Face lines age 40 - what to do? (photos)

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 and thank you for your question! When it comes to facial lines - more commonly known as expression lines - there are many treatments out there that can help them smooth out and, in some cases, disappear overtime. Facials and microdermabrasion are fantastic treatments to start with - but if you are looking for something that is stronger and has longer, lasting effects - Dysport is the top option! Dysport is a neurotoxin that is a prescription injection that improves the appearance of moderate to severe expression lines all over the face by preventing muscle contractions. This treatment combined with your monthly facials will help you get the results that you are looking for!

Great question! You can go a few different routes here, there really is no one answer! In your case, would recommend a package of 3 Morpheus Microneedling Treatments. Morpheus8 is a fractional skin treatment that uses Radiofrequency and Microneedling together. This treatment can deeply penetrate the layers of skin and stimulate collagen production in the underlying layers of the dermis. It significantly improves fine lines and wrinkles and improves overall skin texture and laxity. As we age our skin naturally loses collagen and laxity and we begin to see the wrinkles that you are noticing!

All of the treatments mentioned, i.e. the facials, retinoids, microdermabrasion, and microneedling work best for very superficial, surface texture issues, but not, as you found out hard way, for smile- (motion-)related lower cheek fine line wrinkles and crinkling. Microdroplets of fillers, such as Restylane Silk, with or without the additon of microdroplets of Botox placed in a grid-like pattern throughout the area, can be quite helpful with this problem. Make sure to consult with an experienced, board certified cosmetic dermatologist. Best of luck.