When I look in the mirror I feel like I have aged a lot in the last few years, but really this year. I will be 38 in a couple months. Short of actual surgery, what would you suggest? In the past (over a year ago) I have used botox for the 11, and crows feet and a little juvaderm to help with nose asymmetry, and divits on each side chin. Areas that bother me are my nose, my under eyes and chin/jaw area. As women in my family age they get jowly & baggy eye. Ive also attached a pic from 2009.
Best options to look better at 37 without surgery? (photo)
Doctor Answers 22
Facial rejuvenation without surgery.
I frequently see patients in my office who tell me they just don’t recognize themselves in the mirror anymore. As they have aged these patients have developed wrinkles, saggy skin, less facial volume and uneven pigmentation. They often tell me everyone keeps telling them they look tired. Everyone ages differently. Contributing factors to aging are genetics, sun exposure, and lifestyle choices. Alcohol consumption, smoking, stress and getting enough sleep all play a factor.
For patients seeking facial rejuvenation, there are several non-surgical way to address the visible signs of aging.
MEDICAL GRADE SKIN CARE PRODUCTS:
Good skincare starts with a good medical grade skin care product. These products can make the skin look its best and help lighten those dreaded pigmentation spots. In my office I carry the SkinMedica skin care line but there are other skin care lines that are comparable. Make sure you are using a skin care line that is 'medical grade' meaning it can only be obtained through a physician.
After you've established a good skin care routine you might want to go to the next step and start Botox injuections to stop crows feet and forehead wrinkling.
Fillers are another line of defense against wrinkles. They are often used in conjunction with Botox. While Botox addresses the wrinkles in the upper part of the face and Juvederm addresses the wrinkles in the lower part of the face. Fillers can fill in where facial volume has been lost in the mid face, they can also fill in the other lines that form around the mouth region.
JuvedermXC and Juvederm Ultra XC are two very popular fillers made by Allergan. A skilled injector can determine which of the 2 Juvederm products would be best suited to the patients needs. During the procedure the Juvederm, which is a jell, is injected into the face to smooth out wrinkles. The procedure takes about 15 minutes and last from 6 months to 2 years.
Chemical peels are another popular way to make your skin look it's best by removing fine lines and fading age spots. A chemical peel is a quick 15 minute procedure. Your skin may be red and peel for up to a week after the peel but this can be disguised with a light foundation.
If the patient further desires to take 10-15 years off of their face they may consider the surgical route and undergo a face lift, eye lift or a brow lift.
Options for facial rejuvenation
Go for an energy based device solution (rather than fillers for your face structure)
The best way to address deflation is with fillers such as Restylane, Radiesse, Juvederm, Voluma, etc. However, the mistake that some people make is to fix all aging with fillers and that leaves a big balloon face. Deflation should be re-inflated with fillers but descent should be lifted.
You have some deflation around the mid-face but most of your aging is with descent. I think fillers are (probably) not the most appropriate option for you at the current time. I think Botox in certain strategic areas can lift up your eyebrows and maybe even turn-up the downturn smile.
I think you were too young to consider a mini-lift or facelift, so the best option is noninvasive techniques for someone in your situation may be facial lasers or Ulthera or Thermage. I know this is in the liquid lift section, but I think your needs are going to be more well-suited for an energy-based device.
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Options to Look Younger
The first thing that we would recommend to you is a really good skin care routine utilizing some of the newer antioxidants and retinol products out there, or use growth factors, all along with sunscreen to give the skin the help that we all need as we age.
Second, I would maximize the use of fillers at this point, as you do show some signs of volume loss in the mid face region, although not much. Fillers such as Voluma, Perlane, Radiesse, and Sculptra, all work well here.
Third, I would recommend a series of IPL treatments to rejuvenate your skin, or perhaps a series of non-ablative fractional lasers that will also help here. One of the newer devices, the Solta Clear & Brilliant, is a wonderful way to enter into the laser world, as it is typically regarded as a milder form of fractional lasers.
There are lots of things you can do – go slow, do not overdo, and work with a skilled provider to make sure that you are getting the corrections that make you feel good about yourself
Anti-aging for late 30s
The Best Options for a Non-Surgical Facelift
A combination treatment approach will be the most effective way to achieve the desired results. Injectable Fillers can help replace volume where it has been lost, Botox can help smooth fine lines and wrinkle, Ulthera (ultrasound technology) can help tighten the skin and C02 laser can rejuvenate and refresh the outer layers of skin. You could choose to do all of these treatments or a combination of just a few. It's worth it to talk to an expert to plan out a treatment regime that will be best for you.
Non-surgical facial enhancents: the Liquid Facelift
Thanks for adding your photos. This is quite helpful. I will be long winded so you understand your options.
Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.
Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.
Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.
Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.
The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin" Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!.
Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.
Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.
Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!
Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.
IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.
We can consider: a traditional face and neck lift, short scar face and / or neck lift.
The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvement you desire.
Reviewing your photos, you appear to have good elasticity and resilience of your skin. Even when smiling, when you have the most youthful appearance, your cheeks remain a bit deflated. It is the changes under the skin, ie the fat and soft-tissues which are descending.
I believe you would benefit from:
- Botox brow lift
- upper lid blepharoplasty (lid lift)
- cheek volume such as Voluma
- additional filler volume to the nasolabial folds, mouth corners and marrionette folds
- shave removal of your moles
- and, skin texture improvement with a therapeutic exfoliation, retinol and anti-pigmentation program.
Should you wish to improve the slight concerns in your nose, you may proceed to non-surgical rhinoplasty but I believe your facial enhancements will bring you the goals and satisfaction you are looking for.
Please consult with a Board Certified and well experienced Plastic Surgeon who can provide a proper examination and all these options for your consideration.
I hope the above has been helpful. All the best!
Optimizing facial balance at 37yo
I believe that you are a great candidate for:
1. Upper blepharoplasty
2. Filler to lower eyelid furrow (restylane, belotero,...)
3. Filler to cheeks to highlight malar eminence and triangulate face
4. Shave excision of right cheek and possibly left chin raised benign appearing skin lesions.
PS-Consider a rhinoplasty refinement if you so desire.
Thank You for your question.
Without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of any further treatments it is difficult to be comprehensive.
Based on your photos your problematic areas seem to be centered around the eyes and mid face. Your neck line appears adequate at this stage.
I would consider long lasting fillers such as Voluma around the midface area which would shorten your lid cheek junction and lessening the obvious shadows around the lower eyelid. Also you could consider filler to the tear trough and lower eyelid.
Lastly, complementing this with Neuromodulator such as Botox would be helpful.
I would seek care from a facial plastic surgeon in your area who can evaluate you in person to discuss your options.
Facial Rejuvenation without Surgery
As an alternative to surgery, you may want to add to your regimen of fillers and Botox. Consider adding a Micro Laser Peel and a Photofacial. These can give mild skin tightening.
To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have these treatments.
I hope this helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.