Filler or Sculptra? (Photo)

Question

Hi! I’m 47 and wanting a more defined jawline to address marionette lines and a little loose neck skin under chin. I had 3 rounds of Morpheus 8 last year with minimal results. I’m worried about my face looking wider with filler or sculptra. Just not ready for facelift yet.

Nelson Lee Novick, MD · Answer

I am not at all surprised by your lack of success with your prior RF treatments. My regular followers can tell you that I have been warning them for years already that the use of the expensive bells and whistles fraxel laser and RF devices with all their fancy names is backed up far more by marketing hype and social media buzz than any hard science. Sorry.
Sculptra is expensive and typically requires about three treatment sessions in order to realize results. It is for these reasons that I gave up using it quite a few years ago when robust HA volumizing and lifting Fillers were approved for use that typically yield the desired results after just one treatment (immediate, on-the-spot results) that last almost or as long as those from Sculptra. What's more, if for any reason, there is a need to dissolve the filler, HA fillers can be dissolved by a simple injection of a natural enzyme. Sculptra cannot be dissolved since there is no such equivalent enzyme for it. You would be wise to make sure that you consult with an experienced, board certified cosmetic dermatologist filler expert. And one more piece of advice. You would be wise not to go in to a consultation asking for a specific treatment because to your later disappointment and frustration, you are very likely to get what you ask for. Hope this helps and best of luck.

Sheryl D. Clark, MD, FAAD · Answer

Hello pattona:

I do think you would benefit from strategic placement of filler along the jawline, gonial angle, pre-jowl sulcus, and marionette lines.

If you were to measure the height of your face from chin to hairline, and the width of your face from zygoma to zygoma, you would see that your face is actually somewhat narrow. The ideal ratio is 1.618 to 1 for those two measurements. This ratio is called the phi ratio or the golden ratio, and is a ratio that we see in objects and in people that appear beautiful to the human eye. So I don’t feel you need to be concerned about making your face too wide. With the treatments areas I outlined, you would see a more defined jawline, less jowling, smoothing of marionette lines, and a more pleasing ratio.

It is important to know the depth and location that will create the most natural results and the safest treatment, and to use a blunt cannula instead if a needle to reduce trauma and make the treatment safer in certain areas. My ProContour MD liquid facelift was developed to respect these considerations. Please seek out an advanced injector with many years of experience, who understands the anatomy of the face in depth.

Please feel free to reach out with an additional questions questions.

All the best from New York City, Sheryl Clark MD, FAAD.

Leonard Grossman, MD · Answer

My first advice is not to have any more Morpheus treatments. With improperly selected needle depth the subdermal fat is destroyed, making you look considerably older some 6 to 12 months after the treatment. The one thing that happens in all individuals as the age, is the loss of facial volume. Facelift makes you look tighter, but not necessarily more youthful. The best way to restore facial volume and make you look younger, the way you used to look some 10 or 15 years earlier, is with the use of fat grafting. In my hands, fat grafting has produced natural and practically permanent results. This is not to say that everyone gets the same results, I do have only 31 years of experience in fat crafting. I hope this helps and good luck from New York City Plastic Surgery.

Filler or Sculptra? (Photo)

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