Dr Edmond Phua

Depending on the cause of the saggy cheeks, the extent of facial volumetric deflation(if any), degree of soft tissue descent, bone structure, skin quality, gender and facial proportions of the person. the following are some of the common treatment options that can be done to improve saggy cheeks/sagginess of the face in general. 1. Energy devices like Thermage, HIFU and Ulthera can help to boost collagen stimulation, tighten and lift up saggy skin over cheeks. 2. Dermalift or intradermal microbotox injections can also help to tighten and lift saggy skin over the lower face 3.

10 days after TCA CROSS treatment is definitely too short a time to see significant improvement and you are right that you would need 4-8 weeks to appreciate the full effects as it takes time for the fibrosis and collagen stimulation to occur. Also, depending on the depth and type of your acne scars, it may take a few sessions before you can see significant improvement. Also, you may need other adjunct treatments like subcision to improve the deep and tethered scars, and fillers for the very atrophic ones.

There are definitely treatments that are effective for both hyperpigmentation and enlarged pores . However, first and foremost, it will depend on the cause and kind of hyperpigmentation that you are having, the cause of your enlarged pores and presence of any other associated conditions like acne, as well as the extent of your hyperpigmentation. By and large, topical therapy, injectables, lasers and radiofrequency micro-needling will be able to treat hyperpigmentation and improve skin texture e. g. enlarged pores to a certain extent.

From the picture, it looks like the acne papule has developed into a nodulocystic lesion. Options in this case where there is only one single nodule will include: 1. Intralesional steroid + antibiotic injection - This will aid in destroying the bacteria over the lesion and decreasing the inflammation and proliferation of the nodule. Usually the contents of the cyst can also be "flushed" out during the injection as well and typically the nodule will flatten in a matter of days. Occasionally a repeat injection may be required. 2.

If you are referring to hyaluronic acid(HA) skinboosters, Rejuran can be combined with non cross-linked skinboosters which will provide additional deep hydration to the dermis and plumping up the skin, leading to reduced appearance of fine lines, in addition to the rejuvenative and reparative effects of Rejuran. Though Rejuran has been reported to react with cross-linked HA fillers causing granuloma formation, experts have now agreed that it can be safely used together with lightly cross-linked HA skinboosters like Vital and Vital Light.

From the picture, it looks like your face shape looks nice and is relatively V-shaped already. If you are looking to make your face slimmer, the only additional treatment you need would be to reduce your cheek/buccal fat a little, which is slightly bigger on the left cheek. A good treatment to consider for that will be buccal fat radiolysis. With regards to treatment options to achieve a slimmer face, it will depend on the bone structure, skin quality, gender and facial proportions of the person.

It is unlikely that the Carbon Laser Peel causes acne outbreak per se. The Carbon Peel Laser actually helps to lightly ablate/exfoliate the top layer of dead skin, break up pigments and break down the debris lodged deep in the pores. The combined photothermal and photochemical peeling effect also aid to shrink sebaceous glands, stimulate collagen and reduce inflammation, improving acne. It is possible that some people may experience some mild outbreak during the week after the carbon peel laser due to the exfoliation and increased cell turnover from the treatment.

From your description, the brownish marks are Post-Inflammatory Hyperpigmentation marks which have occurred due to the inflammation from your acne, trauma from squeezing the acne and extraction during facial. As the name suggests, Post-Inflammatory Hyperpigmentation(PIH) may occur whenever there is an insult/inflammation to the skin, and the skin reacts by producing more melanin. It is temporary, but may take some time to heal and resolve without treatment. It also happens more commonly in darker-skinned individuals. Treating PIH takes time and patience.

Fillers can help to temporarily correct a mildly crooked nose. However, you should get a proper assessment by a certified and experience aesthetic Dr who will be able to tell you all the options available and whether in your case, it is amenable to augmentation with fillers. For an extremely deviated nose, the best option is often surgical rhinoplasty. Another option that can help to augment the nose is nose threads, which can be used singly or in combination with nose fillers. Both fillers and nose threads are not permanent.

Firstly, it is important to have a good skincare regime. For oily skin, it is also important to keep your skin moisturised, or rather hydrated. You should choose moisturisers that are non-comedogenic, light and fast-absorbing and contain humectants like glycerin, hyaluronic acid, aloe and squalane. Avoid those that are heavy and overly oily on the skin and contain ingredients such as mineral oil and petrolatum.

It is safe to undergo subcision, TCA Cross or RF microneedling while on low dose isotretinoin. There is a published paper/guidelines by the American Society for Dermatologic Surgery in October 2017 that elucidated this. The task force concluded that it is safe to undergo superficial chemical peels, nonablative lasers, including hair removal lasers and lights, vascular lasers, and nonablative fractional devices for patients currently or recently exposed to isotretinoin. In fact, the paper further highlighted that there are potential benefits while on isotretinoin and undergoing scar treatments.

Acne scars can be classified into hypertrophic or atrophic in nature. Hypertrophic scars are usually thickened and raised lumpy scars, which are usually more common over the chest and back but can occur over the face as well. With regards to the face, 80-90% of the time, atrophic scars are formed as sequelae of acne. This is due to the aberrant production and degradation of collagen during the inflammatory and healing process of acne, which leads to a net destruction of collagen and loss of volume.

From the picture, if the lump is causing you some pain, you will need to get it assessed by a doctor to exclude the possibly of a cyst/infection over there first. If it is truly a keloid scar, treatment options include: 1. Application of topical products for scars like silicone based sheets or gels which help to regulate collagen production over scars, or topical retinoids/azalaic which increase cell turnover rates and hence reduce the appearance of scars and post-inflammatory hyperpigmentation 2. Chemical peels 3.