When I smile I have many lines on my cheeks. I also have some issues with sunspots. Would Thermage or Ultherapy help? (Photo)

Question

41 Year Old Female - Use Obagi and TRIA Anti-Aging laser. It's not that I don't want any lines when I smile, but I have so many, and I really am extremely self conscious. When I'm not smiling, the lines are not noticeable. Would Thermage or Ultherapy address this issue? Fillers? I do not want Botox as I tried that once and had a reaction to it. I was thinking of getting full face Ultherapy to tighten my cheeks and brow line as well. Have noticed drooping in my brow too. Help!

Lu-Jean Feng, MD · Answer

We have a large experience with thermage in our skin care clinic. It is one of the best nonsurgical facelifts available without downtime. Patients who respond to the treatment tend to be younger like yourself with only dynamic wrinkles and not wrinkles at rest. There are also other adjunct treatments available such as micro laser peel which will further improve the quality of your skin. Ultherapy tend to be a more painful treatment for some patients. The results are fairly comparable in my opinion.

Joshua L. Fox, MD · Answer

I’ve
seen good results from Ultherapy for tightening and lifting the face, and I
think that or Thermage would be the right choice to begin to address the smile
lines on the cheeks that you are concerned about. They will not help with sunspots. Those would
need to be addressed with a course of chemical peels or various laser
treatments.

Michele S. Green, MD · Answer

I have been using Thermage with outstanding results for over five years in my office.  The benefits for patients who are young are really remarkable.  You will produce new collagen gradually from the radiofrequency technology and it will help rejuvenate your skin.  Thermage works deep into the skin to tighten it.  However, it will not remove sun spots which are superficial to the epidermis.  The best way to remove these sun spots are with Fraxel to treat the whole face or the Alex Trivantage for localized sun spots.  Please consult a board certified dermatologist with a great deal of experience with these lasers for the best cosmetic results.

Michael H. Gold, MD · Answer

Thanks for your question and thanks
for including the photo as well. Both Thermage and Ulthera will work here and
you should see significant tightening from both. There is a pain component from
both procedures and both have newer protocols available to clinicians to
minimize this in most people. I do suggest that you consult with a board-certified
dermatologist or plastic surgeon to learn all the options, including some of
the other RF skin tightening procedures that people are doing, including the
Venus Legacy, the EndyMed 3Deep, and Ellman Pelleve that also can do some very
nice skin tightening.

My concern for you and question for
you is that you say you have had a reaction to Botox in the past. This is very
unusual, and one would like to know what you had done and what you think you
reacted to. Botox is an incredibly safe procedure in the right hands, there are
no allergic reactions or things like that, and if you had a side effect, most
all of that is injection technique, not due to the product per se. Have the
right consultation, learn the facts, and do the procedure that feels right.

When I smile I have many lines on my cheeks. I also have some issues with sunspots. Would Thermage or Ultherapy help? (Photo)

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