What mixture of fillers, fat transfers, surgery and lasers would you recommend for me to look more youthful? (Photos)

Question

Hello, recently I’ve wanted to feel rejuvenated, and would like to ask what you recommend for me in terms of under eyes and facial lasers. I had under eye fillers in 2023, but was recently told I’m no longer a good candidate and should consider surgery. What mixture of fillers, fat transfers, surgery and lasers would you recommend for me to look more youthful. Im 36 but feel that my face is looking 40 or 41 all of a sudden, and recent weight loss (down 14lbs) is likely a contributor.

Shahnoos Mahdavi, MD · Answer

Greeting.Significant weight loss can lead to increased skin laxity and sagging due to loss of underlying fat support and reduced collagen and elastin over time. This is especially noticeable in the face, jawline, and neck. In these cases, the most effective non-surgical approach focuses on collagen stimulation and skin tightening rather than adding volume alone.
Sculptra (a biostimulator) helps restore firmness by stimulating the body’s natural collagen production, improving skin thickness, elasticity, and overall structure gradually and naturally. RF microneedling further enhances results by tightening loose skin and triggering collagen remodeling through controlled radiofrequency energy delivered into the deeper skin layers.
Combining biostimulators like Sculptra with RF microneedling offers a powerful, long-lasting solution for post-weight-loss skin sagging, improving skin tone, firmness, and contour without surgery.

Anna Chacon, MD, FAAD · Answer

Thank you for such a thoughtful question — and I want to start by reassuring you that what you’re noticing is very common, especially after recent weight loss. Losing volume in the face can make changes feel sudden and more dramatic, even though nothing “went wrong.” At 36, this is much more about volume redistribution and skin quality than aging in the traditional sense.

Based on your history (prior under-eye filler and being told you’re no longer an ideal candidate), here’s how I’d think about this in a balanced, conservative way:

Under-Eye Area

If under-eye filler no longer looks right or is creating heaviness, that usually means the issue isn’t just volume loss in the tear trough itself. In many cases:

The problem is midface (cheek) volume loss, which makes the under-eye look hollow or tired.

Repeated filler directly under the eyes can worsen swelling or contour irregularities over time.

Better options may include:

Strategic cheek filler (small amounts, deeper placement) to support the under-eye indirectly

Fat transfer if true volume loss is significant and you want a longer-lasting solution

Lower blepharoplasty only if there is true skin laxity or fat herniation — surgery is not automatically the right answer for everyone

Fillers (Where They Still Make Sense)

Fillers can still be very helpful when used thoughtfully:

Cheeks (structure and lift)

Temples (often overlooked but very aging when hollow)

Jawline or chin (for balance, not sharpness)

The goal isn’t to add volume everywhere — it’s to restore support so your face looks rested, not filled.

Fat Transfer

Fat transfer can be beautiful in patients who:

Have had weight loss

Need broader, softer volume restoration

Want something more natural-feeling and longer lasting

It’s not for everyone, but in the right candidate, it can create a very youthful, soft result — especially in the midface.

Lasers & Skin Quality

This is where a lot of “youthfulness” actually comes from:

Resurfacing lasers (depending on your skin type) to improve texture, fine lines, and tone

Collagen-stimulating treatments (like RF microneedling or non-ablative lasers) to firm skin that’s lost elasticity after weight loss

Good skin quality often makes less filler or surgery necessary.

Big Picture

What you’re describing sounds less like “aging” and more like:

Volume shifts from weight loss

Loss of midface support

Skin needing collagen stimulation

The most youthful results usually come from a combination of subtle volume restoration + skin quality treatments, not just one aggressive procedure.

Darryl J. Blinski, MD · Answer

Based on your post photos appears your candidate for a mini temple face neck lift with muscle tightening. Best of virtual consult with expect fees to arrange from $8000-$15,000. Best of virtual console with.

What mixture of fillers, fat transfers, surgery and lasers would you recommend for me to look more youthful? (Photos)

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