What's the best way to tighten skin and lift mid face for Asian face?

Question

I’m 31 years old. In just the past year, I've noticed pretty big changes on my face. It really made me sad that my face now look longer, skinnier (I’m the same weight as before) and I have cheek hollows on the sides. It’s like the fat from my mid face area moved down to around my mouth area, creating that square long face and deeper lines around my mouth. I have decided to do PRP microneedling, and fillers to achieve the look I had just 2 years ago. Is this going to address the problem?

Jason Emer, MD · Answer

A combination approach is needed to get the most improvement with skin tightening for the face. I recommend fillers, microneedling combined with J Plasma, lasers (Fraxel, Clear + Brilliant, Co2), ultherapy and rf treatments to get the best outcomes. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Luis A. Cenedese, MD, FACS · Answer

PRP micro-needling AKA the Vampire Facial is performed by isolating a patient's own platelets and driving them into the face with thousands of channels created with a micro-needling device. Improvement in fine lines, large pores, discoloration and scars is typical.  Side effects include redness, bruising, swelling, scratches, allergic reactions to numbing creams and alcohol and infections.  Patients report a high satisfaction rate after one to three treatments during a six month period. 
PRP injection AKA the Vampire Facelift involves injecting one's own platelets below the skin into select problem areas (the lower eyelids, between the brows, around the mouth, cheeks or forehead.  Improvement in fine lines, large pores, discolorations and skin texture should be evident within one month following one treatment. Significant volume enhancement or skin tightening are not to be expected from PRP treatments alone.  For patients desiring augmentation PRP combined with fillers, fat or Sculptra injections should enhance the results and longevity of these treatments.
Bruising and swelling are more common after the injections than micro-needling.
Please use this information when consulting in person with an experienced Board Certified Specialist prior to making treatment decisions.

Karen Leong, MD · Answer

You got it exactly right! As we get older, the malar fat pad which used to sit up on our cheeks and give our faces that youthful, oval appearance starts to lose elasticity and falls into a lower position on the face. This in combination with skin that isn't as strong as it was before due to hormonal changes, sun exposure, and gravity, gives our faces that elongated look. 
The best approach to maintaining your face is to understand that this is a lifelong process of small steps along the way versus big overhauls. In our office we talk about the Signature Four: Color, Texture, Volume, and Elasticity. This means good skincare, building collagen in the skin, laser resurfacing/tightening, and fillers among others. A full evaluation is performed for every patient and a game plan is tailored to your needs.
For you, the goal is to start building collagen in your skin and to replace volume where you have lost it. For collagen, microneedling +/- RF plus PRP, laseMD, thermage, or ulthera are all viable options. Filler is temporary so you would have to return periodically for treatments. Sculptra could also be an option for you - this is a poly-L-lactic acid filler that builds collagen unlike the HA fillers and is nice in slender patients. Always, always use a broad spectrum sunscreen and mostly everyone benefits from retinol, but again, you would need to be fully evaluated before recommendations can be made.
Make sure you choose a physician you trust and whose plan aligns with your goals!
I hope this helps! - Dr. Leong

What's the best way to tighten skin and lift mid face for Asian face?

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