27 Years old, premature aging, nasolabial folds, frown lines. What's the best treatment? (Photo)

Question

I am a 27 year old female. I have experienced severe stress for most of my life and had smoked for the past 14 years. I have also battled moderate to severe acne which I am now getting treated. I lost 40 pounds 2 years ago and lost a lot of the volume in my face. I am extremely depressed and upset by the haggard old look I already have at my age. Please advise on the best course of treatment. Please see photos for reference. Your help is beyond appreciated.

Deborah Pan, MD · Answer

Fillers would be your best option since you have two factors working to accelerate the aging process. Smoking and weight loss are causing the premature changes. If you can at least attempt smoking cessation it will definitely help your face and skin in the long term. Acne and cysts are often exacerbated by smoking as well. Juvederm or Restylane would be great as first line fillers for the entire cheek area as well as around the mouth. If you like the results you can then "graduate" to more long lasting options.

Jason R. Lupton, MD · Answer

I agree with the other doctors here that facial fillers would be a great option for you. Due to your significant weight loss it appears you have significant loss globally in your face. I would suggest starting with a hyaluronic acid filler like Restylane or Juvederm. You can always transfer over to more longer term or permanent fillers if you are pleased with the results. Good luck.

Anthony Youn, MD · Answer

It's fairly common for people to develop volume loss in their face after losing weight. Ten years ago the only real option for patients like you was fat grafting. Today we have Juvederm Voluma and Sculptra, which are both very easy and effective ways to replace volume in your cheeks without having to go under the knife. Results last up to two years. Congrats on the weight loss! Good luck.

Naveen Somia, MBBS, PhD, FRACS · Answer

Thanks for your photos.Your facial ageing is due to significant volume loss, this is predominantly fat.So you need to replace what you have lost to restore a youthful lookI recommend Hyaluronic Acid Filers such as Juvederm Voluma or Modelis. If you like the look, then you can consider fat transfer to the faceAll the best

Steven Wallach, MD · Answer

Smoking significantly ages the face prematurely.  You might want to consider facial fillers as a possible solution for facial wasting.  Good luck.

Jeffrey Schiller, MD · Answer

You have such dramatic and global volume loss that Sculptra may be a good choice for you. It is excellent for filling the entire face and temples. You would probably need at least 6 vials depending on how your body reacts, because Sculptra stimulates your body to make its own collagen.

Alix J. Charles, MD · Answer

Thank your for your question.  You might benefit from using some hyaluronic acid fillers like Juvederm Voluma to add volume to the mid face and perhaps even the temples (hard to see from the pics).  This would make direct injections into the nasolabial folds more effective. Filler around the mouth and perhaps even for the chin might also make a noticeable difference.  The overall texture and tone of the skin could be improved with a foundation of excellent skin care products coupled with a laser resurfacing procedure or medium depth chemical peels.  To plan and execute a course of action such as this will require a face to face consult with a very well trained and experienced cosmetic dermatologist or plastic surgeon, so do your homework and select the right practitioner for you.  Best of luck to you on your journey of self improvement!

27 Years old, premature aging, nasolabial folds, frown lines. What's the best treatment? (Photo)

Answers (7)

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