Best Non-surgical Treatment to Lift Skin and Build Collagen?

Question

I only have 2 wrinkles around the mouth and 1-2 on forehead. What I do have is facial sagging especially around the nasolabial fold. What is best for lifting? Are there any creams that work?

Sam Speron, MD, FACS · Answer

Building collagen has been most effective through laser resurfacing, in my opinion.  These lasers can get you the beautiful skin that you desire, but you may need several treatments depending upon how much downtime you can tolerate.

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

Sheila S. Nazarian, MD · Answer

You really need to meet with a Board Certified Plastic Surgeon to go over your non-surgical options and to set realistic expectations of what each method can do.  I have found thread lifting, FaceTite and Fillers to be very useful.My best,Dr. N

Robert W. Sheffield, MD · Answer

You can do plenty of things to help you with your expression lines, but first of all, we must talk about why these lines appear; one of these reasons is sun exposure that can gradually cause loss of collagen and elasticity; constant facial expressions is another reason. I recommend drinking 1lt of water daily, a good sunscreen above 30, regular facials with microdermabrasion, microneedling with platelets rich plasma, and a combination of CO2 laser and erbium laser. I suggest that your forehead lines get botulinum toxin like Botox or Dysport to relax your muscles, giving you a more relaxed look. For your lower face and bars around the mouth, I suggest dermal fillers such as Restylane to fill in each line and hydrate the skin from giving you that natural refreshed look.

Daniel Chang, MSc, MBBS, MRCS · Answer

Dear dee4now,
Thank you for your question. To anwer this, lets first understand why do we have saggy skin. It is due to 2 main reasons.
1. Biological ageing – Gradual loss of collagen, elastin, hyaluronic acid in skin, bone loss and soft tissue loss
2. Photo-ageing – Sun exposure leads to free radical damage of skin collagen, elastin, Hyaluronic acid
Here are your non surgical options.
Microbotox + FillersLifting with ThreadliftMaintainence with energy based devices – RF, HIFU
Micro-toxin is a special technique that helps to tighten and firm the upper layers of your skin.
Fillers help to revolumise, hence restoring volume to your alar groove.
Threadlifts serve to lift, reposition your saggy skin causing the nasolabial folds.
HIFU and RF stimulate fibroblasts to induce neo-collagenesis.
All the above treatments promote collagen growth, hence further enhancing the skin firming and tightening result. This improves skin quality and dynamism. 
For optimum results in patients with a fair degree of sagginess, I advocate combining all 3 steps. step 1 and 2 to fill and lift your face. This is followed by maintainence with step 3, 3 months later. 
I hope this helps you.

Robert Applebaum, MD · Answer

Creams cannot lift facial skin but can improve surface texture and reduce sun damage. For visible skin tightening you can investigate a non surgical procedure using radiofrequency energy that has proven effectiveness to tighten skin. The other option is to see a board certified Plastic Surgeon to consult regarding facial surgery for lifting.

Dennis Gross, MD · Answer

One of our newest lasers for skin tightening is the 3-D Collagen Firming Laser for face and neck. It firms, lifts and tightens your skin by stimulating collagen. This is the most effective rejuvenating laser treatment that is non- invasive!

Douglas J. Key, MD · Answer

There are three answers here, and I believe that all three are needed to give you your best result. I am speaking about those pesky nasolabial folds, often called the marionette lines.The first answer is tightening the cheeks because the folds are not just deepening but falling down. You can tighten and lift the cheeks with Ultherapy.The second answer is to tighten the folds as well. For tightening the around the mouth folds and lines we are using a new treatment, ThermiSmooth, which takes skin tightening around the eyes, mouth and neck to a whole new dimension. ThermiSmooth is a new generation of smart technologies that uses precisely controlled radiofrequency energy (RF) combined with Thermal Image Monitoring&trade;, to gain precision and greater effectiveness and in return gives you the best tightening response. The third answer is fillers, most likely Juvederm UltraPlus XC. Ultherapy and ThermiSmooth are great tightening tools but they don’t fill and fillers don’t tighten. Together they will fill and tighten for the results you’ll love.

Daniel Shapiro, MD · Answer

Thank you for your question. I would suggest Ultherapy for facial skin tightening. Ultherapy deposits focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will actually begin to lift and tone over time. Collagen is a natural protein that gives skin its youthfulness by keeping it firmed, toned and elastic. Plus, the treatment is completely non-invasive and does not require downtime. I have seen excellent results with the treatment.

D.J. Verret, MD · Answer

For your particular situation, as always consultation with a qualified physician is your best option. On a more general question of building collagen, there was a recent article in the New York times about collagen rejuvenation (August 18,2008 available online). The article was cited a review in The Archives of Dermatology which indicated that there were only 3 treatments scientifically proven effective at increasing collagen: topical application of retinol, carbon dioxide laser resurfacing, and injection of hyaluronic acid. Though these were the only treatments with studies, the theory should also hold for other laser ablative resurfacing modalities and probably other injectibles.

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