ok docs i'm all yours.After weight loss (150 lbs and maintaining yeah me) i'm left with this mess i know the turkey neck needs a knife,But what would you (yes you) suggest for the 1, nasal lab folds 2 eyes 3 cheeks? ( I ask cause I was told that they need attention upper cheeks) had one consult and was given a fat graft consult,not sure about that rout.So i'm looking towards injectables or any other recomendations. details 42,and filled face out very nicely thanx.
Nasol Labial Folds, What Are My Options?
Doctor Answers (6)
Fat or absorbable facial fillers are an option to fill out your face a bit. With weight loss, deflation occurs. Sagging occurs as well, and you may need a facelift as well. An exam would be important to go over the best plan. Good Luck.
Direct excision of nasolabial folds
Direct excsion of nasolabial folds, especially in men, will give a great result. I would resurface the skin at the same time. It is a local procedure, can be done in office. You will spend too much money in fllers, and will not help with the loose skin you have.
Weight loss & facial aging
Aging usually involves both "descent" and "deflation". Descent is best improved with lifting (surgical) while deflation is best improved with inflation (ie, adding volume). Another way of looking at this is that concavities (depressions) are associated with aging and convexities (roundness) are associated with youth. When there has been significant weight loss, usually both descent and deflation are present. So for starters, adding volume with fillers such as Radiesse, Scuptra, fat, and/or the HAs make sense. Both the midface and the nasal labial convexities are important. Good luck! DRC
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Injectables for nasolabial folds
After looking at your photos, It seems you would benefit from some volume enhancements using injectable fillers. While you can have hyaluronic acid based products injected like Restylane and Juvederm, I would also recommend collagen stimulatory product such as sculptra. I think a combination of the two would be ideal to give long lasting natural results with some immediate efficacy.
Facelift after massive weight loss
Your posted photos she excess neck skin, hollowed drawn cheeks, deep nasolabial folds and downward shifting of the soft tissue under the cheek skin. There do not seem to be any marionette lines or jowls. It is unclear how much if any excess cheek skin is present. I can understand that given your history of weight loss you would be reticent to have any fat or anything else injected into your face.
You understand that the neck skin will have to be surgically removed. This is best done via a facelift incision (around the ears and just under the chin). However, in my experience your nasolabial folds are so deep that the facelift alone will not be enough hence the need for some filler there. At the same time with the cheek skin lifted up during surgery the surgeon has access to deeper tissues and will be able to shift lower cheek soft tissue to a higher position on the face.
The photos do not show the eyes clearly but it looks like you have visible tear troughs. That could be addressed at the time of the facelift.
It might be better if you approach this as having lost weight/fat all over in an uneven manner and possibly too much in some areas. The object would then be to shift some fat to areas where there was too much fat loss.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
You may consider an Injectable Filler treatment to add volume to your midface.
I read your concerns and reviewed your photos. After your weight loss, you have lost a lot of volume in your midface. Fat grafting is an option to consider. In my practice, Silikon-1000, an off-label filler for permanent results, may be utilized to restore lost facial volume. You may require several treatments for complete correction. There is typically no downtime.
I hope this is helpful for you.
Regards from NJ.
Web reference: http://ericmjoseph.com/index.cfm/PageID/4247
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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