When Tear Trough Fillers Go Bad…

2 Mar

Don’t worry!  You can be fixed!

There are plenty of scary things on the internet about aesthetic injectables gone wrong, and although I hate to add fuel to that fire (because majority of the time the result is amazing!), I had a client come see me over the holidays who was having one of such situations (not from me!).  She allowed her pictures to be used, so should someone else experience a similar situation, they would hopefully find her story!

Remember, no one is every perfect, and filler is meant to improve your natural beauty.

tear trough

I have had many people contact me about tear troughs.  Belotero is a game changer for this area, and I LOVE the results from it.  I am very experienced with this area and this product.  If you are seeking tear trough augmentation, make sure you seek out someone who specializes in it!

Because Photoshop doesn’t work in person… only on the internet!


Want a good photographer?  Everyone should have one!  Check out one of my favorite fashion photographers, Alyssa Silvestri.

More info on Belotero?  Check out my previous blogs!

Video Blog: Tear Trough Augmentation.


What to Expect (with your skin) When You’re Expecting

31 Jan

Many people search my blog for information about skin care and what is safe during pregnancy.

I assume maybe half of these searches are women who are using a controversial product prior to your pregnancy confirmation.  If you have been using a product is considered “controversial” (ie Retinols) and found out you were pregnant after the fact, don’t freak out.  There are no valid studies showing it is unsafe.  My OPINION is it is a million times safer than smoking a cigarette.  Stress is much worse for babies!

Here is a little video presentation.  I’m getting much better at them!

On a side note, I had to do a million takes because I kept saying “it’s probably fine.”  I have never been pregnant, but I don’t think I’d like it if someone said “it’s probably fine!”

I promise (in the far future) when I am pregnant I will post my skin and associated dilemma on the safety of Retinol.  It is difficult to give advice on situations I have not experienced!


Video Blog: Tear Trough Augmentation

18 Nov

Check out my video blog on YouTube: 

One of my favorite procedures to do since the introduction of Belotero Balance in the United States last October.

The tear trough is a grooved demarcation where the cheek skin meets the much thinner and highly vascular eye skin.  Because of the anatomy of this area, a thinner hyaluronic acid like Belotero is the perfect product (Belotero: The Buzz.).  It does not last as long as the more viscous hyaluronic acids, but it also has fewer complications.

Treatments in the middle third of the face, which contains the eyes, nose, and cheeks, require an aesthetic eye and advanced knowledge of facial anatomy.  Filling the tear trough area often requires cheek augmentation as well in order to look natural.  The cheeks can require a large amount of product depending on the degree of volume depletion.  Make sure you discuss this with your injector prior to injections!

This is a very advanced procedure, make sure you check out before and after pictures before being injected!  Many practioners do not offer this procedure because of the advanced training and skill it requires.  When done correctly, it looks AMAZING.  I’m not even a very good iPhone photographer, and I have some great before and after’s on my Pinterest and in other blog posts:

More Belotero!.

I hope you enjoyed my video.  They are really hard to make!

Rosacea: the Basics

28 Jul

I have been seeing an increasing number of patients who have been diagnosed with a skin disorder called rosacea. These patients state they have very sensative skin, and are often nervous about treatments.

What is Rosacea?

Rosacea is a chronic skin disorder of unknown origin that begins in the 30’s and is characterized by redness on the cheeks, nose, chin or forehead (most commonly, it can occur on the body as well). There are no specific tests that can be run to determine if you have rosacea. Rosacea occurs in periods of flare-ups and remissions. While there is no cure, treatments aimed a reversing signs and symptoms are necessary. Rosacea will worsen over time if left untreated, becoming ruddier and more persistant.

Who does it effect?

Patient Profile
30-60 year old females
Family history
Fair skin and blush easily

(Ihave found it very common in patients of Irish decent, which is a large population in Boston.)

If you think you may have rosacea, schedule and appointment with a dermatologist.

Signs of Rosacea
Primary Signs
persistant redness
bumps and pimples
visable blood vessels

Sub-Types of Rosacea

Four Types of Rosacea
facial redness (erythematololantagic)
bumps and pimples (papulopustular)
skin thickening (phymatous)
eye irritation

Many patients experience more than one subtype and symptoms occur in varying degrees of severity. Treatment is based of type and severity of symptoms a patient presents with. Flare-ups are most likely to be associated with certain stressors. Remember, even with this disorder, different patients need to follow different treatment plans based of their symptoms. Many dermatologists suggest you keep a diary of flare-ups and remissions to help track your stressors.

