I'm 32 years old and my face always looks tired. Recommended treatment? (Photo)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question and photos. A combination of the right medical spa treatments can create beautiful results for people interested in anti-aging procedures. Injectable fillers can restore lost volume in the cheeks, chin and nasolabial folds. BOTOX® injections can smooth out dynamic wrinkles beside the eyes and between the brows. Laser skin resurfacing is also a great anti-aging treatment, as it stimulates collagen production and can create a smoother, clearer complexion.
 

This requires a combination approach to get long term improvement. I recommend a combination of Cosmelan, salt facials, peels, lasers, microneedling/prp, blue light, radiofrequency and isotretinoin. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

From the photos provided, particularly the non-smiling one on the left, it would appear that there are several issues that need to be addressed in order to refresh and rejuvenate the face and make it less "tired looking."  Volume loss particularly in the cheek bone regions has led to an overall flattening and falling of the face below them and to the increasing prominence of both the nasolabial folds (smile lines) and to the development of marionette lines. It is also in large measure responsible for the early jowl formation along the jawline and the "boxing off" of the lower face. Likewise, it has contributed to the hollowing and tear trough formation under the eyes. Accordingly, a nonsurgical cheek augmentation using a volumizing filler, such as Voluma XC, which would be my choice in my Manhattan office (or Stylage XXL, which would be my choice for this in my Israel satellite facility, where a far greater number of regulatory agency approved volumizers are available) would help to address many of these problems. Next, if necessary, any residual undereye problems, i.e. hollows or tear troughs can be treated with Belotero (NY) or Teosyal Redensity II (Israel).  The marionette lines and jawline can be significantly improved and straightened by the use of Restylaner Lyft (NY) or Restylane Volyme (Israel). All of the above can be performed in one treatment session or divided into multiple visits, and each should a go long way to helping to restoring the more youthful and refreshed appearance you are seeking. All of the above are advanced injection techniques that should not be left to the hands of inexperienced, novice injectors trained only to treat simple smile lines with ordinary Restylane or Juvederm. If you want a "Wow!" reaction right after treatment, make sure you consult with a board certified aesthetic physician and insist upon seeing his/her before and after pictures of each treatment area before agreeing to proceed. Best of luck. 

 It appears that you were I brows and forehead are sagging which is quite common. The best treatment for this would be a  brow lift done at the hairline with the irregular  Trichophytic  incision and possible hairline lowering if you desire this. If your hairline is low which it does not appear to be then it can be done endoscopically which will raise your hairline. Choose a surgeon very familiar with the IT Browlift and look at the hairline.  There should be no scar seen. Since the hair grows through the scar so it is not seen. 

Dear Sommer,It appears from you photos that you have sun damage to your facial skin and this is affecting the tired look you describe. First its important to protect your skin daily with sunprotetion creams. Next to repair past sun damage, certain medical creams containing retin-a can help.Certain BBL(broad based light) treatments can help as well to improve the appearance of facial skin.Finally, deeper laser treatments can more dramatically reverse sun damage but have recovery time associated with them. I'll leave a link below to help you learn more.I hope this was helpful. 

From what I can see there are a few things you could benefit from to give your face a pick me up. First start with good skincare! I good Vitamin C serum, sunscreen and a Retinol will help to turn the cells over and brighten the skin while protecting it from sundamage.A photofacial is a great no down time treatment that can also brighten your skin and get rid of any sundamage. Next your eyes seem to make you look tired. Having some fillers to the tear troughs can make all the difference in the world. Make sure you go to a physician who is experienced in this treatment though because if not done properly you can have issues. A little filler in the cheeks could also help the sagging around the mouth area by lifting everything up. At your age starting with these few things can really help give you results you are looking for in a relatively short period of time.

By looking at your photos I would recommend a combination of treatments and products.
Begin with a medical grade skin care line for daily use. This will improve and maintain the appearance of your skin.
To really brighten up and rejuvenate your skin I would recommend a series of chemical peels and microneedling with PRP.
I would also recommend filler to the tear troughs, cheeks.By lifting your cheeks, the nasolabial folds may improve and the marionette lines. If not you can add filler to those areas as well.
Hope this helps,

Hello and thank you for your question. In looking at the photo's that you submitted, I would recommend using fillers (Restylane or Juvederm) to give a more fuller look under your eyes as well as your Marionette lines and Nasolabial folds. You may also want to look into having a micro needling type procedure to rejuvenate the skin. Lastly and most importantly, to protect the skin, use sunscreen on a daily basis. Think of sunscreen as protecting your investment. Hope this helps.