Im 33, and Looking at Antiaging. Am I Too Young for Ulthera? Fraxel? Botox is Too Frozen for Me.

Even though my skin doesnt have terrible elasticity, my eyes and forehead make me look at least 5 years older than i am. I had botox and dysport once in my forehead, but i really dont like the frozen look, plus i know i had to repeat the treatment for a few times to remove the forehead wrinkles, which I didnt. In Bangkok where I live, they have suggested fillers in my eyes, which petrifies me. Then someone suggested fraxel, and someone else suggested Ulthera. Any thoughts very appreciated.

Doctor Answers 7

Ultherapy, Fraxel, Facial Fillers and Botox - Facial Rejuvenation

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If done correctly, Botox will not give you a 'frozen look'. Ultherapy is super to tighten the skin in the mid and lower face, jawline and neck as well as providing you with a subtle brow lift. Facial fillers will rejuvenate the face and replenish volume lost in the nasolabial folds, marionette line, tear troughs, lip, etc. 

Ulthera will give you skin tightening

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It really depends on what you are trying to achieve.
Fraxel will improve the coloring (brown spots) and fine lines (wrinkles).
Ulthera will give you a subtle lift to your brows, midface, and jawline.
Fillers under the eye fill in a sunken tear trough. 
If done properly, Botox should not make you look frozen.  It should just soften the lines and movement of your face.
Often, it is a combination of all of the above that ironically gives the most natural, subtle, younger look, because that brings everything back into harmony.
Best, Dr McNeill

Anne Marie McNeill, MD, PhD
Newport Beach Dermatologic Surgeon
5.0 out of 5 stars 1 review

Tightening and lifting with Ultherapy and rejvenation with Fraxel

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There are patients in their late twenties who can benefit from ultherapy facial tightening and Fraxel skin rejuvenation. There are many variables including genetics, the amount of sun exposure in the past, smoking history, skin type, etc. that create a different level in the aging process of one patient's skin vs. that of another. These factors are considered in the consultation with the physician who then creates a treatment plan for that patient. Chronologic age, by itself, is not a determining factor.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Ultherapy Candidate

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Thank you for your question. Based on the information you shared, I believe you would be an excellent candidate for Ultherapy. A good candidate for Ultherapy is someone with skin that has "relaxed" to the point of looking, and often feeling, less firm. A lowered eyebrow line or sagging skin on the eyelids, for instance, is often the first sign of "maturing" skin. Typically, those in their thirties and older who have mild to moderate skin laxity are candidates.

Keeping Your Youthful Skin

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Ultherapy, BOTOX, Fraxel; each of the treatment choices you mentioned can play a role in improving your appearance. In order to minimize sagging skin, wrinkles, age spots, volume loss, these treatments are helpful. BOTOX, when used correctly, should not give you a "frozen" look. When the right amount of BOTOX is used, you should have just enough to relax the muscle so you can't make/create the wrinkle in your face and still look natural.  The treatments you mention produce different results, and you should consult with a qualified physician to review your goals, and to discuss treatment options. By addressing things early, you'll have a long tine to enjoy your youthful looks.

James Chan, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Treatment Options for Antiaging Concerns

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Age sometimes is not as important as genetics, so "starting" age for taking care of things that bother you is not important.

Ultherapy is a lifting procedure that can raise your brow and tighten up the face and neck. For wrinkles it's not the first suggestion I'd make.

As to wrinkle removing, if your wrinkles are caused by muscle movement, then the best course of action is Botox and/or Dysport.

If they are wrinkles from sun exposure and collagen breakdown, then you can get some relief with fractional laser and or fillers.

Despite the fact that you would need to repeat Botox or Dysport, if you have habitual muscle activity that's making those wrinkles, then using a relaxer will help prevent them from setting in. Plus, used in the right muscles, you can easily affect a temporary brow lift.

Used appropriately, Botox will not cause a frozen look. Obviously too much can give anyone a stone face and agreed, it is not attractive.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Ulthera is a great option

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Ulthera is a fantastic option for you.  It is very safe and can induce significant connective tissue changes to tone the dermis and deep fascial layers.  It also can be repeated with continued improvement.  I hope this helps!  Good luck!  If you have darker skin tones you must be very careful with fraxel or any of the carbon dioxide lasers, which can result in hyperpigmentation or hypopigmentation.  Ulthera is very safe for the epidermis and is essentially color blind since it is focused sound waves.

Curt Samlaska, MD
Las Vegas Dermatologist

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.