Is Botox, filler or Hifu better for me at 42 for wrinkles and sagging? (Photo)

you need a combination of treatments. fillers for volume iwth sculptra, lasers and microneedling RF in the office.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see linkt) should be started now to prevent further aging.

For facial rejuvenation, I would suggest a combination approach of
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

I have personally been injecting Botox for treating wrinkles since 1991. It (as well as the other neuromodulators) is now used for treating every kind of dynamic (movement related) wrinkle from forehead "worry lines," crow's feet, Nefertiti Lift, vertical neck cords, horizontal necklace lines and crepey chest skin crinkles. I have been using fillers for well over three decades, since the days of the first collagen fillers, Zyderm and Zyplast. Today, fillers treat not only fine wrinkles and creases, but jowls, skin sagging and folds, thin lips, under eye bags,flattened cheeks and recessed chins, and a host of other aesthetic issues--all with time-tested and proven efficacy in experienced hands. So, why would you even consider expensive devices whose hard science to support their purported benefits lags well behind the heavy marketing and advertising. Make sure to keep this in mind when evaluating claims for this or that supposedly "next big thing" device to come along that supposedly replaces yesterday's supposedly supposedly great "in" device treatment. Best of luck.