Is It Possible to Make a 30 Year Old Look in Her Mid Twenties Again?

Question

I have noticed some hollowness under my eyes since I have turned thirty. My ear through is more visible and I have lost a lot of volume in my upper cheeks, they have started to "sag" a little. I was wondering if these are things that can be repaired. To fill up the tear through would it be best to use an implant or fillers? Can you move the muscles in my upper cheek back to their position as when I was younger? What procedure would be necessary? Is itpossible? I want to look fresh like when 25

Jason Emer, MD · Answer

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Sanusi Umar, MD · Answer

Based on what you are describing, Radiesse is probably the best solution to fix these issues.

	Unlike many other forms of dermal fillers, Radiesse has the ability to offer structural support.

	It is made of calcium based microspheres in a gel.  This calcium is able to provide structure, rather than filling in depleted volume.  So it is quite versatile since it will conform to different tissues.

	Radiesse can be used for non surgical cheek lifts.

	And it is a wonderful filler for the tear troughs.

	Here is a patient video which addresses the concerns you mentioned. Radiesse was used to lift her cheeks and correct the signs of aging in her tear troughs

William Portuese, MD · Answer

Flat and saggy cheeks are usually best addressed with cheek implants. These implants are composed of silicone and are inserted through an intraoral incision just above the upper teeth and placed directly over the bone to lift the soft tissues. Tightening of cheek muscles is not necessary.

Michael Law, MD · Answer

Structural fat grafting is a powerful tool for correcting one of the primary processes of facial aging: the gradual loss of facial soft tissue volume, which primarily represents the atrophy of facial fatty tissue. The importance of restoring facial fullness cannot be emphasized enough, for without it, very few facial cosmetic surgical procedures are truly rejuvenating. As we age the skeletal features of the face become more obvious, and create subtle visual clues that tell the observer 'this is an older person'. Fat atrophy is often very obvious when it appears as hollowness in the temple area and as flattening of formerly full cheeks, but can also exist as more subtle changes that still convey an appearance of advancing age, such as the development of a hollow in the space between the upper lid and eyebrow, or as indentations in a formerly smooth and gently curving jawline.

	Lifting skin and trimming the excess has been the standard approach to the treatment of facial aging for centuries, but when performed without some means of restoring the youthful fullness of facial soft tissues, the result is an older-looking person with tighter skin. The word 'rejuvenation' means literally 'to restore youthfulness' or 'to make young again', so if the goal of surgery is to rejuvenate the face then it cannot be accomplished solely by means of redraping the skin and removing the excess.

	In my practice fat grafting is not an afterthought that is thrown into the surgical plan for the occasional patient. It is a key component of almost every major facial rejuvenation surgery that I perform. It is in fact that very first part of the surgical procedure for my patients undergoing a full facial rejuvenation surgery.

	Fat grafting also gives the surgeon the ability to provide a minimally invasive, quick recovery solution for some of the earliest signs of facial aging, in many patients long before they could or should consider a more involved (and much longer recovery) procedure like a facelift. Most people show evidence of facial soft tissue atrophy in their thirties, long before they develop the degree of skin laxity that warrants skin redraping and removal. So younger patients now have a means for 'turning the clock back' by maintaining or restoring facial fullness through structural fat grafting. These enhancements look beautiful and natural, not like surgery, and over and over I hear fat grafting patients tell me that "none of my friends or co-workers can figure out why I look so great".

	As with any cosmetic surgical procedure, there can certainly be 'too much of a good thing'. Over-grafting of fatty tissue will distort facial features and produce unnatural proportions that look like surgery rather than appearing to turn back the clock. An important part of my preoperative evaluation is reviewing photographs with patients from their twenties and thirties (and from their forties for patients in their sixties and seventies). Such photographs are invaluable in confirming the manner in which a face has aged, and in planning a surgery that is designed to help a patient look more like their youthful self.

Samir Shureih, MD · Answer

You are describing the typical facial aging, loss of volume or deflation of the face. Drooping and loss of elasticity. All these changes can be reversed and rejuvenated. Fat transfer to the face where fat was lost. and a face lift to lift the structures and put them back where they belong. You need to understand the surgery, the risks, and cost then choose the right plastic surgeon with proper credentials and experience.

Stephen Weber MD, FACS · Answer

Yes. These changes are possible. For most women in their 30s, injectable dermal fillers are the best option for cheek augmentation or filling in the tear trough. This is a non-surgical procedure and can be performed in the office. The results look natural and last about 9-12 months. Cheek and undereye injections are not for rookie injectors. Make sure that you consult with an experienced Plastic Surgeon or Dermatologist for your injections. I hope this information is helpful.Stephen Weber MD, FACS

Robert E. Zaworski, MD (retired) · Answer

Without seeing pictures, I cannot determine what is needed. Based on the information you have given, it sounds like you could be a candidate for fat grafts and/or cheek implants. You should consult with a Board Certified Plastic Surgeon, certified by the American Society of Plastic Surgeons (ASPS) for an evaluation.

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