Balancing + Enhancement + Aging? (photo)

Question

I have been considering a variety of surgery and treatments the last few years and am ready to pull the trigger. My desire is to have a more attractive and youthful appearance, and though I I don’t want to look like a completely different person I do be a few tweaks could go a long way. I’ve considered many things; a rhinoplasty, facelift/necklift, brow lift and bleph, forehead reduction, hair implant, j plasma, co2 laser, RF microneedling and forehead vein removal. So that leaves me wondering… If I was your patient, what would you recommend? I’m 47 years old and have had filler and Botox but no other procedures. Thank you for your feedback!

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your goals and concerns. It's great that you're considering a comprehensive approach to achieving a more youthful and attractive appearance. Given your age and previous treatments with fillers and Botox, here are some considerations that might help guide your decision:

Rhinoplasty: If you're looking to enhance the balance and symmetry of your facial features, a rhinoplasty can be a good option. This procedure can refine the nose shape and improve facial harmony.

Facelift/Necklift: These procedures are effective for addressing sagging skin and deep creases, particularly in the mid-to-lower face and neck. They can provide significant rejuvenation and help tighten and lift the skin.

Brow Lift and Blepharoplasty (Bleph): A brow lift can elevate drooping eyebrows and smooth forehead wrinkles, while blepharoplasty can rejuvenate the eye area by removing excess skin and fat from the eyelids.

Forehead Reduction: This procedure can lower the hairline and reduce the forehead's height, enhancing facial proportion.

Hair Implants: If hair loss is a concern, implants can restore hair density and improve overall appearance.

Minimally Invasive Options:

J Plasma: This can tighten skin and improve texture with minimal downtime.
CO2 Laser and RF Microneedling: Both are excellent for resurfacing the skin, reducing fine lines, and improving texture and tone.

Forehead Vein Removal: This can be considered if visible veins are a concern.

Given the range of procedures you're considering, a combination approach might provide the best results. However, it's crucial to consult with a board-certified plastic surgeon or dermatologist who can evaluate your specific needs and create a personalized treatment plan. They can help prioritize procedures based on your goals and the current condition of your skin and facial structure.

Balancing + Enhancement + Aging? (photo)

Answers (2)

Recommended reading

Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.

Balancing + Enhancement + Aging? (photo)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Microneedling

Our mission is to create a world where every investment in modern beauty is Worth It.