Would a chemical peel or ultherapy be a good option for me? The skin on my face is starting to sag. (Photo)

Question

I am 34 year old mother of 2. I have had a nose job 10 yrs ago. I have recently noticed all the skin on my face is starting to sag and my nose appears to be concave. I have also began to notice acne scars and pot marks that are getting worse as the years go by. I have a few overactive sebaceous glands on my nose and have been breaking out as well as dealing with this loss of firmness. Would a chemical peel or ultherapy be a good option for me? Do I need to have a revision nose job?

Raffy Karamanoukian, MD, FACS · Answer

Ultherapy is a non-invasive procedure that lifts the neck, chin and brow, and improves lines and wrinkles on the upper chest. As we age, collagen breaks down, resulting in loss of skin strength and elasticity. For tissue tightening, Ultherapy is ideal for the lower face and neck and we often combine it with CO2 laser or Morpheus8 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.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Bryson G. Richards, MD · Answer

An excellent way to treat acne scarring and fine wrinkles is with either a CO2 laser or deep phenol/croton oil peel. Either would help significantly.As for the rhinoplasty, you need a formal evaluation from a plastic surgeon experienced in rhinoplasty surgery.

Jason Emer, MD · Answer

You have brought up many different cosmetic issues -- skin texture, scars, color, sagging, as well as nasal shape.  My suggestion is a formal consultation with a cosmetic dermatologist and/or plastic surgeon.  Your skin looks nice, but appears to need preventative treatments such as a peel, fraxel or co2 laser as well as some skin tightening (thermage, ultherapy, pelleve ect).  Each doctor has different recommendations based on their experiences.  These procedures do compliment themsvles very well for an improved cosmetic outcome.  You should also be on long term preventative skin care as well as sun protection.  As for the nose, that should be evaluated by a surgeon with experience in revision surgery.  I suggest Dr. Paul Nassif in Beverly Hills or Dean Toriumi in Chicago.  I wish you the best, Dr. Emer.

David Hansen, MD · Answer

I think that you should be doing both a medium peel and ultherapy for maximum benefit since they work differently and would compliment each other.

Jonathan Pontell, MD, FACS · Answer

Hi.  A chemical peel is to address sun damage to the surface of the skin (fine wrinkles and sun spots).  Although there may be some minor tightening, tightening and lifting is not what chemical peels do.  When we age, the skin, subcutaneous fat and muscles all sag.  Treatments to fix sagging must address all of these layers.  A facelift or Ultherapy would be the procedures to consider for sagging.

Sheryl D. Clark, MD, FAAD · Answer

You have raised a number of issues that you are not happy with. i suggest you consult with a board-certified dermatologist and plastic surgeon to set priorities and discuss a plan of treatment. Pellevé can help to tighten the skin and shrink sebaceous glands. It also helps acne and scarring and surface texture. It is painless and reliably effective, inlike Ultherapy which is very painful and a bit unpredictable in terms of results. So perhaps #Pellevé is a good place to start.  A regime of effective topical creams will also help some of the issues you have raised including keeping your acne under control.I notice that you have a deep horizontal furrow in your chin and you may be very happy with a bit of filler in this area.

Pablo Prichard, MD · Answer

Thank you for your question. It is hard to see the nose in your pictures as they are very close up. I would recommend consulting with a plastic surgeon to see if you are in need of a revision. As for the laxitey in your skin I would recommend a laser treatemtn over a chemical peel since the peel will only address the superficail texture and not the laxity. Speak to your plastic surgeon aobut this as well for more detailed information to see if you are a good candidate for resurfacing laser. Best Wishes,Pablo Prichard

Would a chemical peel or ultherapy be a good option for me? The skin on my face is starting to sag. (Photo)

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