Age 30. Sagging Cheeks Causing Prominent Nasolabial Creases and Jowls. Not Interested in Fillers?

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Thank you for the question.  Without photos and a direct examination, it is always tricky to give out good advice in this arena.  But, in general, in someone of your age, skin excess is typically not your enemy.  Thus, a face lift or other skin tightening measure is probably not necessary.  If you feel that you have lost some cheek volume and your skin hangs or sags differently, then replacing that volume may be your best bet.  To do that, you would either have to utilize a filler via injection or a fat grafting procedure.  Both options can ultimately get you similar results.  Fat grafting is certainly more permanent when the fat takes well.  It is a bit more involved since you need to harvest the fat very much like minor liposuction at the abdomen or hip.  Sculptra is a longer lasting filler that gets replaced with your own collagen in the end.  It costs more than your typical filler (average $750 a vial) and requires 2-3 sessions (or vials) to get you to that endpoint.  The Sculptra should offer a lasting impression for several years although it is meant for subtle enhancement.  Those are the two options I give my patients when they present in clinic for this reason.     

It is hard to say what is needed without pictures.  A facelift is not needed at age 30.  Flat, hypoplastic cheeks can be augmented with placement of a small cheek implant.  These silastic implants are placed thru an intra-oral incision under a brief general anesthetic.    

It is difficult to answer this question without photos and/or a direct clinical examination. Typically someone in your age range (25-34) does not need invasive treatments such as a facelift. You mention not wanting fillers, but fillers are often a great way to address volume loss, sagginess, creases and jowls in a relatively young individual.  Another option that may give some benefit (again depending on the clinical exam and patient expectations) is skin tightening.  At this point, the best advice I can give you is to consult with a board-certified dermatologist or facial plastic surgeon to discuss treatment options that will best suit your needs.