What to do for laxity around mouth? (photos)

Hello,I agree with you, Ultherapy really hasn't proven it's worth as a 'skin tightener', and may very well cause fat reduction, something that is not desirable in the face. Beyond that, you don't really have laxity, you have changes in your skin composition, and possibly in subcutaneous fat content. I think you'd be better off with hyaluronic gel fillers, a safe and reversible way of improving skin contours and appearance.Best of luck! 

Thank you for sharing your question and including a photo. Based on your age and recent weight loss, you may be an excellent candidate for non-surgical thread lifting. NovaThreads, made from PDO suture material, are inserted beneath the skin and positioned to subtly lift sagging facial tissues. In my practice, I like to supplement the results of the thread lift by restoring lost volume with a dermal filler such as Restylane or Juvederm. For the right patient, NovaThreads are a great alternative to surgery and results can last up to 9 months. Since you are so young, your degree of facial sagging likely does not warrant a face lift at this juncture. For more information, I recommend scheduling a consultation with a board-certified specialist who is also trained in thread lifting. He/she will be able to evaluate you in person to determine which procedures are right for you. 

I have done occasionally done facelifts at an early age for those with massive weight loss and marked skin laxity, but you do not fall into that category. Although fillers can improve your laxity somewhat, they are temporary, and not the best long-term solution. In my patients’ experience, Ultherapy has been disappointing as well. With weight loss, your face has lost fat, and so fat transfer would be the optimal solution. Even if you are relatively thin, using small cannulas and harvesting from multiple sites can yield significant volume without donor site problems, and it gives lasting improvement. You would benefit from significant volume (many cc's).

Underneath the skin that you are noticing around your mouth is loose muscle. There is also  a deep indentation in the lower part of the cheek above your jawline.  What you're experiencing  is a combination of primarily volume loss and as a result of that, muscle laxity. There does not seem to be much skin excess. That being said, I would recommend researching volume replacement with fat transfer or hyaluronic acid fillers.  These must be performed by  a doctor who is highly experienced in the technique required for this area. Placing filler or fat in the wrong area will only worsen the problem.  It may also be beneficial to consider a mini-lower facelift to address the loose muscle. Unfortunately, if you just have procedures that tighten skin (non-surgical or surgical), there is a very good chance that you'll be disappointed , because, again, the skin is not the problem. 

Thank you for your question! Based on your photograph, and your age I would think that a hyaluronic filler would be an ideal place to start to help resolve this laxity around the mouth.  Hyaluonic acid fillers, such as Juvederm or Restylane, are made from molecules that make up cartilage.  They work not only by adding volume, but also by hydrating the skin.  Be sure to consult with a board certified, fellowship-trained facial plastic or general plastic surgeon who specializes in facial rejuvenation.I hope that this helps!-David Gilpin

You are still relatively young.  Your choices are surgical or nonsurgical.  I would consider volume replacement at this point.  There are some spectacular results achieved with Sculptra in this region.  Hyaluronic fillers would also do the job: Juvederm/Juvederm Voluma/Radiesse/Restylane Lift.  Surgical options would be to obtain your own fat and injected as a filler.  Each one of these options have pros and cons.  Consult with an expert in your region.