My jowls are dropping along with my other facial features. ARRGH! Can you suggest some skin tightening procedures that don't require going under the knife?
People should not expect facelift results from non-facelift treatments. Radiofrequency, fractional laser and CO2 laser all help to tighten skin slightly but won't restore the youthful architecture to the face the way a volume restoring facelift does.
Many patients are happy with minimally invasive treatments, but not patients who have been expecting facelift results.
I have a large practice with patients who ask this same question. Additionally, I myself ask the same question when I look in the mirror, as the years pass by. I have a formula for success.
It begins with the basic foundation-effective medical skin care -skin care products that have therapeutic agents in them in concentrations that can truly effect changes in the collagen- laden dermal layer of the skin. Other vital ingredients boost the vitality of the skin in both the epidermal and dermal layers are topical, including:
Drinking enough water, avoiding the sun, getting enough sleep and avoiding stress, avoiding cigarettes and religious attention to your diet and excercise are all the keystones for preserving the elasticity and radiance of your skin.
Then, there are treatments that do not involve the knife, but can be quite effective, especially if started early and continued on a regular schedule several times a year or what we term as "the club membership approach" to non-surgical treatments.
I advise patients to consider skin tightening procedures that interact with collagen to help it remain organized and supportive in the dermis of the skin.
The Cutera-manufactured "TITAN" procedure is very effective method of tighteninig the skin of the face, jawline, neck and other body areas. The skin is treated with a special wavelength of light and it is very comfortable, and can be completed in one hour with no downtime. We recommend an intial series of 3 to 5 treatments spaced @ 3 weeks apart.
Following the series of inital treatments, the patient is advised to return for the "club" treatments 2 to 4 times a year, quarterly is preferred, to maintain the results and keep the collagen in a regenerative state of flux, favoring collagen generation and preservation. The skin feels immediately smooth following the Titan, and over time, the patient will see a difference, a tightening of the treated areas, especially if you look at picture from 1 to 2 years ago.
You will be pleasantly surprised at how much better you look. It is great for the jowl region, if the jowls are not so saggy that they are in need of being surgically lifted. This is why starting early-at the 1st signs of jowling-is the best time.
I am also impressed with the Cynosure "Affirm" which is a fracional CO2 peel that can be a "programmed peel' for anywhere from 3 to 5 to 7 days of downtime. This is a nonsurgical peel and is quite effective for wrinkles, scars, pigment and demonstrable skin tightneing.
Skin resurfacing techniques can also be used, and I have used various combinations of laser and non-laser light and plasma treatments to peel the skin which can not only treat the surface, smoothing wrinkles, but also treating pigment and causing skin tightening, This can be very effective around the eyes, mouth, jawline and neck.
Dermal fillers, such as Juvederm, Restylane, Radiesse and others are also great allies to have in the battle of aging-as they can be precisely placed along the jawlines to blend the jowl tissue with the surrounding tissue, adding a support layer so the skin in the jowl area does not sag. It is remarkable how powerful the fillers are along the jawline, mouth, cheek and brow regions.
The modern day fillers can be used to lift the face- jowls included, and this is what you hear termed as a "Liquid Facelift."
The Cynosure SmartLipo MPX is a minimally invasive surgical techniques in which a laser beam is used to melt fat and tighten the skin, and this is very effective in the neck.
In the face, one does not want to remove fat, as fat can fill the face and makes it have a youthful plumpness- so in the region of the face, no fat is melted, but the MPX double beam laser is blended to produce skin tightening and this is termed "SmartLifting." It can be combined with other procedures used to rejuvenate the face, and is surgical, but effective and minimally invasive.
These are the major keystones in my practice. I also recommend lighter treatments for maintenance of the skin vitality such as MicroPeels, Vivite Peels (GLX technology glycolic /botanical peels), and microdermabrasion.
Looking great? It is a battle, but is is one that can be won with education, dedication and execution of a maintenance plan, or formula, which I have devised and outlined above.
Every one talks about various fillers and laser treatments but these are very disappointing by themselves. I do think they are helpful as an adjuctive treatment to help improve the results but they can't replace a good Silhouette lift combined with a ribbon lift procedure.
The procedure is done under only local anesthesia and can be done in about 1 1/2 hrs. I use the combination since the ribbon lift gives the greatest pull up and stabilization of the tissue while the silhouette threadlift fine-tunes the skin to smooth out any puckering. Hopefully they will last 3-5 yrs and cost about $3500-5000 for the cheeks/jowls.
Fillers like fat tend to disappear after 6-8 months and leave noticeable lumps or bumps afterwards. These are very popular with full real facelifts since you can place it deeper and fill in areas better at that time.
Thermage and Titan are suppose to tighten the skin a little, but I have yet to see anyone who saw any noticeable improvement even after 3-5 treatments. A tiny improvement, yes, but not worth the $5000 price tag for a series of them.
Other dermal fillers do fine tune the superficial creases nice and are worth it after you first pull up the saggy skin with the lifts. Some people need a little liposuction of the jowls ($1500) if they are too full. This is very easy and can be done at the same time as the tread/ribbon lift.
Radiesse $850/syringe for cheek and Nasolabials Juvederm $550/syringe for lips and under eyes, Lip Verafill Implants for permanent lip augmentations $2000 per lip, Chemical TCA Peels for refreshening the face $1500. As you can see there are a lot of procedures that can be done and new ones are always coming out.
Sincerely,
David Hansen,MD
Although a facelift would provide the definitive solution, there are other modalities if used for the right indications that can provide marked improvements. Lasers such as Thermage (radiofrequency) and Titan (infrared) can provide some dermal tightening with stimulation of callagen synthesis. Yet, one can not expect results similar to a facelift. At best, they provide some minor improvements in skin elasticity and minor skin tightening.
Fillers such as Restylane, Juvederm, and Radiesse can provide volume, which can counteract loss of facial volume that accompanies age and contribute to the sagging appearance of skin. These fillers are temporary and require re-injections at regular intervals (6 months for juvederm and restylane and 1 yr for radiesse).
Permanent fillers are also available such as Artefill - but I usually reserve this for the veteran patient who has prior injection experience.
Then, there are other surgical options other than a straight facelift. These include:
Appropriate utilization of the above modalities either alone or in combinations give excellent results for those individuals who have realistic expectations.
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