Loose skin on lower face, what are my options? Laser or threads for best results? (photo)

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Thanks for the picture. You have multiple options and maybe best to discuss in person. Part of facial ageing includes facial volume loss and then loosening of the skin and soft tissues on the face and neck.

A quick improvement would be do perform facial fillers, which would restore volume, especially to your midface area and it would also give u some lifting of the skin on the lower face.

Other options include threads, energy based skin tightening devices or surgery.

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

Hi godeogodeo, Threads are well suited to address uneven areas as the tissue can be rerpositioned with different vectors (directions) in different areas or sides of the face. It is harder to control the degree of tightening with technologies such as laser/RF/HIFU. There are many types of threads with different calibers, barb designs and lengths so be sure to see a practioner that can incorporate different threads to correct as a much as possible the uneven areas—easily placed under local anesthetic and sedation by mouth is an option. Should last about one year and can repeat or change gears to a facelift later without any problems. Good luck! Dr. Doolabh

Unfortunately, no surprise that there was little value to the HIFU. I have been cautioning my followers for years that so much of the hype surrounding these relatively expensive, faddish light and energy-based bells and whistles lags woefully behind the hard science to promote their use. I gave up threads many years ago, since, despite the promise to the contrary, the results don't last particularly long, the treatment is expensive, there is post-treatment downtime and there are a significant number of adverse reactions, including infection, skin dimpling, and suture extrusion. On the other hand, the use of an appropriately robust HA fillers can nonsurgically lift, straighten and define the jawline. straighten the downturned angles of the mouth, and address the smile lines--all in one treatment session, if so desired, and with little to no significant downtime. Just make sure that you consult with a board certified cosmetic dermatologist. Best of luck.

It appears from your photo that you would be a candidate for FaceTite. This minimally invasive procedure uses RF technology to tighten skin with no general anesthesia required. You can consider adding Morpheus8 treatments to optimize your results. The next step is to schedule a consultation with a board certified plastic surgeon to learn more.