Manage factors that promote aging
As most on the blog suggest options at this point should not emphasize procedrues but should emphasize practices that reduce the liklihood of prematurely aging like smoking, drinking heavily, sun exposure, lack of exercise, improper hydration. The only procedural things we recommend to young women are to begin a sound skin care regime utilizing pharmaceutical grade skin care products.
Develop a sense of self-esteem that will support an aging face
Society puts a lot of pressure on women to look as good as possible so it is not surprising that you are so concerned about your appearance. Body dysmorphic disorder is an abnormal preoccupation with minor or imaged issues. One of the keys to the diagnosis is related to how much of your day is taken up by such preoccupations.
Recognize that aging is inevitable. Nora Ephron (Sleepless in Seattle) has a wonderful essay in a book of the same name titled: "I hate my neck." The essay is about her fears of having surgery based on how overdone women become even after having surgery by relatively famous plastic surgeons. Her advice is to love your youthful neck and take every opportunity to show it off. She had no idea at your age how great her neck was. The moral is don't get lost in obsessive thoughts, and enjoy what you have.
Now, lets answer you questions. First avoid surgery as much as possible. As great as I or my colleagues are as surgeons, every surgery is associated with unwanted side effects no matter how brilliant the surgery was performed. Unfortunately we live in a world were you will eventually find someone who will do what you are asking for whether it is the right thing or not. You need to learn to be your own best advocate. Protecting yourself from the unintended consequences of surgery is essential.
The suggestions of Dr. Kasden are very appropriate. Some people are under the impression that tanning beds are safer than tanning in the sun. The reality is that both are bad. A prescription for Retin A from your dermatologist for use every 4 or 5th night can be helpful-just don't over do it. Moisturizes are helpful in making the skin look better but that is all they do. Don't spend a fortune on them. Also, there is no scientific support for "staying well hydrated." People drag around big bottles of water and slavishly try to get their gallon of water a day. Your body is very good at conserving water and making you thirsty if you need more. So there is no reason to be a slave to the water bottle.
Finally, recognize that the images of your favorite actress or model are often manipulated in photoshop and then presented in a way that is designed to make us feel bad (so we buy the product they are selling). Try to keeps things in perspective and not drive yourself totally insane looking for perfection.
There are many things you can do
Well performed fillers and Botox and medical grade skin care and SUN AVOIDANCE will keep you looking young. Please don't even consider any kind of facelift at your age. Any doctor worth seeing would never consider doing this surgery on you now.
Young women don't need anti-aging options, because they are not aging
You said it yourself. You are obsessed. Self esteem has to come from the inside. I am sure you have heard that. You have a lot of the signs (concern with minor imperfections, yo-yo dieting) of someone who absolutely should not have plastic surgery or dermatology treatments, BECAUSE THEY ARE NOT GOING TO MAKE YOU FEEL BETTER.
There is a book I recommend for you: FEELING GOOD by David Burns. Buy it and read it. It is easy to read. It may change your life.
The prominent nasolabial folds that are bothering you may be due to lax skin of the cheek. If this is the case, you may benefit from filler to augment the cheek areas. At 24, it seems premature for you to be considering a facelift procedure. Botox is not for nasolabial folds but for dynamic wrinkles.
Get several opinions from plastic surgeons, they are usually free
I am not a plastic surgeon but a cardiovascular surgeon who has a huge vein practice and constantly see women and men who care about how they look - So, I don't think there is anything 'wrong with you' and I don't think you should be labelled to have "body dysmorphic syndrome" as the previous doctor suggested.
One of the best things going in plastic surgery is that most good ones provide free consultation and therefore you should take the opportunity and get 2 opinions, not more - and think about your options. When you get more than 3, you may get confused.
Remember that cosmetic surgery/plastic surgery is aesthetic surgery and plastic surgeons will have varying opinions - so don't get too confused with their recommendations and just take your time in making your decision.
My brother is a plastic surgeon in Beverly Hills, CA and I have the luxury of practicing with him in New York and use him as a sounding board for advice. I don't think you have body dysmorphic syndrome. Enjoy life.
An individualized approach is best
Thank you for your post.
At 24, I would consider you pretty young for most cosmetic procedures, although I totally understand that you want to look your best and continue to do so for years to come. So, for right now, I would do minimally invasive treatments such as Botox, IPL, light chemical peels, microdermabrasion, and Retin-A/sunscreen. Without seeing you personally, it would be hard to suggest juvederm or any other filler for the nasolabial folds, although if indicated, this should be a fine treatment as well.
I'm a big proponent of Botox used to prevent wrinkles, so that would be an excellent first line choice. Doing sunscreen every morning will also preserve and moisturize your skin and prevent sundamage. Retin-A is a proven wrinkle reducer / preventer that would be an excellent choice every night. Doing glycolic acid 30% peels +/- microdermabrasion should be very helpful in giving your skin a nice glow. IPL can be done if you have some freckling or signs of sun damage. Other procedures, such as Fraxel, are more likely needed if you have fine texture abnormalities or acne scarring to repair.
A face lift at 24 would be hard to recommend, and fillers must be recommended only if indicated when you are officially evaluated.
Less invasive anti-aging options
You are very young to think about a face lift, mini or otherwise. Fillers gently used beneath the nasolabial folds can usually fix the creases nicely, without giving you puffy cheeks.
The best things you can do to maintain your youthful appearance is avoid smoking, excessive drinking, and sun exposure. Additionally, keep weight stable, well hydrated, and use moisturizer creams and makeup with sun block.
Finally, you need to take a look at your values, and perhaps read your post. I get the strong sense that you may have body dysmorpic syndrome. I may be wrong in this, but that is the feeling I get. If this is true, you may want to get help with it, because people who suffer with this issue, are usually never happy with themselves.
Non-surgical skin tightening and fillers are best for younger skin
Without seeing you I can tell you that you do not want a face lift-you are too young and the improvement would not be worth going through surgery and having scars.
I use the non-surgical skin tightening Infrared machine called LuxIR Deep for facial and neck skin tightening. You would need 4 treatments scheduled 4 weeks apart and the maximum skin tightening would be seen at 6 months. This type of procedure is ideal for someone your age. Other brands are Thermage, Titan and Refirme but I prefer the LuxIR Deep.
Filler injections like Juvederm (or Restylane and Radiesse) can be used to plump the nose to mouth lines or nasolabial folds.
We also do a procedure called the liquid face lift using Radiesse which actually helps plump the cheek and improve the fold.
See before and after pictures of liquid face lift.
At your age you probably don't need anything. You can always find a surgeon to do something to you, and you will probably look worse. See a reputable surgeon or dermatologist to see if fillers might help.