Travis James, DO

Thanks for your question. In my opinion, there isn’t a one size fits all treatment for acne scarring. The reality is there are different types of acne scarring that require different types of treatment. In your type of acne scarring I really think you would benefit from the CO2 and fillers, plus or minus subcision. I am not as familiar with the infini RF but I do think this could be helpful but in my opinion you would benefit from some HA based fillers or my preference would be to do hyperdilute Radiesse filler to stimulate collage and elastin to help with the overall contour. The Alma hybrid laser is a great CO2 laser that combines non-ablative fractional resurfacing along with the CO2 which I think would be ideal to treat acne scarring as it gives you the benefits of both the ablative and non-ablative treatments. I would recommend seeking out a board certified dermatologist or plastic surgeon that is family with acne scarring for your treatment. Good luck.
Dr. James

Thanks for your question. First off, everyone’s face is different and unique and even though they talk about the ideal heart shaped face there are many beautiful women out there that don’t follow this exactly. In review of your pictures, at rest it appears you might benefit from Botox/Dysport treatment to your masseter muscles which are the muscles involved in chewing. In your at rest picture it seems like this would help achieve what you are desiring. In general you have a great smile and you have great cheeks, the masseter hypertrophy gives more of that square jaw which I believe is what you are really seeing and responds great to toxin. As with any cosmetic treatment, I would encourage you to seek out a skilled board certified dermatologist or plastic surgeon for this treatment. Hope this helps.
Dr. James

In general the technology available isn’t necessarily dependent upon whether it is a med spa vs a dermatologist as laser hair removal is generally not as restricted as other devices. As a dermatologist our training and board exams include information that demonstrate an understanding of the different laser technologies and the science behind them. I think the big difference, speaking generally, is that there is likely to be more customization and increasing intensity of treatment when you seek treatment at a dermatologist office as there may be a better understanding of the technology more than the technology itself being better. You can have the best laser in the world but if you don’t understand it you are unlikely to get great results as well as it becomes much more dangerous with increased frequency of bad outcomes. The other aspect that needs to be kept in mind when considering the difference is that dermatologist are specialists of the hair, skin and nails so it could be assessing the hair to ensure it is the type that would respond well to laser hair removal because really fine vellus type hairs typically don’t respond very well. Hope this was helpful.
Dr. James

Was there known trauma to this location. The expectation of resolution is really dependent upon the cause. I would recommend evaluation by a board certified dermatologist and then better recommendations could be made. Good luck.
Dr. James

In short there is no one size fits all approach to aging. In reality people often need to do multiple things to address the different aspects of aging. I would highly consider treatment initially with sculptra as this has the benefit of helping with some of the hollowness as well as you often see improvement in the quality of the skin. In regards to the ptosis there are some improvements that can be had non-invasive with things such as RF microneedling devices, more specifically the Agnes RF as it is a little different than traditional microneedling RF but eventually would likely need a blepharoplasty. Hope that’s helpful. Good luck.
Dr. James