The skin next to my nose is sunken in and so it seems like my mouth protrudes. What can I do? (Photos)

Question

I have had these strange lines that almost look like a mustache, that I hate and feel make me look haggard, since I was really young.

Harold J. Kaplan, MD · Answer

Hello Izzy.  You are a great candidate for dermal fillers.  As another practitioner hasd pointed out, you are a good candidate for Sculptra as you are thin and the area of the cheek that is of concern to you (see photos at link) is one that responds very well to Sculptra.  Sculptra is also a longer lasting filler as it is your own collagen that creates the fill.

Nelson Lee Novick, MD · Answer

From the photos provided, there appears to be a deficit in cheek volume (as evidenced also by the tear troughs under the eyes), as well as the fairly pronounced nasolabial folds. Bolus injections over the cheekbones of a  lifting filler, such as Restylane Lyft or Hyabell Deep, will not only help the incipient hollowing under the eyes, but will likely secondarily smooth to some degree the smile lines. Following this, filler may then be added directly to the smile folds to further elevate and smooth them, which would no doubt diminish the unwanted shadowing that so disturbs you. The results of these treatments are immediate, generally engender an immediate "Wow!" reaction and result in little to no significant downtime. Threads are relatively expensive, have downtime, and really don't last as long as promised. And the purported benefits of other expensive "bells and whistles," like fraxel lasers and radiotherapy or ultrasound treatments, are supported more by marketing hype than hard science.  Make sure that you consult with a board certified aesthetic physician and ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

Jason Emer, MD · Answer

this needs fillers, threads and morpheus for non invasive options. but you may want an early face lift to give ou more results. this is sagging and you should also get peptide or hormonal therapy.

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Michael A. Persky, MD · Answer

Hi Izzy,
I would treat you with Sculptra to fill the area and naturally smooth the "hills and valleys" that are causing the shadows which make you look haggard and you hate.  The treatment is quick, easy, safe, and effective when performed by an expert.  It is very important that you choose your treating physician most carefully to achieve your goals and the best possible results.  Please feel free to contact my office to schedule your consultation/treatment appointment.  Good luck, be well, and hope to see you soon.
Michael A. Persky, MD
Encino, CA

Nadia Yousri, FRCOG, PhD, MBChB, · Answer

Hi Izzy,  Thanks for your query. Full medical history & full face assessment is essential- for the facial muscles especially those involved in smiling. use of fillers for lifting/volumizing the cheek area in a particular way will correct the sunken area subsequently. Fillers can be also injected to modulate the active group of muscles if deemed necessary. You need to see a highly experienced doctor to assess & provide the necessary fillers. All the bestDr. NY

Matt Tahsini, MD · Answer

Hello and thank you for your question, You are an excellent for fillers that will add some volume. Come on by for a consultation to discuss your concerns and options. Best wishes. 
Dr. T

The skin next to my nose is sunken in and so it seems like my mouth protrudes. What can I do? (Photos)

Answers (6)

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