Age 50, years of sun damage, loads of stress & RBF - suggestions? (Photos)

Based on your age and photos, a lower face and neck lift with CO2 laser resurfacing would be the most beneficial and impactful for you. Anything else is putting a bandaid on a large wound. some Botox would be nice but very temporary. Same with fillers like Juvederm and Restylane. I can't see your eyes in the photos but Blepharoplasty often pairs well with face/neck lift procedures. Find a good surgeon near you and go for it!

Getting a lower face/neck lift under local with a little iv sedation for complete comfort and the addition of Morpheus/ TCA peel at the same time would look so amazing and is so easy to undergo for roughly $20,000.

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

lines around the lips or smokers lines otherwise referred to as life lines are caused by a combination of loss of skin elasticity, sun damage and the mobile skin and soft tissue around the lips. This is one of the most frequently requested areas of treatment in a plastic surgery office. Interestingly surgery is not the answer here although we treat these frequently lines during facelifts and other cosmetic surgery of the face.
The 2 options are a resurfacing or fractionated laser which works well with varying amounts of down time and recovery versus injectable fillers which have no down time but don't last as long as a laser. The brand of laser can vary from a C02 laser to erbium laser and filler may include Belotro, Retylane or Juvederm.

Hello, and thank you for providing photos along with your question. Refreshing your appearance can be done in several ways, and with the sun damage that you have, you can benefit from a combination of treatments. Botox with fillers can reduce lines and facial creases, while lasers and RF devices, as well as chemical peels, can help treat sun damage and renew the skin from the inside out.

I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Such experts will have the knowledge of facial anatomy and have an eye for symmetry and facial balance. During your consultation, your surgeon can properly assess your skin quality and facial profile, customize the right procedure plan for you, and ensure the best possible results.

Hello,
Thank you for your question. Based on your photos, you would benefit from a lower facelift, necklift and lip lift with perioral resurfacing. Best of luck!
Mark G. Albert, M.D., F.A.C.S.New York, NY and Boston, MA

The two good options are a facelift and then fillers. Facelift will pull back the jowls and the loose neck skin. After that fillers can really help the lip lines. The combination of lasers for the whole skin and peels etc after the facelift healing is complete will make it even better.
Regards
Dr. J

The definition of facial rejuvenation varies from surgeon to surgeon and means different things to different patients. In general it is the process to try to reverse the facial appearance caused by aging. It may involve improving the skin texture and complexion, diminishing skin discoloration, minimizing fine lines and wrinkles, contouring hollows, or tightening loose tissue that has lost its elasticity.

There are a variety of procedures, both non-surgical and surgical which can be utilized to achieve these various goals. Fillers, Botox or Dysport, micro-fat grafts, chemical peels, a skin care program, lasers, skin tightening, and surgical lifts are some of the methods that are used to achieve a cosmetic improvement. Each has advantages and disadvantages as well as limitations of what they can achieve. The best technique or combination of procedures depends on desired outcome, individual anatomy, underlying medical health, and extent of aging. There is no one approach that is ideal for everyone.

I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with who has all of the modalities of treatment available. You should discuss your concerns with that surgeon in person.

Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California