Best non-invasive way to treat sagging skin around mouth and lower eyes? (Photo)

Thanks for your question. As we age we lose volume and skin elasticity and that can show up as lines around our eyes and mouth. At your age, it is too soon to discuss anything surgical in my opinion. However adding volume would help significantly. You’re thin and need more volume to fill out your loosening skin. This can be achieved with fillers, such as Restylane, Juvederm, or Voluma. Or your own body fat, if you have any extra. Seek an experienced plastic surgeon in your area and ask about both options. Fat has an added benefit of providing stem cells in addition to volume. I wish you the best!

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

The soft tissues of your face are supported by your teeth and bone. While we cannot see your teeth I assume you haave a marrow maxilla, Dark buccal corridors (space between teeth and cheeks)

I would encourage you to get an consultation for evaluation for maxillary Expansion.

At age 28, you seem way too young for a facelift and non-invasive treatments are very appropriate. Not only will non-invasive treatments make you look better now, but they will prevent lines from forming later. We like to call this “prejuvenation”! I’d suggest laser treatments to improve the quality of your skin overall, such as a light fractionated laser for texture, combined with intense pulsed light to even out color. To really smooth out wrinkles and fill in under your eyes, you may want to consider minimally invasive procedures, such as injectables. Botox and the hyaluronic acid fillers can really bring back youth to your face with just a few injections. Please find a board-certified dermatologist to work with you now and over the years to keep looking fresh and lovely.

Thank you for your questions and pictures are always very helpful.  You are still quite young; so your options are more than most.  Dermal fillers such as voluma in the cheek area to lift and add volume could be an immediate option.  You could also have a consultation for a laser or Profound RF Lift.  The Profound RF design to address the jawline by lifting, tightening, and is the 1st device to create all 3 skin fundamentals: Elastin. Collagen. Hyaluronic Acid in one single treatment.

Dear lhanson33,
Thank you for your question. It is difficult to make an accurate assessment and recommendations based on photographs alone. We recommend you seek an in-person consultation with a facial plastic surgeon or plastic surgeon who can perform a thorough evaluation and discuss the best treatment options to address your goals. Neurotoxins and fillers are two non-surgical treatment options that can help reduce the appearance of certain facial lines. A good skin care regimen including retinol and a good eye cream are also very beneficial and least invasive. Treatments to improve the appearance of the skin such as PRP, laser resurfacing, and microneedling are helpful and can be combined with the other above mentioned treatments. 

Hello,Thank you for your question and pictures. Based on what can be seen it appears that you may benefit from some fillers like Voluma or Sculptra. They will give some support to the face and reduce the lines you see forming. However, you need to consult with a local physician to determine the best course of action. Good luck!

I don't see much true sagging on your photos, but you do look like you could use some volume in your cheeks. The added volume will make the cheeks look "lifted" and get rid of that "saggy" look. Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa Aesthetic Centers

Facial volume loss, particularly in the pillow-like pads of the cheeks and mid-cheek regions, is a major contributor to many of the age-related manifestations that disturb most people, such as the appearance of sagging, tiredness, angry-looking or sad-appearing countenances. Central facial volume loss and the accompanying descent of the remnants of these shrinking fat pads are largely responsible for the mid-facial flattening we see; the accentuation of the smile lines and marionette lines; and the formation of the hollowness, incipient bags and tear trough formation under the eyes. Accordingly, injectable volumizing fillers can be used to restore a more appropriate youthful fullness to the midface and cheek regions, which would usually result in an immediate "Wow!" improvement in smile and marionette lines (i.e. less sagging and jowling) , as well as softening of both the tear troughs and early bags under the eyes. If necessary, the under eye area may be subsequently treated for further improvement. In my NY practice I would choose Voluma XC for the cheeks, Ultra Plus XC for the mid-facial region and Belotero Balance for the under eyes. In my Israel satellite facility, where a far greater number of regulatory agency approved volumizing fillers are available, I would opt for Stylage XXL for the cheeks, Princess Volume for the mid-facial rejuvenation and Teosyal Redensity II for the under eyes. You would do well to make certain that you consutl with a board certified aesthetic physician with experience and expertise in nonsurgical facial rejuvenation with injectable agents. Be certain to ask to see his'her before and after photos of each of the areas that require treatment before agreeing to proceed. Best of luck. . 

A combination approach will give the most improvement. I recommend fillers for the folds themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer