front better than left. (scab wise) Thank you.Dr. said put nothing on it. I am putting Aquaphor on skin not incision

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Thank you for your concern! Healing of a surgical incision is probably the most mis-understood aspect of any surgical education process. In today’s fast paced society, we wish for quicker healing due to less recovery time. Unfortunately, we can optimize the healing process but not make it as fast as you expect or wish for.

The following is a simplified overview for you to consider in your quest for fast healing.

The healing process depends on many factors. The body, whether it is the face, trunk, arms and legs or organs follows a fairly defined process to seal skin and tissue breaks or injury. Short and long incisions, invasive or non-invasive; healing is the same. It is the magnitude of the trauma that prolongs healing according to the bigger or smaller injury. Scar, collagen or fibrosis are all the same name for the mortar that keeps the tissues together with incisions or thickening of the skin which we desire with dermal lasers and medications or injectibles.

Each patient is unique and creates the environment for optimal healing. your heritage, high blood pressure, heart disease, clotting syndromes, diabetes, nicotine use, vascular disease, auto-immune syndromes, nutrition, hydration and prior skin injury are many factors which can prolong healing.

When the skin is lifted off the underlying tissues as they are with a facelift, the incision AND the underlying skin is now devoid of it’s normal supply of circulation. This compounds the factors towards optimal healing and prolongs the process. The “larger” the flap, the more potential lack of circulation. Incisions in hair-bearing areas and certain thicker healing areas will factor into facelift incisions.

In general, in the most optimal case, it takes:
3 to 7 days for circulation to stablize;
7 to14 days for healing cells called fibroblasts to begin to make scar;
3 weeks to develop enough scar strength for return to non-exertional activities of daily living;
3 to 6 weeks for swelling to diminish (although it roller coasters with increased activities until 6 months or longer);
3 months to maximal scar thickening and lumpiness; and
3 to 12 months or longer for the healing to “remodel”, ie thin and stablize to its best.

Your surgeon will guide you in the ways to optimize your healing. Sorry your expectations are not met but nature does not follow our best desires.

I hope this has been helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

Does each vial you get of Sculptra add together producing more collagen or do they not build on each other? Im confused?

Question from Ohio, IL : How does the vials injected weeks apart come together to produce the amount of collagen necessary to give you the results your looking for? Isn’t the first vial of sculptra crystals gone by the time the second vial get injected 6-8 weeks later then so on with the next Vial? Just like to know how it works thanks.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Sculptra is a most interesting product! It is found not to “volumize” or “fill” but to stimulate the production of fibroblast molecules such as collagen, elastin, hyaluronic acid and other glycosaminoglycans in the dermis.
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​The reason for the slow onset of results is that it needs to prime the skin cells, particularly the fibroblast to make the collagen and other products you desire for your results. Each time Sculptra is again injected, it further stimulates these cells to a higher level of production.
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​For the longer onset, you also get longer duration of effects. We have seen improving skin firming and line reduction during the 2 years the product information states. This seems to further endure with other non-surgical stimulatory procedures such as Clear Lift laser, retinoid cream stimulation, deeper chemical peels and the like.
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​Be patient. This product with controlled stimulation has shown remarkable results for a non-surgical approach but is not instantaneous gratification. For that consider injectible fillers.
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​I hope this has helped! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

How soon can I get Restylane after Kenalog injection?

Question from Madison, CT: I had a Kenalog 40 injection into a raised hypertrophic incision scar which got rid of the all the scar tissue in a week. I have read the Kenalog stays in your tissues for a month. I would like to get some restylane in the area, but do not want the water absorbing properties of restylane to hold the steroid in place for longer than a month. Is it safe to get restylane soon – or is there a way, such as a saline injection, to help flush out the remaining Kenalog beforehand?

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:  

Kenalog is a suspension of a synthetic steroid used to reduce inflammation. When used under the skin or intralesionally, as you have, it stays localized to the injection area for a prolonged period of time; 40 days per the prescribing information (see reference below). Kenalog is NOT ordinarily used as a water or salt retaining steroid as other glucocorticoids are prescribed.
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​You should have no trouble receiving Restylane or any other HA (hyaluronic acid injectible) outside the area of a Kenalog skin injection.
​
​I wish to wait 6 to 12 weeks (42 to 84 days) following injection of kenalog in a hypertrophic skin lesion to allow it to fully work prior to assessing whether a patient requires more kenalog or as you suggest a filler. This will allow you and your injector to determine the extent of atrophy caused by the steroid and the amount, type and placement of filler you will need.
​
​Always use the most experienced, board certified plastic surgeon or injector for your skin injection needs.
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​I hope this was helpful! All the best.

