Ask Our Doctor

Please check this area often as we update it regularly with useful information and advice from Dr. Lach. If you have a question, please feel free to email it by clicking here. We treat your information with utmost confidentiality, and if your question is published, we will use only your first name and location.

Dear Dr. Lach:
I am 45 and considering a mini face-lift. I had blethroplasty last year and  have been using BOTOX for the past three years. Are there any other alternatives you can recommend? I am not ready for a full face-lift but, would like to restore some muscle tone to my skin.   Unfortunately, I  spent a lot of time in the sun when I was younger.
Thank you,
Johanna, Natick

Johanna:
Good news/ Bad news
Bad news: Sun damage is cumulative.  It causes premature aging.
The Good news is, for slightly sagging skin and premature aging, the fractional resurfacing laser has been an excellent addition to our laser practice. My patients are happy with the results.  I can achieve tightening, and line softening after a series.  In addition, I have been able to remove the unsightly brown age spots.  Up until this point any changes were only temporary.  This is a permanent change to your skin.

Dr. Lach:
What is the difference in results between a photofacial and laser resurfacing? I understand the descriptions of each, but which is better for the age spots on my cheeks, for example?
Russ, Boston

Russ:
For age spots, my recommendation would be a photofacial.  Your issue with dark spots are on the upper layers of skin. The penetration depth of the IPL is better suited for this than a laser (which may be too deep and unnecessary).

Dr. Lach:
Can laser resurfacing be used on my chest, for skin exposed in v-line shirts or low-cut dresses? Or is IPL better?   I'm 53 and have sun scars from years of sun bathing. I've successfully used IPL (your photofacial machine) and my face is looking great. I did a series of microdermabrasion in conjunction with IPL, including eliminating some broken cappilaries around my nose. I love the results. But now I'm worried about my chest. It looks old in comparison.
Michele, Cambridge

Michele:
I would recommend Fractional Resurfacing to regenerate new tissue called collagen remodeling.  This laser will cause small wounds beneath the skin causing new tissue to grow.   Scars will be less apparent.

Dear Dr. Lach:
Which is better for treating puppet lines around my mouth, radiesse or restylane? I also have a line across the top of my nose, between my eye brows. Is that treatable with a filler or is it BOTOX?
Jason, Boston

Jason:
To properly assess you, we would need to see you in person.  However, for lines around the mouth, we are recommending Radiesse.   Radiesse nd is a thicker injectable requiring less product and lasts much longer than Restylane.  As for the line across your nose, Botox will definitely soften the appearance and if necessary we can fill it.