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 they do better than inflammatory peels like VI (see link). in off you need lasers. sagging will not improve from peels or lasers and needs skin tightening or lifting. 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 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.