Important Facts
Skin Care
Have a gentle skincare routine with minimal products.
Moisturizer is key for preventing burning, stinging and irratation. A strong moisture barrier will keep out impurities and irritants that may aggrevate the skin.
Wear SPF.
Test products on the neck before using them.
Make-up can dry and irritate the skin. Use water-based make-up products. Avoid waterproof and heavy foundations. Avoid make-up removers. Look for a light foundation that contains silicone (for skin barrier protection). If it contains a broad spectrum SPF, even better!
A dermatologist may perscribe you a product called Metrogel. It can be drying, so again, use a good moisturizer.
Products with Vitamin C: Vitamin C is known to decrease free radicals, which play a major role in inflamming rosacea when patients are exposed to the sun. The formulation of the product matters! Make sure it doesn’t containt alcohol as an ingrediant, specificall propylene glycol!

Avoid anting that causes redness or stinging like salicylic acid, AHA’s, or retinol (even if you have rosacea with pimples as your subtype!)
Avoid products containing alcohol, witch hazel, or fragrances. Avoid peppermint, eucalyptus oil, clove oil.
Avoid acetone.
Check your products for an ingrediant “propylene glycol,” which is a perservative that causes stinging.
Do not use a toner, astringent, or anything that exfoliates. These products will dry and irritate your rosacea.
Be careful with over the counter products for redness. Altough they may claim they can help, you really should talk to a dermatologist.

**Interesting note: One article suggested patients with rosacea avoid so-called “natural” skin care products. If you look at the list of ingrediants in these products, it is usually very long, and is likely to contain something that will irritate rosacea.


Avoid triggers.
Food (here’s a few)
citrus fruits
cheese, yogurt, sour cream
hot baths


Antibiotics are typically perscribed for their anti-inflammatory properties (not their bacteria fighting capabilities). They come in creams, lotions, or oral forms.
Medications containing sulfer or azelaic acid may be prescribed as an alternative to, or in conjunction with, antibiotic treatments.
Acne drugs are sometimes prescribed. Avoid these if you are pregnant or plan on becoming pregnant.
topical steroids (speficially mentioned is prednisone).
drugs that dialate blood vessels, such as certain heart medications (NEVER discontinue a heart medication without a doctor’s approval!).



Laser Treatments
Lasers emit light energy that targets red blood vessels. Heat for the laser’s energy causes the red blood vessels to disintegrate.
Expect to have 3 treatments
removes visable blood vessels
decreases extensive redness

Preventative Botox

22 Jun

The 40-52 year-old age group continues to be the majority of Botox recipients, but injections continue to become increasingly popular amongst younger clients (ASPS 2013 Plastic Surgery Statistics Report).

It’s Never too Soon to Start Botox!

One in four women over the age of 30 is interested in learning more about Botox injections. It is around this age we start to really notice fine lines on our faces. It is actually better to start treating the fine lines of the face at a younger age, preventing the fine lines from becoming deeply etched “railroad tracks,” as one patient of mine in her early 30’s, L.M., so lovingly called her forehead.

There is no specific age that is “perfect;” it’s never too late to start, and so long as you’re over the age of 18 and you have wrinkles forming at rest, you are a candidate for Botox injections. I have a few clients in their lower 20’s with the skin of a 40 year old. The scale we use to determine the age your skin looks is called the Glogau Scale.


Does your skin look the age it should according to the Glogau Scale? If you think your skin looks older than it should don’t put off trying Botox because you think you need to wait to be a certain age to start. Botox will prevent the premature advancement of mild to moderate wrinkles to “railroad track” status. Botox will completely erase mild to moderate lines with small “natural” looking doses. As lines progress into the advanced to severe stages, higher doses are necessary to soften the lines. At a certain point, Botox will not completely get rid of deep wrinkles, and fillers are needed in conjunction with Botox treatments. Yep… starts to get expensive. Starting early means less Botox needs to be injected, and if you keep up with it regularly, the amount you need will decrease in number of units and periods between treatment times, due to muscle atrophy (your muscles become weaker and more sensitive to the product. And your metabolism slows down… the one good thing about that is that the body doesn’t metabolize your Botox as fast. Or cake. Unfortunately. 😦

Being preventative is always the best approach to your health. SUNBLOCK is your first line of defense! But if you feel like your skin is looking older than it should, a lil Botox never hurt anyone.

I’d say a majority of my patients are in the 20-45 year old age range. It’s becoming more acceptable to openly talk about doing Botox amongst younger people. (Although there’s always that one person who has to put their negative opinion in the mix when it comes up. THEY would NEVER do it. Yea… I’ll see them in five years, when all their friends are doing it!).


L.M. started doing Botox a few years ago, and doesn’t regret it at all! Her cousin started coming with her to see me, who then brought her friends and her sisters. These women are all starting in their early 30’s, and they look amazing. You would have no idea they are doing Botox unless they told you. They are all health-conscious and hard working (ie not Desperate Housewives!). It is also such a bonding experience to share amongst your close friends. Nothing says friendship like a needle to the face… Errrrr…

If you’re thinking about doing Botox, talk to a professional about whether or not it’s right for you. And if there’s one quote I’ve heard over and over again it’s

No one ever regrets having kids, getting divorced, or doing Botox.


