I Am 59 Years Old and Considering Having Some Cosmetic Surgery. My Surgeon Does Not Feel I Need a Facelift Yet?

I have a small amount of skin laxity around the mouth and jaw line which bothers me. I am considering some type of laser or RF treatment. I had Thermage 10 years ago with NO results. My goal is: to remove age spots; to remove fine lines around the eyes and lips; to stimulate collagen and tightening around my mouth and jaw line. What is the best all around treatment? I am not interested in doing fillers around the mouth. I have not been happy with the very short term results.

Doctor Answers 23

Peri-Oral skin laxity with fine lines (rhytids) and age spots

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If your surgeon feels you're not yet ready for a facelift, and you want to address peri-oral skin laxity you may be a candidate for peri-oral laser resurfacing. Those with fairer skin and fine lines are often good candidates for LR (Laser Resurfacing). LR is not recommended for dark or olive skin types. You should also stop all topical retinals (Reine A, Roc) for at least two weeks prior to laser resurfacing as these can lead to hyperpigmentation and mottled skin after LR. IPL (Intense Pulsed Light) or BBL (Sciton- Broad Band Light) are well suited to dealing with age spots but often require several treatments and should be followed up with topical skin bleaches and sun block.

West Palm Beach Plastic Surgeon

Laser Resurfacing or Face and Neck Lift

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   In general, laser resurfacing is appropriate for fine lines and wrinkles, but please do not expect that sagging or deeper wrinkles will be corrected with this modality

Lines around the Mouth

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Dear tab726,  Although the accuracy of this answer is qualified by the lack of pictures, I agree with previous posters on this issue.  Generally, a facelift is not effective in addressing lines and wrinkles around the mouth (perioral area).  Sometimes fillers, fractionated CO2 resurfacing lasers, or a combination is the best approach.  Always appreciate the advice of a Surgeon who tells you that you don't need a procedure when you don't have the indications that will be addressed by that particular technique.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Try Ultherapy for early aging

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It seems as though you are describing the ideal Ultherapy patient.  New techniques with this technology will help with some loose skin, lines around the mouth and eyes, and the process is made to stimulate deep collagen regeneration.  Your skin spots may need to be treated with a superficial therapy such as a peel or laser, but these will not help with the deeper structures that the focused ultrasound of Ultherapy targets.

Age spots and fine lines

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A facelift is not needed if there is only a small amount of skin laxity present.  Botox and Fillers would  help for those areas.  IPL (Intense Pulsed Light) will help with age spots.  Expect 4-5 treatments

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

How to remove age spots and fine lines around the eyes and lips

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Hi.  I find that the Fraxel Repair laser is the best treatment for age spots and fine lines.  This has a quick recovery and is very effective.  Thanks.  

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 113 reviews

Best Option for All Around Facial Rejuvenation

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I am not sure that there is there is one single best option to accomplish everything you are looking for.

As many patients, you may benefit from combination treatments for best results. This can include resurfacing (i.e. lasers or chemical peel), facial fat injections, face lift etc.

If Thermage gave you Zero benefit 10 years ago, I would be hesitant to expect a meaningful improvement with a similar procedure today.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Face lift or laser

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By 59 most Caucasian women will see great results from a face lift, but:

  • Tretinoin based skin care, Botox, peels and laser will help the fine lines.
  • They will also remove age spots
  • But for a predictable, permanent result in my experience, only face lift surgery will help the skin looseness of your face and jaw. Recovery is a few weeks.
  • Women of Asian and African-American heritage are less likely to need facelifts. If your surgeon won't do a face lift, you might get a second opinion.

Hope this helps!

Facial Rejuvenation

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There are many methods for facial  rejuvenation including surgical and nonsurgical techniques.  For patients that are not a candidate for surgery or not interested in surgery;  lasers can be employed to improve skin color-tone, reduce wrinkles and have some skin tightening.   Some lasers have down time whereas, others have no down time. 

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon

Laser, Peel, or Facelift, depends on you.

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Hare to tell without photos.  It sounds to me that an ablative procedure is what you are leaning towards.  A deep peel or laser resurfacing may help the age spots and fine lines and wrinkles.  Do not expect lifting of the soft tissue with these techniques.  If you want tissue lifted, then lift the tissue, (surgically).

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.