Pre-jowling and skin laxity: Best next step, Sculptra, more threads? (photos)

Question

I have had PDO threads, kybella and Ultherapy to address my pre-howling and skin laxity on lower face. I still see them and am not sure what should come next. Sculptra was suggested or more threads. Please weigh in.

Theresa M. Jarmuz, MD · Answer

I do strongly believe in building a support system of Collagen that can be built upon over the years. That is where Sculptra comes in. Sculptra in the upper face: Zygomatic Arch and Pre-Auricular region will allow collagen infrastructure to form and create tension up and back. That will lift the lower face. Kybella in the jowls is very helpful, but it must be combined with elevating support from above. You can try lifting at the Malar Fat pad where you have less volume. CO2 Laser is great for tightening. I suggest Sculptra if you want to avoid surgical options. J. Scaljon

DHH Med Spa · Answer

Hi there, One good piece of information to know would be your age. You may be a candidate for surgical measures such as a facelift. If you are not looking to go that route more Sculptra most likely should improve that area however you did not mention how many vials/sessions you have had already. Filler in the angle of the mandible and the chin itself may help as well.

Camille Cash, MD · Answer

If you are not wanting to undergo a traditional neck lift there are a few other options to consider.  FaceTite uses RF technology to tighten skin up to 40%.  Adding Morpheus8 treatments can enhance your results.  We also recommend using medical grade skin care products and wearing sunscreen every day.

Nhi Le, MD · Answer

To achieve instant result and 1 to 2 years lasting results, I would use barbed threads to lift your jowls and cheeks and smooth threads to boost collagen in your skin since you already experienced thread lift! Alternatively you can try Sculptra or hyperdilution radiesse injections to achieve collagen boosting and firmness gradually!

Jennifer Scaljon, MD · Answer

I would suggest Sculptra in the pre-auricular area (in front of the ear) to help increase tension using Collagen. I think it would help pull your lower face back and decrease that laxity that you are seeing lateral to your chin and mouth. I hope this helps. Dr. S

Dean P. Kane, MD, FACS · Answer

Dear Magical4738,

Thanks for sharing your photos. Your face appears beautifully thin and contoured. You have 2 options.
•	Continue Sculptra and TCA chemical peels to non-surgically create collagen to tighten the skin BUT this will not redistribute the jowling or redrape the skin laxity. . I am a proponent of Thread Lifts but this will not help you in the short or long term. 
•	I recommend you consider a face and neck lift to achieve elevated redistribution of your neck and jowl and redraping excision of skin laxity.
•	Please consult with a Board Certified Plastic Surgery expert in surgical facial cosmetics. Use the minimally invasive options to maintain your restored foundation. 
I hope this helps. All the best.

Leonard Grossman, MD · Answer

You have already figured out by now that threads did not really last for a very long time and the results are extremely minimal at best. If you do not wish to have any kind of surgical solution with respect to facial rejuvenation, Sculptra will add more volume to the face but Sculptra cannot be used everywhere on the face unfortunately. In my opinion fat grafting would do the best job in restoring the youthfulness of the face making it look considerably younger by at least 15 to 20 years with minimal downtime which is by the way similar to that of Sculptra. The  results of fat grafting, when performed by a plastic surgeon with lots of experience in fat grafting techniques, are natural and permanent. I hope this helps and good luck from New York City Plastic Surgery

Darryl J. Blinski, MD · Answer

Using non invasive or minimal invasive options seems not to be working in your presented case? I recommend invasive option of a mini FL/NL SMAS plication + HA fillers or nano fat grafting to multiple areas. Expect fees in the $10,000+ ranges.

Pre-jowling and skin laxity: Best next step, Sculptra, more threads? (photos)

Answers (8)

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