Blog with Dr. Irwin


Hi Dr. Irwin, First, I love your blog. You answer so many of my questions. I have been seeing a dermatolgist for approximately one year now. I have had perlane and restalyne and botox with him . But, I am very concerned over the staying power. In September of 2009 I had two vials of Radiasse placed in my cheeks (for some hollowing) and nasolabial lines. It looked fabulous for about 3 -4 weeks. In october I needed another vial. End of November 2 more vials and 90 units of botox (forehead, eyes, lines around mouth, chest) Now it is approaching Feb and I see that that I have hollowing again on the right side, and the laughlines are back (not as deep, certainly, but defintely back). I also get about 90 units of botox approximately every 2-3 months. This is breaking my bank! Is this normal? Prior to the Radiasse, I had almost 6 vials of perlane starting back in March of 2009 through August. I believe I have spent over $10,000 in less than a year on fillers. The Dr is now recommending Scuptra. I don't know anyone who has this problem. What do you think? Is this normal? I can send you a picture.

Thank you -  I LOVE doing this blog! 

 Something seems odd to me.  In  18 years of practice, I've never seen anyone go through so much product, unless you are in your 70s or 80s.  And, I... more


I am 50 yrs old, I feel like I'm 30 but when I look in the mirror, I see differently. My face has always been thin and over the past 2-3 years I have developed this loose skin starting to sag under my chin - I am so self conscious of it. I was told that I should consider Thermage and Sculptra - right now I cannot afford both procedures, which one would you recommend to help with the sagging. Thanks so much!

If you are a low body weight person, loss of volume is probably more your issue, soI would definately vote for Sculptra (with the understanding that you'll need 2-3 treatments over a 6... more


Problem with Evolence?

Posted in March 2010 on Mar 09, 2010 | Permalink

I was wondering if you can shed some light on why I have bumps where they injected a filler. The filler was evolance and it has been over three months now and I can still feel the "bump" and I can see it if I stretch the skin. I was wondering if that is normal and what it is? It's not noticeable to someone else unless I show them.
I don't use Evolence but I know from dermatology meetings and journals that there have been some problems with this product.  The best thing to do is go back to the doctor who did the... more

how do you get rid of your acne that is one your; back, alittle on your chest, and your face in under a week?
Well -  the answer to this is you can't but....... you can make a huge improvement in it depending on what type of acne you have.  You'll need to see your doctor for prescription... more

hi My name is Mary,I am 19.For about 2 years I have these tiny skin colored bumps on the right and left side of my chin.when I get warm or the weather does. they go from tiny to puffy.Then if one decides to erupt it looks like heck.The texture is like brail.There is a tiny little black dot in each one.What would u recommend? I was thinking about starting to use a glycolic face wash,glycolic atringent and cueva lotion I think thats how it spelled .My skin is caucasian and its not thin it pretty resilant in the since that its not thin.luckily....You see them the most from the side views and in different lightening.

Mary -   the little black dots on your chin are probably a type of mild acne (open comedones).  And, if you're 19, you're probably still pretty oily especially in warmer weather.  I think... more


Hi, I live in alaska so cant come in every 4wks for a repeat of the faxel lazer so can you go a little deeper on just one treatment and how much does it cost.?? John turner turnerjcj2000@yahoo.com

John -  Basically Fraxel works best done in a series of 3-5 depending on your situation.  It's possible to do a more aggressive treatment but, if you can really only get one treatment, you... more


hello,i'm dr.olga from ukraine and living in jordan,i'm planing to open beauty clinic and i need hair remuval machine,what the better to bring diod lazer(lightsheer)or ipl,so i can do hair mremuval and also some skin procedureplease i'm so confuse,please i need your advise

Dr. Olga -   I have to confess, I'm a little worried that you are planning to open a clinic to treat patients in Jordan and don't know the answers to these questions.  Could you consider... more


Can Scuptra reactivate (in a good way) months later?

Posted in Untagged  on Feb 26, 2010 | Permalink

Dr. Irwin, I had the last of my sculptra injections in cheeks, face and temples. 15 months ago. A week ago, I had another vial injected into my temples as they were still somewhat sunken in. I feel like the collagen in my cheeks and face had a response of some kind. Would it be transitory swelling, or am I producing more collagen in my cheeks because of some stimulation from the temple injections? I know it sound far fetched, but I always respect your opinion on these mattters. thanks
I think that's probably some transitory swelling related to the sterile water that the product is mixed with prior to injection.  It usually lasts 1-3 days. If it persists, have your doctor... more

What is too young for Botox?

Posted in Untagged  on Feb 26, 2010 | Permalink

Dr. Irwin, How long can u use botox...I hear girls in there 20 staring allready...I would think 50 yreas old would be a good start...I use topical serum for fine lines and trying to hold out as long as possible...also by using botox is more preventative the longer you use it? Thanks! :)
I really agree with you!!!  I think 20 is waaay too young.  I really discourage patients under 40 unless they have real lines to treat.  If someone is getting real frown lines in the center... more

What is a good moisturizer for dry skin and acne?

Posted in Untagged  on Feb 26, 2010 | Permalink

Hi Dr i am 29 and my skin is very dry and nowadays i apply moisture and that onwards pimpiles(ACNE) are coming pls tell me what type of moisturiser will you suggest

For that tough situation with dry skin and acne, I really recommend the SkinCeuticals Vitamin B5 Hydrating Gel.  It hydrates well without adding oil or clogging pores.  If you're still dry... more

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