I have a very thin face and have lost a tremendous amount of volume in my cheeks in the last 4- 5 years. I also have some deep wrinkling (vertical lines) on my cheeks and around my eyes. The cosmetic surgeon suggested full face CO2 and a follow up with 6 vials of sculptra. The plastic surgeon suggested a mid lift and fat transfer to my cheeks followed by a fractionated later. Both agree on amount of sculptra needed to bring volume back. Both seem to be very knowledgable and skilled .
Full Co2 Laser (Ultra Pulse Not Fractionated) with Sculptra After Recovery or Mid Lift with Fat Graft and Lighter Laser Later?
Doctor Answers 1
The gaunt face with heavy wrinkles is a special and difficult problem. We have our own approach.
Typically a face as you describe has the following elements:
- Skin expansion
- Loss of fat in all the fat pads
- Poor elasticity
- a poor neck with a showthrough of a split platysma
- often dyschromia or irregular pigmentatio
We do "total facial rejuvination" at one operation using the following rountine:
- A complete face and neck lift to reduce the excess skin
- All tissue removed from the face and neck is salvaged and placed in the areas of deficiency under the lifted tissues
- The SMAS (underlying tissues of the face) is positioned to create maximum softness of the facial contours.
- A full face and transitional neck fractionated laser is performed to shrink the skin and improve dyschromia
This does address virtually all the problems in one operation using techniques that are very long lasting.
We do use Scuptra later if needed after the swelling goes down in the very, very thin face, but this is usually not needed.
This may seem like a lot, but it gets the job done in one operation, one recovery, and at less total expense than repeated injections, etc.