Without examining patients in person, looking at a two dimensional photograph does not allow a physician to make accurate diagnoses and I would not be able to make the best recommendation. From looking at your very young face in this photograph, I see aesthetically pleasing proportions of the convex curvatures of the cheekbones, no atrophy or wasting of volume. Smile folds and marionette lines are common with smiling and looking natural is as important for an actor or actress as plumping up their face. When skin starts to lose tightness, even before the skin shows sagging, then some facial tightening procedures can help maintain one's youthfulness and I suggest in my NYC practice, for many patients who are in this stage, a series of radiofrequency energy treatments such as ThermiSmooth, or one Ultherapy treatment or Thermage. When skin shows its sagging, then more intense Ultherapy treatments, or minimally invasive ThermiTight and Instaflift suture lifting procedures can be done but the latter two procedures have some downtime (although it is much less with InstaLift). When there is volume loss in temples, cheeks, lips and other facial areas, then fillers of different thicknesses, meant for different depths of placement, are recommended. Botox helps lines that are related to muscle movement, and it is especially important for actors to avoid havimg an inexperienced provider over-botoxing their face creating an emotionless mask. My aesthetic goal is to provide natural looking results, not have my patients spend money on procedures they don't need and to tell patients when they don't need anything yet. This type of recommendation only can be made after an in-person examination, when I view my patients from different angles, and observe their facial contours and lines at rest and with movement.Subtle corrections with small amounts of fillers can create beautiful and significant results in some patients. Finesse and an artistic eye is critical when a provider treats a person's face that needs minimal improvement.
