Q&A With Dr. Quintana
Botox/Xeomin/Dysport
Q: Dysport vs. Botox: what’s the difference?
Dysport is another form of Botox with few differences. Dysport becomes effective up to 24 hours after injection because it is a smaller protein, whereas Botox may take up to a week to be effective because it is structured slightly different.What is important is that both Dysport and Botox contain the main active ingredient called Botulinum Toxin Type A, which creates effectively the same results with patients. Some patients prefer Dysport because they say it gives them a more natural look.
Q: Xeomin vs. Botox – Which Is Better?
Xeomin is just a newer alternative to Botox. They both contain the main active ingredient called Botulinum toxin A, effectively sharing the same result. The main difference between the two is that Xeomin uses the purest form, lacking some proteins that Botox contains. This, however, makes little to no difference in the overall result. Patients who want quicker results tend to use Xeomin more frequently because once it is injected the protein becomes active immediately. On the other hand, Botox may take a while longer due to the time it takes for the protein to activate.
Q: What is the difference between Botox and Dysport? I thought the 2 products were supposed to be so similar?
There are minor differences between Dysport and Botox. Dysport contains smaller protein particles and that is why patients notice its effect much quicker than Botox (usually within 3 days) and it also tends to diffuse quickly. Ultimately both work similarly, relaxing the muscles injected. Most patients will ask for Botox when they are interested in any anti-aging procedure. I normally discuss a patient’s particular concerns to determine which one will work best for him/her.
Q: How Long Before Botox Results Can Be Seen?
Patients will begin to see the results of the Botox about 2 days after injection. Results usually last between 3-4 months after injection. Since the effects last no more than 4 months, I recommend 4 sessions to be performed every 4 months to maintain results.
Q: Treatment Options for Drooping Mouth Corners on Younger People?
All the procedures you mentioned can help in correcting the “frowning look” that is affecting the corners of the mouth. Before undergoing an invasive procedure such as a Lip Lift, I will suggest to try an intervention that will have less risks and downtimes. If you combine a neurotoxin, such as Botox or Dysport, with a filler, such as Refyne or Volbella, it will help correct the drooping and asymmetry that you are explaining.
Q: Does Botox Treat Migraines and Wrinkles at the Same Time?
Botox has been approved by the FDA to treat wrinkle lines and migraine headaches. This happened when patients that had migraines were treated with Botox to smooth their wrinkles reported that their headaches got better. This lead to the studies that showed that Botox relieved the migraine pain.
Juvederm
Q: After-care for Lip Augmentation Using Juvederm?
A: The overall severity of swelling and/or bruising depends on the patient. Generally, the swelling starts to subside after 24 hours of the Juvederm Lip augmentation. It is important to take proper post-op care while allowing time for the swelling to go down. I usually recommend icing the lips, no strenuous physical activity, avoiding salty foods and alcohol, and avoiding aspirin, as it can promote bruising. If you develop bruising, usually it will be easy to cover after 3 days.
Q: How does Restylane Refyne compare to Juvederm and Volbella for lips?
A: Restylane Refyne is very efficient in maintaining movement and expression in the lips, while also treating fine lines and wrinkles. Juvederm also reduces the appearance of wrinkles. Both give a plumping effect to add volume. However, Juvederm results are immediate after injection, while Restylane Refyne may take a couple of days. Refyne also takes on a much more natural look and patients say that it is better for mobility in the lip region.
Like Restylane Refyne, patients say Juvederm Volbella gives them a more natural look. Volbella is a finer product than Refyne and should give the lip great definition. Refyne, Juvederm, and Volbella are all Hyaluronic Acid fillers and will, therefore, share similar results.
Juvederm Volbella
Q: Severe swelling after Volbella lip filler. Can I have some advice?
A: Swelling is customary after Volbella Lip Injection. I recommend icing your lip throughout the day to reduce the swelling. Most patients see swelling go down after 3 days but if your lips continue to swell as severely as you mentioned, then it would be best to see your provider to make sure that there are no complications.
Q: Is Volbella good for tear trough?
A: Volbella is a hyaluronic acid filler that was designed for enhancing the lips, but can also be an excellent option for the tear troughs. There are also a variety of fillers that can be used in this area. The choice of filler is all really dependent on the look you want to achieve. It is always good to discuss with your physician which one would be the best one to use to fulfill your expectations.
Kybella
Q: What is the recovery like for Kybella injections?
A: There is temporary swelling and risk of bruising with Kybella. For the first few days, numbness is also present below the chin. I have noticed with my patients that recovery time is very much dependent on the amount of Kybella that needs to be injected. The more injections, the longer the recovery time from swelling. Generally,the swelling in patients is unnoticeable within a couple of days. However, a full recovery is considered to take place within 4-6 weeks
Q: Swelling has increased 6 days after kybella injection. Will my results be the same?
A: There is temporary swelling and risk of bruising with Kybella injection. Generally, the swelling in patients is unnoticeable within a couple of days. However, there are some cases where swelling may actually increase during that time. Your final results will not be affected by the amount of swelling. But, if this keeps getting any worse and is associated with pain, then you should consult with your physician.
