Fine lines and skin tightening - what's the best option?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Hello LadyP123.
Thank you for your question. Without a photo I can recommend a first step based on what you have described as your concerns. Sun spots and fine lines would be very well treated with Fraxel re:store Dual (both 1927 and 1550). Assuming you are an ideal candidate. The pigment is targeted with the 1927 and the fine lines are targeted with the 1550. Depending on your needs/budget etc, a series is typically recommended. Slight loose skin/jowling is best addressed with filler and skin tightening technologies such as Exilix Ultra (radio-frequency) or even SkinTyte which can be combined with Broad Band Light HERO as maintenance treatments once you have completed your Fraxel series. There are many options. The best first step is finding a trusted doctor/clinic with a range of option so that you can be provided with the best and most suitable plan. Hope this helps! All the best, Manish Khanna, MD FRCPC

Without photos an assessment cannot be made. Regardless, the general route everyone should consider in regards to their aesthetics - especially skin is:

NOTE: If you are overweight Ultherapy would be a better choice than Morpheus8 due to many testimonials of producing "melted-fat" results. Ultherapy is the only FDA approved non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. Ultherapy helps produce new collagen growth; more collagen equals firmer, tighter, more youthful skin

Step 1 - Skin Care & Supplements - Re-define your skin - If you already have a skin-care routine, wonderful. If not, you need one; before spending any time or money on anything else it's essential that you treat yourself to the best skin-care routine possible. You can hire or get a consultation with a skin-care specialist or do-it-yourself by researching ingredients, companies, and constructing an assessment of what you need. Get a blood test - test your hormones and vitamin & minerals levels - supplement accordingly. You will feel and book better when all of your "essentials" are in balance.

Side note: example of supplement effectiveness: Ingesting collagen has proven benefits for improving skin elasticity (i.e. improvement of wrinkles & fine-lines) and health, nail + hair health, supporting accelerated healing (from any burn/wound/cut/trauma) of the skin, improving joint mobility, and decreasing pain for those who suffer from joint pain

Step 2 - Lasers - Sun Spots (IPL or Fraxel - dependent upon the severity of age/sun damage) and Skin Tightening (Morpheus8) - Skin resurfacing (developing healthy-glowing skin over-time; layers of skin will rebuild) - Smoother skin texture, reduced fine-lines and wrinkles, smaller pore size, and looking younger are all side-effects of getting treatments done. For all of the treatments listed above (excluding Ultherapy) it is recommend to get multiple treatments for optimal results.

NOTE: Fillers should only be done after maintaining a skin-care routine and getting power-enabled treatments such as lasers, RF, ultrasound, etc. for optimal results and avoiding potential dissolving and/or complications

Step 3 - Fillers - for any remaining fine lines - It's important to leave fillers towards the end of your tailored "treatment plan"

NOTE: Step 4 & 5 would most likely not be applicable or needed (especially after completed treatment and maintenance of steps 1-3) if your skin-laxity is not severe. But it is important to know all the options.

Step 4 - Non-surgical facelift - Threads - It's possible to produce a partial "non-surgical facelift" result through Steps 1-3. But a complete "non-invasive" result can be reached though a Thread-Lift. PDO Thread lift supports to lift and contour the face and also tighten the sagging skin. PDO Threads will be dissolved by the body in around six months, but the stimulation of collagen will continue for 2 years. however, increased collagen production continues for up to two years. PDO threads area great way to tighten sagging skin, reduce wrinkling, and create new collagen. They are classified as “Collagen Stimulators”.

Step 5 - Surgery (Neck & or Face -lift) - Neck lifts are widely considered the most effective treatment for jowls and majority of neck-lift patients are also eligible for a face-lift. You should get multiple consultations from specialists in all of the areas listed above.