Best options to look better at 37 without surgery? (photo)

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.

Doctor Answers 21

Options for facial rejuvenation

Dermal fillers and botox are great options for smoothing out fine lines and wrinkles. There are certain areas, such as the eyes, that become problematic because it is usually an issue of excess skin that needs to be addressed. A surgical blepharoplasty can be a great option to rejuvenate the eye region, both the upper and lower eyelids. I see this as your main issue at the moment. Many times there is a hereditary component where patients will say their mother or father had the same thing in their 30's. Schedule a consultation with a facial plastic or plastic surgeon to better understand the procedure and see if you are an appropriate candidate. 

Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Go for an energy based device solution (rather than fillers for your face structure)

From looking at your face, you look good for your age but there are definitely some early signs of aging.  There are two ways that the face ages : with 1 ) Descent (which needs lifting) and with 2) Deflation (needing filler).

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.

Options to Look Younger

Thanks for your question, which quite frankly, is something that many of us see in our offices on a daily basis – patients wanting to have a non-invasive approach to make their skin look better. From your photographs, you have lots of great options, many of which have been proposed to you. First and foremost, I would recommend that you consult a board-certified dermatologist or plastic surgeon who is well versed in the use of fillers, neurotoxins like Botox, and the various lasers and light sources that can be used to help you achieve your goals.

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

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Anti-aging for late 30s

At 38 neuromodulators are very popular as they prevent lines and wrinkles from setting in. Ultherapy is also popular, as it tightens and lifts to avoid the sagginess that is seen along the jawline, by stimulating collagen turnover, which decreases with age. In addition, I use lasers under the eyes to help with the crepiness that accompanies the aging process, which is classically due to thinning skin secondary to a decrease in collagen turnover. There are many nonsurgical alternatives one can seek out, and I would recommend seeing a board certified dermatologist, who has a fundamental understanding of the volume and skin changes that are occurring so that the appropriate treatment regimen can be recommended. 

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 66 reviews

The Best Options for a Non-Surgical Facelift

Current Statistics say that 14 people prefer non-surgical options to the 1 person who would consider surgery. Thankfully, the non surgically facelift options keep getting better and better. Although a Facelift is truly the most effective method, there are certainly a number of non surgical options that can provide a patient with great satisfaction. You'll need to consider 2 things: 1) Replacing the facial volume where it has been lost over time and 2) Lifting and Tightening the sagging skin.

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.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 105 reviews

Non-surgical facial enhancents: the Liquid Facelift

Dear Laura7726:

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:
  1. Botox brow lift
  2. upper lid blepharoplasty (lid lift)
  3. cheek volume such as Voluma
  4. additional filler volume to the nasolabial folds, mouth corners and marrionette folds
  5. shave removal of your moles
  6. 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!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 67 reviews

Optimizing facial balance at 37yo

Hello Laura7726-
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. 

Good luck. 

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 35 reviews


Hello Laura7726, 

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.

Good Luck, 

Dr. S

Scott Shadfar, MD
Edmond Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Facial Rejuvenation without Surgery

Thank you for your question.

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.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 143 reviews

Rejuvenation options for a relatively youthful patient with familial aging changes

Thank you for your inquiry.  Evaluating the photographs is indeed helpful.  It is always important to keep things in perspective and photographs are helpful for this.  You do have some volume related changes which could be addressed with injectable fillers.  It is difficult to see the area around your mouth well but fillers under the eyes, in the midface, and most likely along the jaw line would appear to be of benefit.  It is possible that either pulsed light treatments or laser resurfacing (non-ablative or superficial fractional ablative) may be of benefit as well. Good luck!

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 40 reviews

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.