Anna Petropoulos, MD, FRCS

Hello and thank you for your question! Yes, you can likely have Thermage with cheek Gore-Tex implants, but there are some precautions to consider. Gore-Tex is non-metallic and doesn’t conduct heat, so it’s generally safer than metal implants when using radiofrequency. However, Thermage does deliver heat to deeper skin layers, and this could potentially cause localized swelling, discomfort, or tissue tightening around the implant, which may slightly affect its position if not securely placed. You’re likely a good candidate if: -Your implants are well-healed, stable, and placed deep enough. -You haven’t had issues like shifting, inflammation, or visible edges. -Your provider is experienced and avoids aggressive passes directly over the implants. It’s best to consult both your aesthetic provider and, if possible, the surgeon who placed the implants to ensure personalized safety. Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question. "Ozempic face" refers to facial fat loss, often due to weight loss on semaglutide. However, even with minimal weight loss (like your 5 lbs), some patients experience disproportionate facial volume loss, likely due to individual fat distribution or sensitivity. A facelift will tighten and lift tissue, but it won’t prevent further volume loss if the underlying cause (Ozempic) continues. So yes—resuming Ozempic after a facelift could lead to recurrence of facial hollowing. If you're not getting significant glycemic or weight benefit from Ozempic, and cosmetic effects are concerning, it’s reasonable to consider switching to another diabetes medication. Options include: Dulaglutide (Trulicity) – another GLP-1 with less facial fat loss reported SGLT2 inhibitors (e.g., Jardiance) – weight-neutral or mild loss DPP-4 inhibitors (e.g., Januvia) – weight-neutral Discuss this with an endocrinologist and, if planning surgery, a facial plastic surgeon familiar with GLP-1 effects. From the non-surgical perspective, treatments like RF-microneedling and Sculptra can combat or even prevent some of these Ozempic-related changes- that may be worth looking into! Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question! Ozempic is the FDA-approved brand-name version of semaglutide, made by Novo Nordisk with strict quality control. Compounded semaglutide is not FDA-approved, but it can be very safe when made by a reputable compounding pharmacy. The key is that your provider does their research—using only trusted, accredited pharmacies that follow high-quality standards. Should you worry? Not if you're under the care of a knowledgeable provider who ensures the compound is the correct form (semaglutide base, not salt) and comes from a certified pharmacy. When done right, many people use compounded semaglutide safely and effectively. If you’re 25 lbs overweight, you may qualify for Wegovy (FDA-approved for weight loss), but compounded versions can be a good alternative when prescribed responsibly. Best of luck! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question! At 32, it's not uncommon to start noticing midface volume loss and early signs of skin laxity. The flattening of the midface and changes under the eyes you mentioned are typically due to a combination of fat pad descent, bone remodeling, and early collagen loss. Here are some treatment options based on your concerns: 1. Non-Surgical Lifting & Skin Tightening Morpheus8 (RF Microneedling): Helps tighten the skin, stimulate collagen, and slightly improve volume over time, especially around the eyes and midface. Thermage FLX: Uses radiofrequency to tighten and lift skin by stimulating deeper collagen remodeling—ideal for subtle lifting in the mid and lower face, including pre-jowls. These are great options if you're not quite ready for surgery and want to prevent further sagging. 2. Volume Restoration Hyaluronic Acid Fillers: Can restore midface volume, improve under-eye hollowing, and offer a natural lift when done conservatively. Sculptra: A collagen stimulator that works gradually to restore lost volume and improve skin quality over time—excellent for long-term structural support. 3. Blepharoplasty vs. Botox Upper Blepharoplasty is usually reserved for true skin redundancy. If you're unsure, a skilled provider can assess whether it's skin laxity or brow position that's contributing. Botox can gently lift the brows and open the eyes—ideal if you're not yet ready for surgery and have mild heaviness. 4. Endoscopic Midface Lift This surgical option is indeed trending in younger patients who have noticeable midface descent but good skin quality. It repositions deeper tissues rather than adding volume. It's best suited for someone who: Has minimal to moderate sagging Wants a longer-term structural lift without filler Is not seeing enough improvement from non-surgical options If your primary concerns are volume loss and early skin laxity, starting with non-invasive options like Morpheus8, Thermage, or subtle filler may provide the results you're looking for without downtime. If you're already noticing significant descent and want longer-term results with minimal maintenance, then a consult with a facial plastic surgeon about an endoscopic midface lift might be worthwhile. A personalized consultation with an experienced injector and/or facial surgeon can help determine what will give you the best aesthetic outcome. It’s not always about doing the most—it’s about doing what fits your anatomy and goals. Best of luck in your journey! Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA

Hello and thank you for your question! From your description and photos, you're likely dealing with a combination of residual volume and skin laxity. If manually pulling your skin improves your jawline shape, the most effective and lasting solution would likely be a lower facelift or deep-plane neck lift. This surgical option lifts and tightens deeper tissues along the jawline and neck, removes excess skin, and refines the contour for a more feminine and defined look. For a less invasive approach, radiofrequency-based skin tightening treatments like FaceTite or AccuTite can target residual fat and improve skin laxity, often combined with small-volume liposuction. Results build over time and can last for several years. Another minimally invasive option to consider is a Miracu thread lift, which uses long-lasting PDO threads to lift and reposition the skin along the jawline and lower face. While not permanent, this treatment can provide immediate lift with collagen-stimulating effects that continue to improve the skin over several months. It’s a good option if you're not ready for surgery but want visible improvement. Lastly, if your jaw appears wide due to overactive masseter muscles, Botox in that area can slim the face over time by reducing muscle bulk, giving a softer and more contoured jawline. If you're seeking a tighter, more defined look that mimics the effect you see when pulling your skin back, a lower facelift, FaceTite, or Miracu thread lift—possibly combined with masseter Botox—would offer the best results. A consultation with a facial plastic surgeon or aesthetic provider familiar with advanced contouring options will help determine the most appropriate plan for your goals. Best of luck in your journey!f Genie Alexander, RN BSN for Anna Petropoulos, MD FRCS Center for Classic Beauty Boston & Danvers, MA