67 years old- Cheek crepiness & wrinkles, what can I do to improve this area? (Photos)

Question

67 years of age & had a full face & neck lift with fat grafting to temples and cheeks & lower blepharoplasty. When I have a full smile or laugh I now have lines & crepiness on upper checks. The surgery was 5 months ago. What can I do to improve this area? I have more lines now after the surgery.

Nelson Lee Novick, MD · Answer

The crow's feet wrinkles that become visible with smiling and laughing can be reduced with Botox. Additionally, the use of a light, cohesive filler, such as Belotero Balance fanned through the region can further help to reduce this problem. Very important that you make certain to consult with an experienced injector, a board certified cosmetic dermatologist, and make sure to ask to see his/her personal before and after photos of this area before agreeing to proceed. Best of luck.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

Wrinkles can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like RF treatments, lasers, microneedling/PRP or sculptra to get increased collagen, tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Michael A. Persky, MD · Answer

Hi Thoughtful,

I would treat you with Botox around your crow's feet, and then a week or so later treat your peri-orbital area (around your eyes) with a Fraxel repair laser (fractionated CO2 laser).  Radiofrequency micro-needling with PRP may also be helpful. Feel free to contact me with any further questions.
Michael Persky, MD
Encino, CA

67 years old- Cheek crepiness & wrinkles, what can I do to improve this area? (Photos)

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