I want to rejuvenate my face a bit without going under. What treatments would you recommend? (photo)
Doctor Answers 6
Vampire Facelift may improve skin quality and add a little volume, but there are other non-surgical treatments for facial aging
Thank you for question. You submitted a question with a photo, asking how to improve your appearance or to rejuvenate your face without going under anesthesia. You describe undergoing Botox® and fillers in the past, and you are considering the Vampire Facelift®. You want do something to look somewhat younger, but you are not trying to aim for something as drastic as 20 years younger.
I can help you understand how I approach this question, which comes up in my practice every day. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. You are asking a question in a time where there are a lot of options, to the point where there is almost a tug-of-war between different ways to approach a problem without a clear understanding of the principles, so you often see a lot of messaging for different devices, brands, names of procedures, and names for injectables, so it can get overwhelming.
I’ll give you some overall understanding as to how I approach what you describe as a facial aging issue. In facial aging, two things happen: volume loss, and descent and sagging. In addition, things happen that affect the musculature of the face that then affects volume of bone, muscle, fat, and soft tissue of the face, as well as the skin.
To clarify the benefit of the Vampire Facelift®, it involves the combination of platelet-rich plasma (PRP) derived from your own blood to help stimulate your skin quality in a way that restores a lot of glow and vitality to the skin. It combines platelet-rich plasma (PRP) with a single syringe of an injectable filler such as hyaluronic acid filler like Restylane or Juvederm placed very strategically in different places so a person can overall look better, but it is a single syringe.
In the challenge of doing something non-surgical, there is a real opportunity to make a significant impact with a couple of different modalities. One would be restoring volume with something called structural volumizing, which is different from what is usually done to restore volume in the face. In the traditional approach to facial aging, the approach is to chase the lines and wrinkles, which is not bad, but is only one element, and this is normally done by adding volume in soft tissue. You can try to soften lines and wrinkles, and it will make an impact. You can add a little of volume to the soft tissue but will there be enough of an improvement? That’s the open question. When we do structural volumizing, we are placing long-lasting fillers such as Juvederm Ultra Plus or Juvederm Voluma at the level of the bone structure, between the muscle and the bone, in a way that restores some bone loss which occurs with facial aging - it’s a very important factor that is really under appreciated. People don’t realize the bone structure diminishes with age, and a few millimeters can be very significant in volume loss. With structural volumizing, we are restoring volume typically in the cheekbone, the jawline, the chin and restore a lot of the things that define a youthful appearance. There is something known as the Golden Ratio which is really important where the upper part of the face is at 1.6 proportionately to the lower part of the face which is at 1, a ratio of 1.6:1. A youthful face has that ratio, but as people get older, that ratio changes and the lower part of the face gets wider. So structural volumizing would be my approach from the foundational level.
At the soft tissue level, there is opportunity to soften some lines and wrinkles with the variety of fillers such as Restylane, and Juvederm. This creates volume in certain areas at a level just below the skin. When it comes to the finer lines resulting from dynamic activity of muscles, such in between the eyebrows often referred to as frown lines, this is where neurotoxins like Botox® and Dysport® have a tremendous benefit. With strategic placement of neurotoxins to treat different areas of the face, you can look natural, remain naturally animated, and not worry about looking too stiff and unnatural.
Last but not least is improving skin quality and texture, which is where the platelet-rich plasma (PRP) from the Vampire Facelift® concept does have potential value. PRP improves skin quality from within, in a way that nothing else does. Coming back to the more superficial levels of the skin, there are a lot of different devices and chemical peels to help improve the surface of the skin, anything from fractional laser, non-ablative laser, rejuvenation of the skin, HydraFacial- something to help create some glow. The challenge you’ve probably heard is cell turnover of the epidermis diminishes with age, so use of topical and retinols and different things help further exfoliate the skin and create this nice glow. In our practice, we use HydraFacial a lot, which is a device that combines microdermabrasion but uses water instead of crystals, and infuses glycolic acids and hyaluronic acid into the skin for a very nice glow.
The take home message is understand the concepts of what will make an impact, figure out what your goal is, your budget is, and if you want to do things in a stepwise way which many people do. I would say start with the foundations - start with the structure to restore some proportion, then work your way outward, and I think you will find yourself in a good place.
Meet with qualified, experience doctors who perform these procedures. Find someone who will resonate with your style. It’s a very important decision because whoever you go to, you and the doctor should have a real understanding or kind of a synergy in your aesthetics, and really have that communication. Don’t just chase a certain product,device, name or anything. Come up with an idea of the solutions, and figure out what works best for you. I hope that was helpful, I wish you the best of luck, and thank you for your question.
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You need volume in your face to lift it up. The Vampire Facelift lasts much longer than Juviderm alone to raise your face up to where it was when you were younger. I would also recommend bio identical hormones (not the drugs that cause cancer and blood clots), in conjunction with the Vampire in order to water and feed the PRP that has been injected. Bio identical hormones increase circulation to our entire body including the skin and structural fat on our face.
I would recommend Botox for your glabella area and fillers such as Voluma and Juvederm in conjunction with the Vampire Face lift. Which would give you the overall improvement you would need.
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Minimally invasive rejuvenation
Thanks for sharing your photo and your question.
You have a multitude of options, but I tend to agree with the direction you are leaning. I am actually a fan of the "vampire" approach using your very own blood product: PRP (platelet rich plasma). Very popular in my practice is PRP in combination with "Intensif" - radio frequency micro needling; I find the rejuvenation results dependable and the downtime to be almost nothing. You mentioned that you have had Botox before, and a retouch of Botox to the "11s" would be a recommendation that I would consider with you.
Vampire Facelift--Add lasers, sculptra, ultherapy
A vampire facelift is great for rejuvenation, but for best results I recommend a combination approach. I find that a combination of lasers or RF, sculptra for collagen building, microneedling/prp and skin care help the skin rejuvenation and prevent aging. Kybella, Ultherapy and/or ThermiRF treatments (Venus Legacy) would be non-invasive options that would do well in combination for skin tightening. Please see a cosmetic dermatologist for a long term treatment plan. Best, Dr. Emer
How can I look better and rejuvenated?
I think that the most effective treatments for you would be more filler and Botox. PRP Facials will create minimal improvement and wouldn't spend your money on that now. A chemical peel and good skin care that includes Retin A and growth factors such as Lifeline product line is also recommended.
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