Skin sagging or volume loss? Plus pronounced nasolabial folds and perioral mounds (photos)

Question

I am 23 and clearly showing signs of premature ageing. But does it seem to be a skin problem or a volume loss problem? (I have lost 20 kg at some point but am now up 10 kg again and afraid to lose them again). As you can see I can easily brunch up my skin and it’s just really “mushy”. Plus I have pronounced nasolabial folds and perioral mounds especially on one (right) side. What can be done about that? Maybe there’s a structural issue with my jaw? It’s causing me distress, I dislike my face..

Ali Sajjadian, MD, FACS · Answer

Hello,
Based on your weight loss history and your pictures, sagging the lower face is the major part of problem. Best option is a good Profound RF treatnment done by an experienced Practitioner and waiting for at least 6 months to see the final result ( lifting and thightening of lower face ).

Best regards,
Dr Ali Sajjadian

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

From the photos, there appears to be significant chin recession that can be easily addressed with the use of a robust HA voluminzing filler that can yield immediate, on-the-spot results, and engender little to no significant downtime. Appropriately injected HA lifting filler for the upper, outer cheeks will likely contour a more feminine, oval, heart-shaped face and diminish the smile lines, as well. You would be surprised how fast you can have the effects you seek without having the expense or downtime of going under the knife. These are filler techniques that those of us in the field practically perform every single day of practice. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injector. In experienced hands, the chin and the cheeks can be done in under a half hour with immediate results that typically yield a "Wow!" response. Hope this helps and best of luck.

Camille Cash, MD · Answer

From the submitted photos and description of your concerns you may have the best results from a combination of treatments.  Fillers can be used to address volume loss and give more harmony to facial contours.  Morpheus8 is a treatment that combines RF technology with microneedling to improve overall skin tone and texture.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

William Portuese, MD · Answer

At age 23, you do not have loose skin. Your side profile photographs demonstrate a recessive chin, because your mandible bone never grew far enough forward. Consider placement of a chin implant to augment your chin forward for better facial balance and proportions. Placement of a chin implant can be done under local anesthesia as an outpatient procedure, which takes about a half an hour.

Skin sagging or volume loss? Plus pronounced nasolabial folds and perioral mounds (photos)

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