Bruising After Fillers

29 May

I wrote this post MONTHS ago… And I just made a corresponding video. So if you prefer the sound of my voice to actual reading Botox and Bruising vBlog. It does contain different information then the rest of this blog post. So feel free to read on!

A few months ago, Alyssa Sylvestri (a famous photographer/videographer), Sarah Victor (a super famous youtube make-up artist), and I (just plain super) had a business related girls day that was SUPER fun.  This blog will prove it.

Sarah did my make-up.  Then I injected her lips with Restylane and her forehead with Botox Cosmetic.  She is now an addict and will be attending “I’m Young and Beautiful Forever Anonymous.”

Sarah’s Restylane Experience

Sarah asked me what kind of things my clients were interested in learning about when it came to make-up applications.  Easy.  You all HATE under eye circles (which I fix with Belotero and it’s so amazing, check out my Pinterest before and afters!).  The other thing I thought of was how to cover a bruise.

And for some reason I cannot insert the link to this right now….

Moving on….

Bruising can happen.  Period.  End of Story.  It’s the most likely “complication” when it comes to aesthetic medicine.  I put the word complication in quotes because it’s not really technically a complication, but to some women it’s the worst possible thing that could happen to them.  Ever.  (These are called dramatic patients).  Kidding!  Kidding!  But in all seriousness it sucks, but it will go away.  I PROMISE.

A bruise is caused by blood leaking into the interstitial tissue.  It can happen from any trauma.  When you pierce the skin with a needle, you are creating trauma.  But it’s totally worth it in the case of Botox and Fillers.

There are ways to prevent bruising.


  • Blood thinners like Alcohol.  I understand that it is REALLY hard to avoid alcohol for 4 days, especially if you have children/a husband/a job or all of the above.  Do the best you can.
  • Anti-coagulant medications.  Anything with Ibuprofen in it.  This includes Advil.  Other examples are coumidin and aspirin.  **DO NOT DO THIS IF YOU ARE TAKING THESE MEDICATIONS FOR YOUR HEART!  NEVER DISCONTINUE PRESCRIPTION DRUGS FOR VANITY.  Take tylenol if you need too.
  • Fish Oil.  Because it is some sort of blood thinner/greaser type thing.
  • You may want to avoid getting your period.  If you can?  If you can do this… I have some questions.  But what I mean to say here is book your appointments in a timely manner with your menstrual cycle.


  • Arnica Montana:  you can buy this at Whole Foods or GNC.
  • Eat Pineapple.  I think this is what they make Arnica from.  But I could be wrong.  But it’s definitely good for helping bruises.
  • Immediately after injections ice the site.  This causes constriction of the vessels that carry the blood, which means blood flow slows down.  Which means less blood is available to leak into the tissue.  It also helps with swelling.


  • Push on a bruise.  You will make it worse.
  • Fall asleep with ice on your face.
  • Put ice directly on your face. You can burn it.
  • Over dose on Arnica Montana or Pineapple.  More is not better.  Arnica in high doses is not good for your liver.  Pineapple in high does is not good for your stomach.  Trust me.  I know!

If you have more questions, make sure you consult your injector.

The Internet Gives Botox A Bad Rep

29 May

I have heard some interesting things from patients over the years about Botox and Fillers and information they gathered from the internet or from friends who have read stories online. The internet is a wonderfully useful place of information… So long as you are reading it on a reputable site (.org) or from a reputable person (for example, I am an expert in Botox and Fillers, please refer to my credentials page!).

When looking at internet sites, you need to take into account the validity and reliability of the information that is being given to you.

Yes, Wikipedia is great… But it is not a reliable source of information. (Although I still use it!).

Consider who is giving you the information when it comes to product safety. When looking at prices it should be unit based. Like when you go into CVS and you compare how much shampoo is by the unit cost because the bottle size is different. Fillers are charged in number of syringes.

Use your judgement, and remember you can’t believe everything you read! If you have a question, ask someone with expertise in the area. If you aren’t sure their answer is true, or you want a second opinion, get one! But please take the stories you read online with a grain of salt.

Interpreting Botox on the internet.

Aesthetic Consultation: Botox and Fillers

25 May

What to ask for and expect during consultations for Botox and fillers. consultation video


Online Dating: how to increase your odds.

2 May

Starting to date again? Interested in doing Botox first? Here’s why that’s a great idea.


I’m thinking of making this my match.com profile picture! I wonder what type of man I would attract!

Paying for Botox

11 Feb


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