Clifford Albert, MD

Unfortunately as we age 2 things happen-

1)we lose soft tissue losing the natural youthful contours of the facial structure and 

2)we lose bone structure-the orbits become deeper,the jawbone becomes smaller, the maxilla becomes smaller and the nose to lip distance shrinks

The nose being composed of cartilage mostly therefore 'grows' in comparison.

Therefore it is important to use fillers to combat the natural tissue loss that occurs.

I always look at the face and body in the same way using the 'KISS' method-Keep It Simple Sexy based on the four R's of facial rejuvenation-Relax, Refill, Repave, Repair

Relax the lines that move too much with botulinum toxin

Refill lost volume when needed.

Repave fine lines and deep lines with laser and radiofrequency

Repair with surgery when needed (usually the last and most expensive things to do)

The best treatment combines these to give the best result.You can check out my numerous videos on you tube or facebook for more info.

I would recommend a long term filler such as Radiesse which lasts 1-2 years placed in the Nasolabial folds and in the oral commissures around the mouth.This filler will gradually be replaced by collagen and so will give a permanent result without a permanent filler.

To give better definition around the jawline and chin I would use Lipodissolve injections (phosphotidyldeoxycholate). This uses the body's natural process to melt fat via injection and tightens the skin as well via the body's natural healing process.

You also have some mild Rosacea which is akin to a skin allergy.Rosacea is characterized by inflammation, redness and blood vessel dilatation and makes the skin highly sensitive to any irritation so you have to be very careful with wind, sun any skin products.This usually responds well to IPL therapy and may need to be repeated 1-2x/year. Using Elidel will decrease the redness and inflammation.

I would recommend a long term filler such as Radiesse which lasts 1-2 years placed in the cheek areas (although your cheeks are not visible in your photo).This filler will gradually be replaced by collagen and so will give a permanent result without a permanent filler.

To give better definition around the jawline and chin I would use Lipodissolve injections (phosphotidyldeoxycholate). This uses the body's natural process to melt fat via injection and tightens the skin as well via the body's natural healing process.

hi,

I would recommend a long term filler such as Radiesse which lasts 1-2 years placed in the Nasolabial folds and in the oral commissures around the mouth.This filler will gradually be replaced by collagen and so will give a permanent result without a permanent filler.

To give better definition around the jawline and chin I would use Lipodissolve injections (phosphotidyldeoxycholate). This uses the body's natural process to melt fat via injection and tightens the skin as well via the body's natural healing process. 

hi,

I would recommend a long term filler such as Radiesse which lasts 1-2 years placed in the Nasolabial folds.This filler will gradually be replaced by collagen and so will give a permanent result without a permanent filler.