Alexander G. Nein, MS, M.D.
My doctor who routinely mixes his Botox with 1 cc of saline is now changing to 2.5 cc of saline. He says the 2.5 cc is a newer method. Can I still continue to have him inject between my brows, forehead, brow lift, under and around the eyes, nose and chin? I'm worried.
Diluting Botox with 2.5cc of saline is one of the most common dilutions for cosmetic uses, however, the dilution is not really important in the administration of Botox. The total number of units of Botox injected into an area is what will primarily determine the effect of the Botox. A common dosage of Botox for the glabellar area (between the eyebrows) is 20 units divided over 5 injections. If the Botox is diluted with 2.5cc then at each site 0.1cc of Botox would be injected. To achieve the same dosage with a Botox dilution of only 1.0cc would require injections of 0.04cc at each of the 5 sites. With the way syringes are designed, it is actually easier to more precisely inject 0.1cc than 0.04cc. In the end the dilution is not the critical factor. What is important is the number of units of Botox injected.
Due to years of being overweight when I was young, I now have more than the usual amount of loose skin. I am considering liposuction to remove the fat deposits on my thighs but reports I have read suggest that with older people it can result in a 'baggy' effect. I am wondering if, after liposuction, the 'bagginess' can be helped by another type of surgery?
Lipoplasty (liposuction) will reduce the amount of fat that you have between the skin and the underlying muscle layer. It will, however, have no effect on the amount of skin that you have. There can be some contraction of the skin following fat removal but, depending on your skin elasticity, the amount of contraction may be limited. If you have a lot of excess skin now, then it would be reasonable to assume that the problem could become worse following lipoplasty. A skin tightening procedure, such as a thigh lift, may be necessary to correct the “baggy” look. This procedure will leave more extensive scars than lipoplasty alone, but it will improve the contour of the treated areas. An ASAPS-member plastic surgeon can explain this procedure to you and give you a better idea of what the final result will be.