Sagging face at 40- would fillers help? (Photo)

Question

Dear Doctors, Thank you for taking the time to read my question. I am a soon to 40 year old woman with what I feel like, is early sagging. I have few wrinkles and have always been thin but feel like the sagging is aging me. What would you suggest?

Nima Shemirani, MD · Answer

Hi @queengodiva. I recommend a combination treatment of both dermal fillers and Morpheus 8.  Morpheus 8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin 
tightening and lifting.

Best of luck,

Dr. Nima

Ellen A. Mahony, MD · Answer

It is surprising how things just seem to sneak up on us!  But you're not alone, we all go through it.  I started using toxins at 29 and fillers at about 40.  It's amazing how just a little of both, or either, can make such a nice difference.There are many fillers available but I prefer the hyaluronic acids because they are soft, not permanent and can be reversed.The feminine face is remarkable for its greatest width at the midface with tapering to the chin.  There should be a noticeable and unified curve uniting the cheek and cheek bone.  The jawline should be smooth where the chin meets the the jaw.  Nasolabial folds are present on all of us but do deepen over time with the most depth at the crease of the nose.  Marionette lines eventually form from the angle of the mouth and create a fold at the cheek/chin junction.You have only early signs of these features and a couple of syringes of Juvederm would be a good place to start as you can always add more if you like it.  I would disguise the nasojugal fold, enhance the apple of your cheek, fill in the upper NLF and fill in the prejowl suclus (chin/cheek jct)- and see how that looks.  There is no need to over do it as the best results always look natural and "undone."Good luck!In good health,Ellen Mahony, MD

Reza Akef, MD · Answer

Thanks for your excellent question. A combination therapy is more effective. Fillers are mostly for volume loss and enhancement . Devices like clearlift laser, thermage , Ultherapy can help in skin thightening . The other option for soft lifting of skin would be PDO threadI would suggest you to see an expert physician

Michele S. Green, MD · Answer

You have an excellent question and it is representative of what many of my patients want to address.  A combination of treatments can help such as Thermage for skin tightening, fillers such as Juvederm and Restylane Lyft and collagen boosting injections such as Sculptra.  Please consult an expert in lasers and cosmetic injectables for the best results.  Best, Dr. Green

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question queengodiva. I understand your concern. Fillers are used to
restore lost volume in and enhance the appearance of the face. It is difficult to make an assessment without seeing the entire face in different angels. However if I had a patient who looked like the person in these photographs I would say she is likely a good candidate for fillers such as Voluma in the upper cheeks. I say likely because I cannot see the entire face. Voluma restores the youthful apple of the cheeks and pulls up on the lower face addressing the nasolabial folds, marionette lines, and jowls. Please
consult with a doctor for specific recommendations.  Good luck!

Shaun Patel, MD · Answer

Thanks for sharing your question and photos. Age related volume loss due to bone, fat, and collagen degradation is responsible for the visible signs of aging including undereye hollows, prominent jowls, marionette lines, nasolabial folds, prejowl hollows, and sagging of the skin. Combination treatment with Botox and fillers and topical skin care with or without lasers and other devices can be used to address these signs of aging. Fillers such as Sculptra Aesthetic can be used to address the volume loss in the midface. Sculptra works by stimulating your skin to produce more of its own collagen. When Sculptra is placed in the midface, it can lift the face and return normal contours to the face. Once Sculptra has been used to "lay the foundation", hyaluronic acid based fillers such as Restylane and Juvederm can be used to address specific lines and wrinkles. I recommend you see an experienced for an in person consultation and to determine an appropriate treatment strategy. Good luck!

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