What would be the best treatment for the lines and creases around my mouth and eyes after weight loss? (Photo)

Just had juverderm in mouth area and botox around eyes.. don't see a while lot of improvement and was wondering if I need a second round of juverderm or would it be waste of money.. lost weight couple months ago and noticed area losing weight with more wrinkling and creases

Doctor Answers 8

You have a lot of options!

Thanks for your question and for sending in the photos as well. When
I look at the photos, what stands out to me is that you still have some
active acne and some acne scars. I think you need to make a consultation
with a board certified dermatologist or plastic surgeon to learn the other
options that are now available to you, including what we commonly refer to
as energy based devices. This is in addition to getting the acne under
We use the term fractional resurfacing a lot in laser medicine. There
are non-ablative and ablative fractional laser resurfacing that can be useful
here. Non-ablative lasers need 4-6 treatments over a 4-6 month period of
time. Minimal downtime occurs with these treatments. The ablative
fractional lasers also will work here – we commonly use the ActiveFX and
Deep FX from Lumenis, or the AcuPulse from Lumenis, the Cortex from
Ellman, or the Syneron Core. Several days of downtime are needed with
these – and on occasion, more than one session is needed.
We also have radiofrequency (RF) based fractional devices. The
eMatrix from Syneron is the leader here, and we did the FDA studies on
acne scars so we know that 3 treatments here will make significant change,
again with minimal downtime. The Venus Viva is also being used for this
and is pending approval right now in the US, although it is being used
outside the US regularly. The RF microneedling devices also can play a big
role here, and for this we use the EndyMed Intensif for this – 2-3
treatments, again with minimal downtime.
So you have a lot of options. See the right physician, learn what is
out there, and take care of the concerns that bother you.

Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Very difficult to tell

It would be very helpful to see pictures of you before and after the treatments.

Your description of where the injections were is also a little vague.

If your nasolabial folds were treated, they could use a little evening out.

Your eyelids have quite a bit of droopiness to them. The position of your upper eyelid looks like it's encroaching on your pupil, blocking your vision.

Having this treated could make a world of difference. Your upper eyelids do not have an overly excessive amount of loose skin.

Because of this, you would do better with a procedure where you raise the position of your eyelid in relationship to your pupil rather than just taking out excess skin.

This procedure is done well by many plastic surgeons, facial plastic surgeons and oculoplastic surgeons.

In my opinion, you need more than a simple upper eyelid blepharoplasty.

If the time comes for you to consider upper eyelid surgery, make sure the person addresses raising your eyelids without taking out an excessive amount of skin. This is a procedure where the muscle that opens your upper eyelid is either repositioned or shortened and is often done well by oculoplastic surgeons.

Weight loss patients often benefit from general facial volume and hands meds.

This can, at times, require substantial amounts of volume to make a substantial difference.

Using fillers can become quite costly.

Another option to consider is facial fat grafting.

While not as precise as using fillers, it can give very nice effect that is longer lasting or permanent.

Best of luck,

Mats Hagstrom, M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 17 reviews

Under treated

Botox is used to eliminate dynamic wrinkles. The ones that form from the areas of your face that move. Juvederm is used to fill in volume loss in areas that have lost volume from aging or weight loss. Juvederm is only as effective as the number of syringes put in. If you need six syringes but your injector puts in one, then you won't get the desired result. 

Juvederm and anothers modelants and filleers are not as excelent like your own fat and plastma

your own fat and plastma for refilling  besides than last more than 5 years also improve facial skin quality because  they recovery the brightness normal  lozany, so  this  wonderful technique is highly  recomeded to you

Ramon Navarro, MD
Mexico Plastic Surgeon

Lines, Wrinkles and Scars Around Mouth

you need a combination of laser and/or radiofrequency devices for texture and tone, as well as fillers for wrinkles and volume. I suggest seeing a cosmetic dermatologist with experience and who uses lasers and microcannulas for filler injections.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Lines and creases

there are various topical programs that can tighten your skin. However, the best treatment for skin tightening is laser resurfacing. Oftentimes, it is best to be on a topical program for 3 to 6 months before having the resurfacing. I would suggest that you seek out a good dermatologist or plastic surgeon who has experience in resurfacing with a fractionated laser.     jlr

John Louis Ratz, MD
Clermont Dermatologist

What would be the best treatment for the lines and creases around my mouth and eyes after weight loss?

You were UNDR treated with filler. You need much more or a facelift.. Your choice....................

Suggestions for peri orbital and peri oral lines.

Lasers, fillers, maintenance skin care and correctly placed Botox would be great for your skins texture overall and add to the areas you've lost volume and have fine lines. Visiting a board certified cosmetic dermatologist in person for which fillers and lasers will benefit you most is best.

Thank you for your question and for sharing your pictures!

Kate Ross, MD
Bradenton Dermatologic Surgeon

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.