Ask Dr. Karen

Dr-Karen-13Listed here are several common questions Dr. Karen receives.



  1. What are some of the more common requests from patients who want rhinoplasty?

    • Dr. Matthew Karen says:

      Some of the common problems that we see are noses that are too big. Many patients have a “bump” on their nose that we can reduce or eliminate for them. Many patients have broken their noses, and now the nose is twisted, or it has a new bump, or it has a “boxer’s nose” appearance. Some of these patients simply want “their old nose” back, others want additional improvements.

      Many patients have a large, bulbous tip this can make their nose look “bottom-heavy” and unbalanced. Some patients have a droopy nasal tip. Lifting the tip a little can make a tremendous difference in these patients.

      Some patients have noses that are too long, while others have noses that are too short. Some patients have noses that are too wide and it is less common that the patient has a nose that is too narrow.

      Some patients have had a rhinoplasty before but are unhappy with the result. This is called “revision” rhinoplasty.

  2. What is the difference between Restylane and Botox?

    • Dr. Matthew Karen says:

      Restylane is a sugar derivative used to plump up creases in the skin of the face, lip lines, naso-labial folds, marionette lines, tear troughs and cheeks. The injection can be uncomfortable so a topical numbing cream is applied before your procedure to try to alleviate this. Some swelling may occur in the lips for 24-48 hours.

      BOTOX® Cosmetic is a purified protein produced by a bacterium, which reduces the activity of the muscles that cause frown lines between the eyes. Wrinkles are diminished by muscle relaxation not by filling. The procedure takes about 2 minutes and can be performed in the office. The result lasts for approximately 3-4 months. You should avoid any blood thinning products such as aspirin, Motrin, vitamin E, Coumadin, Aleve, Advil or Excedrin for 10 days prior to any injection procedure. Doing so will help decrease the incidence of bruising.

  3. Is there a right age for cosmetic surgery?

    • Dr. Matthew Karen says:

      There is no ideal age to have cosmetic surgery. The time to have an elective procedure is when the desired change will justify the time, effort and the cost involved. Another factor to take into consideration is the potential length of time to enjoy the benefits. For example, if an individual has a facelift earlier in life, the rewards of this surgery can be enjoyed for a greater period of time.

  4. Elizabeth says:

    My eyes get tired at the end of the day. Could this be related to my eyelids?

    • Dr. Matthew Karen says:

      There are several other things that you should check first, with your family doctor and your optometrist or eye doctor. However, sometimes heavy excess skin can weigh down your eyelids and put extra strain on them, so that they can tire out by the end of the day.

  5. What kind of facelift do you perform?

    • Dr. Matthew Karen says:

      We perform standard a standard facelift that tightens the neck and lower face. It requires anesthesia, takes 3 hrs and results last for upto 10-15 yrs. It is called a SMAS facelift. In addition I perform a minifacelift (weekend facelift) which is performed under local anesthesia and has been quite popular and has advantages for pts. The recovery time is a few days and results are excellent. It is ideal for people that do not want a long down time and want a good result. I suggest you come to visit us by making an appointment and we can discuss your needs.

      Dr. K

  6. I have severe damage to the front of my legs due to sun exposure as a teenager.
    Is it possible to have a deep chemical peel on the front of my legs to get rid of the spots?

    I have had the “blue”peel on my face and was very happy with the results.
    Thank you!

    Want to wear skirts again.

    • Dr. Matthew Karen says:

      Hi Sheila,

      The chemical peel wouldn’t really work for your problem. I think you would be wasting good money on something you wouldn’t be happy with in the end. However, I do think that our Obagi line of skin care products would be a good solution to your problem.

      If you could take a few minutes out of your day to stop by and see me, we could determine if that may be the way to go. I will try to find the best solution for you so that you can wear your skirts again!!

      Call my office at 540-667-5105 to set a convenient time to come in.

      Dr. Karen

  7. My top lip disappears when I smile and I have become increasingly self-conscious so much so that I cover my mouth many times when smiling. Is there a procedure that could be done to correct this permanently without making me look like Lisa Rinna?

    • Dr. Matthew Karen says:

      Hi Dawn,

      I would need to see you to properly assess the problem, but conservatively placed fillers and/or a lip implant could help you have a fuller, yet netural looking smile. There are options. Feel free to call my office and schedule a consultation so I can give you a more detailed treatment plan. 540-667-3223

  8. Dr. Matthew Karen says:

    Dear Ann,

    I would need to see your birthmark to make a proper judgement call. I do have some ideas for you, and if it turns out to be something that I don’t handle here in my office, I will recommend someone else that would be able to help you. I will do what I can to help resolve your problem, so just give my office a call and set up an appointment that would be convenient for you and we can get some answers for you.

    Thank you for choosing Exclusively Faces to meet your needs, and I look forward to meeting you in the near future.

    Dr. Karen