Best way to treat texture, large pores, and wrinkles? (photos)

Question

I have tried microneedling, ipls and halos laser. I am struggling with the quality of life as I am only 40 and look much older. Please help offer suggestions. Thank you in advance. I am regular with facials and have done hydrafacials too.

Paul Flashner, MD · Answer

Hello and thank you for your question. I recommend the diamond glow treatment to treat your skin's texture and large pores. The Diamond glow is a dermabrasion device that gently removes the top layer of skin, getting rid of all oil, dirt, and debris, while infusing a serum into your skin. This facial will provide healthier, smoother, clearer skin with unclogged pores and a more even tone. It will also help improve fine lines, any dryness, dark spots and discoloration. This treatment takes around 30-45 minutes with no down time. For the best results, I would purchase this treatment in a package. This contains 3 treatments that are performed every three - four weeks.  For wrinkles, I would recommend doing Botox. Botox will temporarily relax the facial muscles that cause the wrinkles to appear. Botox will smooth out the facial wrinkles improving your appearance and freeze any further movement to cause the wrinkles to get deeper.  Can't wait to see what you decide! Have a great day!

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

John L. Burns Jr., MD · Answer

You've been doing the right things.  Skin rejuvenation is a long game so keep it us.  You might also try SkinVive where micro droplets of hyaluronic acid are injected to plump, hydrate, and smooth the skin.  We've seem some amazing results.

Aaron Gilson, DO · Answer

Skinvive might be something to think about. It's not a filler in the way you might be thinking - it doesn’t puff up your skin or change your facial structure. Instead, it uses a special kind of hyaluronic acid to hydrate your skin from the inside, which can help make it look/feel smoother and fresher. It’s like giving your skin a little extra help in staying moisturized and healthy-looking. Always a good idea to chat with a professional to see if it’s a fit for your skin and your needs!

Jason Emer, MD · Answer

Moxi is a ligher laser and helps with pores, we love it every 4-8 weeks along with peels between at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see link) should be started now to prevent further aging. For facial rejuvenation, I would suggest a combination approach of 1) skin care with products and PRP/microneedling 2) PDT light therapy few times a month with growth factors 3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/Halo, Viva, Co2/Erbium 4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill 5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting 6) botox every 2-3 months to stop movement lines and prevent lines at rest 7) deep microneedling RF like Fractora/morpheus8/PiXel8 for tightening of the skin 8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months) Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

The appearance of central facial sinking and lower jawline jowl formation strongly indicates cheek volume deficit. Facial volume loss can translate not only into sunken cheeks and jowl formation, but can make more apparent any overlying skin irregularities, such as dilated pores and fine skin crinkling. Simply revolumizing the cheeks with an appropriately robust HA filler is likely not only to reestablish an overall more youthful contour, but would likely diminish any very superficial crinkling, as well as diminishing the appearance of the overlying dilated pores. I have been cautioning my readers for years to exercise a healthy dose of buyer beware when it comes to faddish devices, like IPL & fraxel lasers and RF machines whose heavy marketing to promote them for all kinds of things lags woefully behind the hard science to support them. So, no surprises there about the lack of success with them. Sorry. Make sure to consult an experienced, board certified cosmetic dermatologist. Best of luck.

Camille Cash, MD · Answer

Morpheus8 is a great tool to improve overall skin tone and texture.  This treatment combines RF technology with microneedling.  Three sessions are recommended for optimal results.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Leonard Grossman, MD · Answer

There are a few reasons as to why the pores can be enlarged on a face of an individual. Genetics, excessive sunlight exposure and weight loss are some of the most common causes. Because you have some hollowing of the face, I would think that you have two of the causes which created enlarged pores. One is sun damage and two is loss of facial volume. By restoring facial volume with the use of fat grafting you will look much more youthful and the pores will decrease in size or disappear. You can also add Retin-A to your daily routine and that too will help in the quality  of skin. I hope this helps and good luck from New York City plastic surgery