Botox and Exilis

Q: I got treated with Botox for migraines three months ago and it was not effective. It was done by a neurologist and when I asked why it did not work, he said he did it in the “standard Food and Drug Administration” way by a band formation around the head, neck and forehead. This is so disappointing and I paid around $3,000 to have it done.

A: That is certainly disappointing to hear not, only because it did not work, but because of the way it was done. Botox works for a select group of migraine patients who have identifiable peripheral trigger points in the frontal, temporal and occipital regions by both examination and history. It is these very specific points which are injected, not in a random method. You may benefit by Botox injections if you have these trigger points, so your lack of improvement is more likely due to you are either not a good candidateor the injection approach was flawed.

Q: I had liposuction six months ago that has left me with some unevenness over the thigh areas. The skin has some dimpling and a few more obvious humps in the upper portion of outer thighs. My doctor told me to give it six months after surgery to see if they would smooth out, and they definitely haven’t. Would Exilis be able to fix or improve how this looks?

A: Skin irregularities are the result of an uneven fat layer under the skin. They can become apparent after liposuction due to pre-existing cellulite, poor skin elasticity and an irregular layering of residual fat left behind. One has to look carefully at the lumps and bumps to determine if filling the indentations, decreasing the height of the lumps or some combination approach is best.

Exilis is a radiofrequency device that does spot fat reduction and has some degree of a skin-tightening effect. I find it to be one of the best nonsurgical approaches to treat liposuction deformities available today. It will likely have some beneficial effects on the contour of the thigh skin by helping to reduce the thicker or raised fat areas. It usually requires three or four treatments done in the office every two weeks to see the best effect.

But if the indentations are the main contour problems, those are best treated by fat injections.