60 yr old female. Facelift is not an option. I do Botox lower face & Restalyane lower face with great results.What next? (photo)

No facelift! Love Botox and restylane lower face, but my forehead lines and wrinkles on one side of face are killing me. I have an excellent plastic surgeon in Memphis....what about a TCA peel? Cold sore history, scar easy, years of sun damage. I do at home 50% acids peels, the safe level. Any ideas, I won't do a deep peel until Jan.? And I know the deep vertical "1" is only going to soften. I am realistic. Thanks

Doctor Answers 4

BOTOX, Ultherapy, Fillers.

I do not think a TCA peel will address your concerns. My preference would be a combination of methods, including Botox, and advanced technique forehead filling. I would also recommend Ultherapy as a non surgical face lift. Expect a modest improvement with this non invasive non-face lift ultrasound treatment. Video explains. All the best, Dr Davin Lim. Brisbane. Australia. 

Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Cosmetic treatments

Thank you for your question judegreeneyes. There are a variety of  cosmetic treatments used to enhance the appearance of the face. For example, Botox is a purified protein used to address wrinkles associated with facial expression such as the horizontal lines seen on the forehead when one raises the brows and the vertical lines between the brows seen when one frowns. If deep wrinkles are visible at rest, they will not always disappear completely with Botox. Fillers such as Juvederm, Restylane, and Voluma can restore volume in the lower face. Chemical peels can be used to enhance the color and texture of the face. For my patients with significant damage I recommend fractional CO2 laser resurfacing as it can address a number of concerns, but there is 1-2 weeks of recovery time. I treat my patients with a history of cold sores with valcyclovir (Valtrex) 500 mg by mouth daily for one week starting one day prior to the treatment. Please consult with a doctor for specific recommendations.  Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 4 reviews

Non-surgical Options

Thanks for the questions and the photos. If you're only concern is getting rid of wrinkles, then there are a lot of non surgical options. If you're more concerned about the laxity and descent of your facial tissue, then surgery is the best option. In my opinion you would be able to see a lot of improvement in your forehead with some botox and very superficial filler for the lines using belotero or restylane silk. In order to improve wrinkles on your cheeks (not your nasolabial fold) then a laser or peel will be able to help improve your skin texture. These procedures do require some down time to recover. It sounds like you have a good relationship with your plastic surgeon. Set up a time to talk to them about your non-surgical options. Best of luck!~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 34 reviews

Facial Aging and Lasers like Fraxel/Clear + Brilliant, RF like VIVA, Peels, Fillers, Skin Care, Face Lift, Fat Injections

Fillers, sculptra and fat can be used for facial voume, but lasers, microneedling/PRP and RF treatments can be used for wrinkles and tightening. I suggest you see an expert for a consultation.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

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.