I would like to look more youthful, what would you recommend? (photos)

45 years old, height 5.5, weight 56 Kg I have always felt attractive until recently. I have prominent nasal folds; around the eye area it is looking tired; my cheeks have dropped a little; and I have some sagging on the jaw line. I still look attractive when I smile as it lifts my face and I look back to me old self. If I would like to make myself look more youthful what would you recommend? I don’t mind what I do, as long as it is a good result.

Doctor Answers 7

Need Volume to face

Thank you for the question and photos. You are still attractive but over time one tends to lose some volume in the face which can give the tired, deflated look. I think you would benefit from cheek augmentation and tear trough filler. A very conservative lip augmentation can look good if done well without looking artificial. You neck and jaw line have only mild descent but a mini lift can help tighten the neck and jaw line. The augmentation can be done with HA fillers or fat transfer/grafting. Both work well and have their pros and cons. You should see a qualified physician who has experience in face aesthetics to do a full assessment. Good luck.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

More Youthful

Firstly, you look like you have taken good care of yourself and have great skin.  I would suggest some injectables such as Voluma to lift your cheeks and Restylane or Juvederm to rejuvenate the tear troughs.  You could also see an expert injector to see if you are a candidate for Kybella in the chin area and possible Botox in the neck bands.  Wishing you the best!

I would like to look more youthful, what would you recommend?

Hello, and thanks for your question and photos. You have great skin and mild volume loss, so you are an excellent candidate for rejuvenation with hyaluronic acid fillers. I would start with one or two syringes of Voluma in your cheeks to replace lost volume and create structure/definition. This has a nice lifting effect thereby softening some of the lines lower on the face. I would also place a syringe of Restylane in your tear troughs to make you look more rested and youthful. In order to determine the best treatment plan for you, I recommend an in-person consultation with a well-trained dermatologist or plastic surgeon. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews


Thanks for the question, I think you have identified the areas I would recommend to treat to rejuvenate your face.  In my opinion use of a filler to add volume to your cheeks/midface with a product such as Radiesse or Voluma would accomplish a number of your goals (restoring volume, which would then provide some lift to your cheeks and nasolabial folds).  Have a blessed day!

Soumo Banerji, MD
Pasadena Physician
5.0 out of 5 stars 1 review

Textbook description

what you describe is textbook for loss of midfacial volume. Your cheeks lose fat volume leaving your under eye area looking empty and drawn. As a result of your cheek deflation, the cheek skin tends to sag over your nasolabial folds causing them to look heavy. As you smile, your facial muscles pull your cheek pads back up to meet your eye lids and you look all youthful again. This is exactly why we smile in pictures, to look more youthful.  I strongly suspect that you would benefit from some mid facial volumisation and perhaps if thats not quite enough some softer fillers in the tear trough. These will do exactly what you need them to do and if you like the effect you can try a more permanent product or fat into the midface in the future. Hope that helps.Adam Goodwin

Try some HA Fillers

Thanks for the great question and the photos. I always start by asking the patient about what bothers them. Usually there is one or two areas. For you it seems as though you aren't happy with your cheeks or jawline. In my opinion the best option would be to try some hyaluronic acid (HA) fillers to your cheeks. They will not only restore some of the volume, but they should also help to soften your nasolabial folds as well. The early jowling on your jawline can also be partially concealed with some filler along your jaw. Make sure you see someone who is an experienced injector. Best of luck in your area!~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 31 reviews

Looking more youthful at 45

Thanks for your question. You are very pretty and with just a little filler and botox you will gain the look that you feel you have lost. As we age we lose volume, fat pads and elasticity in our face. You are seeing the early changes of this. A filler like Voluma will help bring back that volume very nicely in your cheeks and diminish the tired look. Then follow that up with Restylane or Juverderm to reduce the nasolabial folds, the early pre jowl area and tear-trough area. Your lips also lose volume and this can be improved with Restylane Silk, Juvederm or even Belotero.  Finally, a little Botox will remove wrinkles around the forehead and eyes. If you want to go an extra step then have skin rejuvenation therapy by Syneron. You will love the results. Have regular touch-ups as time goes on and you will look younger then feel that you look today. Good Luck, Dr. Eros

Christine Eros, MD
San Diego Family Physician
5.0 out of 5 stars 2 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.