is micro needling right for me? with RF? PRP? lasers? (Photo)

Question

I am looking for a treatment to boost collagen and prevent volume loss. I have a very lean face and have always had deep creases when I move (talking/smiling) though no lines at rest. I'm 36. I am considering micro needling but am confused by the different modalities and which would be best for my concerns (volume and tightness). I am also interested in lasers but equally confused because there are so many on the market.

Nelson Lee Novick, MD · Answer

Unfortunately, full face and profile views would have been additionally helpful. From what can be seen in the cropped photos provided, a resilient, cohesive, low viscosity HA filler fanned below the parallel laugh line creases seen would likely be very helpful in reducing this problem and in diminishing the degree of their worsening over time. Microneedling, which I have been performing for over two decades, in best reserved for improving very superficial, surface color and texture abnormalities--so, most likely, not what you are seeking. Relatively expensive, faddish, here-today-gone tomorrow  fraxel lasers and RF devices are far more heavily backed by marketing hype than hard science. The same may be said of PRP. So, a healthy dose of "buyer beware" would be a word to the wise when considering these options. You would be wise to consult with a board certified cosmetic dermatologist. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Viktoryia Kazlouskaya, MD · Answer

Microneedling will help with texture and will boost collagen, it will eventually make your skin thicker, brighter, and more even. However, it will not help with volume loss, tightness, and lines. The lines are probably physiology and unlikely to change. The only FDA-cleared device for skin tightening and lifting is ultherapy and you may try it for the chin/lower jaw. Also, using a filler around the mouth area with the specific technique supporting the skin may give an additional benefit. Best of luck, Dr K

is micro needling right for me? with RF? PRP? lasers? (Photo)

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