What would be the best treatment to reduce the deep, many wrinkles especially on the lower part of my face. (photos)

I just turned 58. I would like to know if laser or injections would help. I have a small upper lip. And what are the costs?

Doctor Answers 9

Reduce wrinkles

Based on the photo you submitted I would suggest you could get significant benefit from:

1. Botox to the glabella (between your eyes), 2. Restylane under your eyes, in the nasolabial folds, lips and marrionette lines, 3. resurfacing either with laser or chemical peel.

Hope this helps.

Santa Monica Dermatologist
5.0 out of 5 stars 1 review

Facial wrinkles

MiXto CO2 Laser resurfacing is a great option (price varies by region of the country and extent of treatment - but you would get a lot of improvement for the cost). The patented hand piece delivers the treatment in a Z-pattern which is more comfortable than sequential delivery systems. This can be done with or without sedation using topical anesthetic cream and selective nerve blocks in an office setting. The social down time with optimal treatment is 5-7 days and the recovery is comfortable with little or no risk of infection and scarring. Maintenance of your new skin is important as the photo-aging process will continue. Sun precautions and skin care products (anti-oxidants, moisturizer, sun screen, retinols) are a must. If you are a smoker - this will affect your healing and cause continued aging of the skin. I would recommend Laser resurfacing first, followed by filler, but they could be done at the same time. A pass of OPL (CynoSure Icon MaxG) could be done prior to MiXto - or later as a maintenance treatment of pigment and vessels. Radiofrequency (Pelleve) is an alternative with no down time, but produces only temporary results and requires multiple treatments (much less "bang for the buck"). Often you can find physicians who have "package deals" or specials... Best wishes with your decisions!

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Best treatment for the reduction of deep wrinkles

Thank you for your email and for attaching pictures. In my opinion you would benefit from full ablative Sciton Erbium laser resurfacing of your face. The Sciton laser is fully tunable laser which safely and effectively can significantly decrease your fine lines and wrinkles. The down time is significant, but I have found nothing that delivers as powerful results as this laser. In addition to the laser resurfacing you could consider Botox and Fillers as well as Broad Band Light treatments to maintain your results post operatively. I always suggest a good skincare program complete with Retin A and a physical sunblock to protect your investment. Find a board certified plastic surgeon in your area that is a member of ASPS, is a member of ASAPS and has more than 3 years of experience with the Sciton laser performing fully ablative laser procedures. Best of luck.

What would be the best treatment to reduce the deep, many wrinkles especially on the lower part of my face

Fraxel® laser resurfacing is effective in smoothing any facial lines, but may require more than one treatment and then yearly maintenance. Treatment sessions can range anywhere from $500-$1000 each. Another option is a filler such as Juvederm®, which can fill the lines but often needs to be repeated every 6 months-1 year and can cost $700-$1000.

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 8 reviews

Lower Face Wrinkles/Laser or Injections--Combination Approach--Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juved

To treat deep facial wrinkles, you need fillers/ fat or sculptra to give you back your lost volume; laser resurfacing for texture/fine lines and wrinkles as well as skin tightening such as thermage or ultherapy. I suggest you see an expert for a combination approach.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 152 reviews

Lower face wrinkles

Fillers may be able to help, but if you want the skin around your mouth to be smooth, you will need some sort of laser treatment. I would recommend considering the Halo laser or a full field erbium laser. Make sure you see someone with extensive experience with facial rejuvenation so all your options can be discussed.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Laser and fillers

Fillers will help soften some facial depression along nasolabial folds and oral commissures. You might be a good candidate for some facial peels to get rid of or soften the lines on your face.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Options for lines and wrinkles in lower face

Most of your concerns seem to be related to the surface wrinkes around the mouth and adjacent areas.  Please feel free to look through some of my other answers on the topic of laser treatments and skin resurfacing for more information on the various options.

Resurfacing treatments would offer the most benefit for you.  There are a few options, but a series of 2 or 3 fractionated CO2 laser treatments would offer the most overall benefit.    With these treatments you need to expect gradual changes over time.  It is very difficult to get dramatic improvement with only one treatment unless you have a very aggressive procedure with a lot of downtime.

In my practice I usually combine CO2 with a second pass with an ablative erbium:YAG laser for some additional surface exfoliation.  It is very rare to treat just one area of the face, and that really doesn't make much sense if you think about it.

What we typically do is focus on the main problem area with a targeted treatment at a higher intensity but then treat the rest of the face and neck at lower settings.

Fillers can be useful around the mouth and for the lips themselves, but starting with skin resurfacing is the better option in your case.

Costs involved vary greatly even from office to office in the same city.  I try to keep my fees for these types of laser treatments on the low end of normal since I have more control over the overhead costs (unlike Botox or fillers for example).  What I described above is around $3,000 at my office, but a typical range to expect for a series of 2 or 3 treatments should be anywhere from $2500-$6500.

The effect of the laser treatments lasts forever but many patients will consider another round to boost the initial results a year, or two, or three later.

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lip lines

You have some fine lines all around the mouth.  There are a couple of options here.  You could do some laser resurfacing which will help to smooth out the lines and help with collagen production.  Another option is microneedles with radiofrequency which also will help to tighten the skin.  I would do that first.  It can take at least 6 months to see the improvement.  Then you can use some fillers for the residual lines and to give your lip move volume. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 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.