Restylane Refyne/Defyne
Q: What is the difference between Restylane Defyne and Restylane Refyne?
A: Restylane Defyne and Restylane Refyne are Hyaluronic Acid dermal fillers. They are flexible fillers and help to maintain natural movements. Defyne is typically used to treat deeper areas by smoothing creases and smile lines, while Refyne is used to treat more surfaced lines because it is finer. Additionally, Refyne treats moderate wrinkles and folds and Defyne fills deeper lines while also plumping. Both should last up to one-year post injection.
Q: How does Restylane Refyne compare to Juvederm and Volbella for lips?
A: Restylane Refyne is very efficient in maintaining movement and expression in the lips, while also treating fine lines and wrinkles. Juvederm also reduces the appearance of wrinkles. Both give a plumping effect to add volume. However, Juvederm results are immediate after injection, while Restylane Refyne may take a couple of days. Refyne also takes on a much more natural look and patients say that it is better for mobility in the lip region.
Like Restylane Refyne, patients say Juvederm Volbella gives them a more natural look. Volbella is a finer product than Refyne and should give the lip great definition. Refyne, Juvederm, and Volbella are all Hyaluronic Acid fillers and will, therefore, share similar results.
Q: What can one expect right after a Restylane Refyne injection?
A: After a Restylane Refyne injection there is risk of swelling and bruising. Swelling should go down after a couple of days. A full recovery of the swelling and bruising is considered to be 2 weeks after injection. Restylane Refyne will maintain movement and expression in your lips, while also treating fine lines and wrinkles. Results will last for about 6 months after injection.
Restylane
Q: What is the difference between having Radiesse vs Restylane filler for nasolabial folds? Which is better?
A: The volume line on nasolabial folds can be restored with the injection of fillers. There is no filler better than the other. The discussion of using Radiesse vs Restylane or Juvederm, will depend on the severity of the volume line. For this area there has been great advances and my preference is to inject Restylane Defyne or Refyne since the way they were engineered makes them more flexible which contribute to their natural look.
Restylane Silk
Q: Could Restylane Silk lip injection cause permanent bumps/nodules?
A: Small bumps are a common side effect of Restylane Silk. This may be because of the swelling that results after injection. This is only temporary and should last about a week. In the meantime, you can apply a cold compress to reduce swelling.
Radiesse
Q: What are some complications that could arise after a Radiesse procedure?
A: The common complications of Radiesse are bruising, redness, swelling, and tenderness on the injection sites. Rarely after injections do some patients develop visible nodules or granulomas. It is important to discuss this with your doctor before injections, all medications, and conditions in order to determine if there is any contradiction to getting treated with Radiesse.
Acne & Skin Care
Q: How to Remove Black Marks on my Face From Pimples?
A: This seems like a case of post-inflammatory hyperpigmentation where the skin becomes discolored after acne or any other type of inflammation of the skin. This hyperpigmentation will fade after several months with proper care: avoiding the sun and wearing sunblock to protect the skin. If this does not fade completely, there are other things to consider like chemical peels, or at times, bleaching agents.
Laser Treatments
Q: Best Laser Treatment for Rosacea Redness?
A: The best treatment for redness of Rosacea are either vascular lasers like PDL or KTP, or Intense Pulsed Light devices. Usually patients need several sessions, anywhere between 2-6 in total.
Q: Will a person Get the same results with ResurFX as with other IPL treatments?
A: ResurFX and Intense Pulsed Light are quite different treatments. Both rejuvenate the skin, but in rather different ways. Intense Pulse Light uses a non-ablative laser that is considered to be more superficial. It mostly treats brown spots, hyper-pigmentation, any discoloration and blood vessels. ResurFX uses a non-ablative laser (less invasive) for skin resurfacing in order to treat scarring from acne, eliminate the appearance of pores, stretch marks, fine lines, and photo-damage. They are very effective skin treatments.
Q: What’s the Best Laser Hair Removal Machine?
A: It very much depends on your skin type and hair type. There are several FDA approved devices, as you have mentioned. As long as you see a doctor that is qualified and the doctor uses the appropriate device that is the most effective for your skin and hair type, then you will have successful results with no complications.
Q: I would just like to know what doctors think of the ResurFX procedure. Do you think it is a procedure that really works?
A: ResurFX uses a non-ablative fractional technology for skin resurfacing. It treats scarring from acne, eliminates the appearance of pores, stretch marks, fine lines, and photo-damage. It also treats pigmentation such as brown spots and melasma. It has minimal downtime but, requires a series of sessions. It is the perfect procedure for patients that want to improve their skin without having to heal for a long downtime.
Q: What Should I Expect from Total FX?
A: TotalFX is a fractionated Carbon Dioxide laser. It treats scars, wrinkles, and evens out the skin tone. This treatment overall is very efficient at rejuvenating and smoothing the skin. The most common side effects are redness, swelling and peeling, which usually subsides within 2 weeks.
