Botox and Fillers

Q: I am 36 years old and was considering to start using the kinerase restructure firming cream at skin is not bad but, I am beginning to see crow's feet aroung the eyes & "smile" lines around my the mouth area & just a touch of "less firming" in my face. Would you suggest me using the cream?

Esthetician: Absolutley, Kinerase is a great line as is all the products we carry.


Q: Hi Dr.Berger,
I have a couple of heredity vertical lines going across my neck area (my face is pretty much wrinkle free, even at 49) Is there any anti-aging glycolic treatment you can recommend for me to use at home on this?
(I would not be interested in trying BOTOX® or anything harsher.)
Thank you for any info.

Esthetician: You should look into getting the first signs of aging kit from dermalogica.


Q: Dr. Berger,
I would like to have Juvaderm put in my upper lip for more fullness. I was wondering if there is any harm in having this procedure done while breastfeeding? If it's a naturally occurring substance in the body what is the harm?

Dr. Berger: Sarah, congrats on the new baby! Juvaderm is just Hyaluronic acid… it’s the same across every mammalian species. In fact, they could put HA from my schnauzer puppy into me and I’d be fine. No problem recorded with this product as far as I know.
If your post baby tummy loses the weight, but not the loose skin, consider abdominal Titans… they really are wonderful.


Q: Hello,
I have a question regarding under eye wrinkles. I am only 19 and I developed wrinkles under my eyes. What can I do to rid myself of these under eye wrinkles because again I am only 19? I greatly appreciate your feedback. Thank you so much for taking the time to read my message.

Dr. Berger: Dear Jazmine,
retinol and retin-A products are great for this, providing your skin is not too sensitive to handle them. You’re wise to start young. Anti-aging skin care starts BEFORE we age... not after.


Q: I'm 51 and just starting to get a few lines on my face, would BOTOX® be the answer?

Dr. Berger: BOTOX® is the answer to a lot of questions. Someday there will be a religion where BOTOX® will be a sacrament. It will prevent the scrunching and wrinkling that leads to furrows, and prevent the lines from worsening. Be religious in it's application. Every 4 months.
Go to a cosmetic laser/plastic/derm specialist… please don't let your dentist, GYN or podiatrist play with your pretty face.
As for existing lines, I REALLY like the Pearl treatment from CUTERA, or Laser genesis. I really do NOT like Fraxel.


Q: 1) I am interested in your opinion of Strivectin Serum.
2) I have heard that there are preservatives in the Strivectin serum.
What are the names of these preservatives? 
3) I have also heard that these preservatives may be linked to some cases of breast cancer. On a scale of 1-10, with 1 indicating 0 risk and 10 indicating absolute risk, where would you rate the Cancer risk due to each preservative in Strivectin serum?
4) Is Strivectin Serum ever ingested, or is it only used topically?
5) If Strivectin Serum is used both ways, would you please indicate HOW it was used in the study(ies) you quote in your answer(s)to me?

Dr. Berger: Dear Ariel,
Strivectin is an ordinary moisturizer and potentially quite irritating. It’s basic components are the emollients sesame oil and alkyl benzoate.
Organic, high quality sesame oil costs $14 a quart at!
See for yourself.
In my considered opinion, there are no ingredients in Strivectin which could possibly justify its unconscionably high price.
It is neither an effective treatment for stretch marks and, as regards the claim "better than BOTOX®", whom do they think they're fooling?
Nothing is better than BOTOX®. Its main "active" ingredient is a peptide molecule too large to penetrate the skin and even reach the dermis, where stretch marks and wrinkles are formed.


Q: Dear Dr. Berger,
what do you think of the new snake venom synthetic(Syn-Ake) alternative to Botox treatment? Please advise. Are the results the same?

Dr. Berger: Dear Dave,
why not just stick with what works? BOTOX® has been around long enough and is proven safe and effective (in the right hands!). Go to a good Derm, Plastics or Laser guy and get the real thing. Leave snake venom to the snake oil salesmen for now and we’ll talk about this again in a few years.


Q: Dear Dr. Berger,
please let me know what the best product is available for lip plumping. There are SO many products on the market it makes it very difficult to know which one to purchase.
I am 49 and my lips are disappearing. They have always been rather thin, but lately it is scary to watch how insignificant the outline is and how they are no longer plump in any way. I have not seen any lip augmentations that I find natural (I suppose they are out there) and I can't afford $1000 treatments of Restylane twice a year to plump my lips on a long term basis. Please give me your advice. Thanks so much for your time and attention, it is much appreciated!! (I’m sure I’m not the only woman with this question - ha!)
Sincerely, Valesca

Dr. Berger: Dear Valesca,
all the lip plumping products are essentially geared for the younger market. As we age, we lose lip volume in a way that plumpers just can’t keep up with. Restylane is really the only option which truly works. Try a few of the OTC plumpers and you’ll see what I mean.
It’s really hard to get great filler work done these days, as every MD thinks they’re an artist! LOL I know what you mean. I see patients whose lips get through the door several minutes before they arrive. Find a physician who knows that "less is more" and who does fillers for $750/syringe... like me.