Lower face wrinkles & skin laxity, age 71, what's my best option? (Photo)

I Would recommend a combination of fat grafting and combination laser and dermabrasion. We have had excellent success with two different lasers used at same time. You have a common problem and multimodality therapy which can all be done in the office at the same time has worked very well in my hands. A deep plane lower facelift Woukd help the marionette lines which represents true ski laxity

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Lax skin with loss of volume can be improved with a combination of PDO Threads and Facial Fillers.
These are both in office and outpatient procedures. The first step is a complete consultation to evaluate your individual needs.

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

These type of wrinkles and skin texture problems around the mouth are very common. This is a skin resurfacing problem. Depending on several factors, your best treatment options include medium and deep chemical peels and lasers. I find that an ablative CO2 laser works the best for perioral resurfacing.

Hello Sasha. None of the modalities you have mentioned is specifically designed for treating fine lines and wrinkles on the surface like a deep full field resurfacing is (see link with photos). We suggest a deep full field (not fractional), CO2 or Erbium resurfacing. In our practice this procedure has about 2 weeks of recovery time but does an excellent job of collagen remodeling for the area around the mouth. Best of luck.

Based on the photo, the main issue here is superficial loss of collagen and elastin which is creating the peri-oral wrinkling. This is compounded by the subtle loss of fat volume around the mouth. The ideal solution would be combination treatment:
1. Chemical peel (or laser resurfacing) to create superficial collagen/elastin to help the fine lines/wrinkles.
2. Fat grafting to help deeper volumization of the perioral area.
3. PRP- this can be used in combination with the fat grafting to help better survival of the fat and topically to help facilitate skin healing after the chemical peel (or laser resurfacing)

Good luck

If wrinkling of the skin around mouth is your only concern, ypou should consider chemical peel, laser or dermabarsion; any of these will provide significant improvement. Good luck.

The best option for you is a combination of fat grafting and ablative laser resurfacing to regenerate volume and collagen under your skin.

I would recommend a combination of ablative laser (CO2, Erbium), RF micro-needling, and skin care. Fillers may be added as well. We've had very good results with Tixel (see link).