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

I’m 52 and have hashimotos thyroid. I had Restylane 7 years ago, and would like to do it again. Would it be risky?

Question from Apex, NC : I’ve read some things and I am confused as to weather there is any risks of creating an autoimmune disease. I am in general good Health.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:

The human body is remarkable in it’s ability to guard itself against foreign bodies. In the case of Hashimoto’s Thyroiditis, it mistakenly identifies a molecule on the thyroid as foreign and attacks this organ. This can be similar to any and all allergic syndromes whether they are external such as pollen or internal such as auto-immune thyroiditis.

​Restylane and similarly made HA’s (hyaluronic acid fillers) are a molecule made to be bio-identical to human skin HA and therefore this molecule would have no immunogenic reaction in the body. When Restylane and other injectibles are purified for human use, there maybe micro-impurities which stimulate a allergic style response.
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​The cross-reactivity of one molecule stimulating a immunogenic response to another molecule is even more rare.
​
​I would recommend you contact your endocrinologist or rheumatologist to see if there is any cross-reactivity between these 2 molecules or any other concerns you should consider.
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​I anticipate the benefits will far outweigh the risks. Good luck.

I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

Restylane Vs. Voluma for the cheeks. Which one gives better result?

Question from Manhattan, NY: I have a appointment to add a little bit of filler to my cheek and my doctor suggested using either Restylane of  Voluma. I already had Restylane in my tear throughs with great results, but was wondering the difference between the fillers for adding natural volume to the cheek area and if one will give you better results.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:

Great question! The pharmaceutical industry is producing a plethora of wrinkle rejuvenating injectibles and the FDA is approving them for use for different usages.

Restylane and Voluma are a sub-class of skin and soft-tissue injectible fillers using HA. They are made from the same molecule, hyaluronic acid, a normal constituent of the skin which reduces in quality and quantity with aging, photodamage and other medical syndromes.  Including Restylane, Perlane, Juvederm Ultra, Juevederm Ultra Plus, Voluma, Belotero and many new-comers, the difference is in the linking bonds which make them thicker to inject and harder to break down by natural skin enzymes. It is this difference which makes them useful for epidermal fine lines, dermal wrinkles and skin folds. They are temporary “volumizers”, in effect “fillers” of the skin or soft tissues for the desired results and lose volume over 6-24 months depending on the amounts and quality of linking and amount of enzyme in your skin. If over-done, hyaluronidase, the same enzyme as in the skin can be used to reduce the fill.

I love Voluma, Juvederm Ultra Plus and Perlane for the fuller “apple” of the cheek and the same for the “Nike Whoosh” of the cheek bone.

​Restylane is great for the “crow’s feet” lines not reduced by wrinkle reducers Botox or Dysport.

Other sub-classes of skin and soft-tissue injectibles unable to be reversed include:

• Stimulants such as Sculptra which provide a slow and steady stimulation of dermal molecules such as collagen, hyluronic acid, elastin and others without volumizing. Sculptra firms the skin rather than fill.
• 
  
• Non-HA temporyary volumizers such as Radiesse which is made of calcium hydroxylapatite originated as a bone filler and is cosmetically used in microspheres to fill dermal lines or as volume.
• 
  
• Permanent fillers such as Artecoll, Artefill, silicone and others are volumizers and are not fully broken down by the body.
• 
  

Each fulfills a certain niche in the quest for skin rejuvenation.

Find the most skilled, well experienced injector to guide you through the maze of these and more evolving skin rejuvenation injectibles, procedures, lasers, lights and surgery to achieve your desires.

I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

Belly Fat!

Question:I had a baby 7 years ago i lost weight everywhere but the bottom of my belly. how can i get rid of it?

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Dear “Belly Fat”:

Every woman is different and after pregnancy, the skin stretches and the muscle and fascia stretch out too. You may put some visceral (organ) weight on or fat under the skin. It is best to undergo a proper evaluation with a Board Certified Plastic Surgeon and consider your options.

