Nonsurgical facial rejuvenation

Think of your face in three zones.  The upper 1/3rd starts at the hairline and extends to the bridge of the nose.  The middle 1/3rd continues to the base of the nose and the lower 1/3rd includes the jaw and neck. 

Here are solutions for each zone:

Upper: Botox to alleviate the forehead wrinkles and furrows as well as to nonsurgically raise the brows.  Hyaluronic acid fillers to further "erase" the wrinkles around the scowl lines and brow lines.  Sculptra to fill the temple hollows and round out the brow.

Middle: Hyaluronic acid fillers: Perlane or Juvederm UltraPlus for cheek volumization.  Prevelle silk or the finer HAs, Restylane or Juvederm for the hollows under the eyelids or crow's feet lines.

Lower: Evolence (porcine collagen) for deep nasolabial lines.  Sculptra for hollows under the cheek bones.  Radiesse for the prejowl sulcus (the area in front of the mandibular jowls) and for better chin projection.  HAs to support the corners of the mouth and plump out the vermillion border of the lips.  Botox to neutralize the corners of the mouth (DAOs), soften the lipstick bleed lines, relax the platysmal bands.  Sculptra has been used, in extremely dilute concentrations to retexturize the neck and decolletage; this is an "off label" indication.

Overall skin texture can be improved by light based therapies, such as Lumenis, Active Fx, etc as well as retinols, moisturizers and sunscreen.  While these may not produce as dramatic results as a surgical procedure, they are complimentary and depending on your endpoints may result in great satisfaction.  good luck.

The Liquid Face Lift is a painless, 30 minute, in-office procedure usually performed by a physician very experienced in filler and BOTOX injections. Utilizing various fillers and Botox Cosmetic, a Liquid Face Lift (LFL) can rejuvenate and lift your face to create a naturally younger look.

A LFL can:
Fill in wrinkles and folds, such as smile lines and marionette lines.
Smooth out frown lines, crows feet and forehead lines
Enhance and lift cheeks.
Restore volume to flattening and sagging areas.
Lift eyebrows up to their youthful position.
Hide bags under eyes.
Reduce jowls and create a straighter jawline.
Plump lips and smooth out lip wrinkles.
Lift up sagging corners of the mouth.

I recommend you have a consult with an experienced dermatologist or plastic surgeon who performs this technique to see if you are a candidiate.

This is a very common question in my practice. Mild and moderate skin laxity and droopiness of facial structures could be addressed with non surgical techniques; however marked anatomical facial changes will require some surgical intervention.

To summarize:

1. General care: Proper skin care, sun screens, hydration, healthy food, exercise.
2. Photo facial and lasers: Are helpful to achieve some tightening, resurfacing and reversal of dark spots or small blood vessels. This is not an alternative to surgery and in the same time it is important to avoid aggressive skin resurfacing that could lead to Hypopigmentation.
3. Botox, fillers: Very useful in elimation of skin lines, Different names used e.g. liquid face lift, etc...The key is moderation too much filler could leave an unnatural appearance. Start with hyaluronic based products until you like the result before using longer lasting ones.
4. Minor surgical techniques: In many occasions an upper lid surgery or a neck liposuction (under local as an office based procedure) could address the most relevant facial aging signs.

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A 'Liquid Facelift' is a nice non-surgical alternative to a facelift, especially when combined with different skin tightening lasers. A Liquid Facelift may include Botox along with dermal fillers such as Juvederm, Restylane, or Radiesse. However, realize this is still not the same as a true surgical full facial rejuvenation procedure such as an endoscopic browlift, upper and lower blepharoplasty (eyelid tuck) and a facelift or necklift.  Many surgical patients benefit from non surgical options in addition to their surgical procedures.

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