At the time this video is being recorded, we currently have three neurotoxins approved for cosmetic use by the FDA; Botox, Dysport and Xeomin. The basic techniques for reconstitution are essentially the same for all three with the only difference being the amount of diluent, which is largely determined by injector preference but the diluent itself is the same. Its 0.9% normal bacteriostatic saline. It should be noted that along with diluent volume recommendations, the package inserts for all three recommend reconstitution with preservative free normal saline. And that's because all three manufacturers use preservative free saline in their clinical trials and then in the data which they presented to the FDA for approval. So, therefore, legally, these companies can only tell you to use preservative free saline and they're bound by their FDA approval.

So, as usual, you have to assess the dynamic of the smile, it’s very important, and with this lovely lady, we gotta have a surprise, in fact, that's what I discovered a few minutes ago, in fact. The fact is, normally when you smile, as we say, we have the bone and the gum, so the upper lip is leaning on the teeth and on the gum and the upper lip is reversing naturally, increasing the volume when you smile.

This is an image of anatomy for lips for sculptors, it's very relevant as an injector, we are essentially sculpting the lip shape using fillers. It's important to be aware of the different three-dimensional shapes of the separate regions or subunits of the lips. The upper lip has three central bumps and they can vary in size; in some patients, the central one is larger and the two on either side are smaller; in some patients, the two just lateral to midline of the upper lip are larger and the central one is smaller. In the lower lip, there were two large midline bumps that comprise roughly the central two-thirds of the lower lip. The lateral edges of both the upper and lower lip are flatter than the midline portion and the border of the upper lip tends to be a sharp edge.

Is it normal for Allergan Botox to not have worn off after six months? I'm panicking that this is permanent. I can move my forehead – it's probably back to 80 to 90% movement as it was before, but at the sides of my eyes, it just isn't wearing off. My cheeks are still being pushed forward instead of creasing at the sides of my eyes as it did before. I'm desperate for it to wear off as I hate it. The clinic who did the Allergan Botox said they can't give a timescale for it wearing off. Advice would be greatly appreciated.

A Hyaluronidase for filler removal-specific question. I had filler 2-different time in the past 3-months to fix a dent left in my forehead from cortisone injection. Although it’s now pretty smooth, Dr. […] filled it a little leaving a bruise like shadow, because it’s raise a little and visible in [certain] light. Considering having it dissolved and waiting for my skin to bounce back, my question is what are the risks? Is there any chance of it indenting my skin again or taking away any of the natural collagen of my skin along with the filler?