These include:

1. a traditional tummy tuck where the ab muscles are tightened, the sides are liposuction contoured, the excess skin is removed, the mons lifted and a new belly button is created.

2. a mini-tummy tuck where the skin below the belly button is removed and mons lifted.

3. a panniculectomy / lipo-sculpting where the large lower roll of tummy skin is removed and the upper tummy and sides and / or back are reduced with liposuction.

4. a body lift used with patients who have super-skin excess and the tummy, sides and back skin are lifted with or without muscle tightening.

5. liposuction of the circumfirential trunk for body contouring.

6. liposuction of partial areas such as the front abdomen with and without muscle etching, love handles, inner and outer thighs, arms, neck; any of which use traditional, syringe and ultrasonic liposculpting.

7. Cool Sculpting is a non-surgical option of multiple spot fat reductions without anesthesia.

As you can see, there are many options dependent on your desires, future for more pregnancy, budget and recovery time.

I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

How should I care for behind ear incisions after face and neck lift? They feel itchy and irritated.

Question from Florida, NY

Just a little over two weeks post opt, very itchy and irritated feeling? Using perioxide and antibiotic ointment 2 times a day.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

2 weeks after a facelift incision, the dynamic changes of healing call for inflammation. This maybe the reason for the itchiness and irritation. It could also be a developing infection. Please see your surgeon to evaluate and make his recommendations.

I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

I’m so scared of the side effects I got from botox, can I die? Please help! I had 4 units above the lip.

Question from New Sweden, ME: 2 days after, as I felt the Botox over lip, I felt something in my throat, and difficulty swallowing. Next day my tonsil under the jaw was swollen. Head itching. Hives on legs. Pain in ears. Later hives on arms, face, body and felt like my face would burn up. Numbness and sensations in the face, lips, tongue, throat, legs and arms. 18 days later it’s on going. I’m so afraid! Can I die? Can the botox be spreading and develop to botulism? Can I get an allergic chock? What to do? Use antihistamine.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Botox and other like muscle relaxers are a pharmacological grade purified protein made from the fermentation of the bacteria clostridium. There are 7 different types but only 2 are used for cosmetic and therapeutic purposes. There has been no reports of the small cosmetic doses of these medications traveling to areas farther than injected causing the symptoms or concerns of botulism. In fact, Botox, Dysport, Xeomin and Myobloc, are used 1000’s of times daily around the world.

Botulism is the growth of live bacteria in the body producing and dispersing this molecule within hours of eating it.  It is found in soil and water and can occur by a using a contaminated “street” injection, consuming improperly prepared food or getting it into a wound. Onset is within hours so this is certainly not your case.

Many drugs are now made in similar fashion by fermentation and purification including antibiotics, antibodies and other life-saving uses from bacteria and fungus. The purified protein may be a cause for allergy formation from prior or serial exposure of this drug. Like the rare side-effects of Botox, flu-like symptoms and swelling or redness can occur. This sound more like your description and may or may not have been caused by a flu or Botox.

It is best to be evaluated and treated by your primary care physician or seen in the Emergency Department of a hospital if the symptoms and concerns are progressing. If there is concern that this maybe an allergy related to the Botox molecule, you may be sent to a allergist to diagnose this.

I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322

I’m 22 year old and looking at Botox/Dysport. Is this too young?

Question from Sydney, AU

What age is it typically recommended to get Botox injections? I’m 22 and I’m starting to notice fine lines.. By no way are they very noticeable but I know Botox is preventable. Is it also true that the injections can work as a brow lift? Because I have very slightly hooded eyes and I would love it if these lifted the forehead area up a bit..

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Botox has both therapeutic and cosmetic applications. It is used functionally in young children with various spastic muscle and many other problems. ​For cosmetic uses in relaxing the muscles of facial expression before deeper and more permanent lines set in, Botox is never to early. This will help along with properly used retinoids to prevent lines, wrinkles, folds, pigmentation and aging skin.  Please seek the advice of a well experienced, board certified plastic surgeon or other expert injector and skin specialist for a review of your best options.

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​ I hope this was helpful! All the best!

Dr. Dean Kane

www.DrDeanKane.com

DeanKane@DrDeanKane.com

410-602-3322