Thank you for your question. You’re asking if you are too young to have a Vampire Facelift®, and will you need to continue doing it. You are 21-years-old, and dealing with certain issues, including acne scarring, uneven skin tone, and sagging around the mouth. I can share with you, even in the absence of a photo and more details of your situation, the approach I would suggest, while explaining what exactly is a Vampire Facelift®. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I’ve been a longtime member of the Vampire Facelift® Network of doctors and I’ve also been a resource for media periodically when questions arise about the Vampire Facelift®. It’s important to make a distinction between the Vampire Facelift®, which is a very specific procedure exclusive to the doctors trained to perform these procedures in the Vampire Facelift® Network as developed by Dr. Charles Runnels. The Vampire Facelift® is a very specific procedure that involves the application of a single syringe of a hyaluronic acid filler, that is generally used for people who are experiencing facial volume loss often associated with facial aging. It means placement in areas such as the upper part of the brow, the nasolabial fold, under eye area, the lower lip area, the outer corners of the mouth, but it’s one syringe, which is one cc. With that is the use of platelet-rich plasma (PRP) applied in a very specific way to create a stimulation of the layers of the skin so the face has a nicer glow to it - a benefit very unique to PRP. That is in distinction to what is often used to incorrectly refer to the Vampire Facelift® which is PRP, or platelet-rich plasma, by itself. Stepping away from the concept of Vampire Facelift® now you understand what it is, acne scarring management requires proper evaluation. One strategy for acne scars doesn't apply to everybody. When I look at a patient with acne scarring, I take regular pictures, and also take photos with a method called backlighting to look at the shadows. I classify the different scars according to a standard, including rolling scars, boxcar scars, ice pick scars. There are different levels of all of these scarring, but there is a strategy of interventions are based on these specific classifications. It is also important to recognize whether there is volume loss such as fat loss under those scars. When you are considering a procedure, there is a potential value in helping your scars with PRP. We have done a combination of PRP injection with hyaluronic acid to help fill out the scar. Hyaluronic acid adds volume and provides a scaffold, while the PRP brings in collagen, blood supply, and does a lot of things to help remodel the skin. We’ve also done microneedling, then put PRP on top, so there are different ways PRP can be applied. We also injected PRP under the skin to help improve the fat volume and quality of the skin. Acne scarring can also be managed not only through regenerative technology, but with different laser and thermal energy devices. You can appreciate there are a lot of ways to manage acne scars. For the potential role of PRP, there is something to be said of its value. It is important to understand that there is no way for most people with acne scars to eliminate the scars altogether because these are areas of permanent tissue loss. Our goal as physicians is to diminish the contrast between the different depths of deeper shadows, versus contrast which draws the eyes’ attention, so it’s about improvement. Often these improvements are not just after one procedure, so you treat, observe, then get a perspective after particular areas are improved, so there’s an ongoing process. You asked whether you have to maintain anything. To a degree, there’s a certain amount of maintenance, but there’s also a treatment plan that usually means you are building on what you’ve done before, whether it’s the application of laser treatments, injectables, or procedures that undermine or release the scar. There are a lot of things we can do with acne scarring, so it’s important to understand what kind of scars you are dealing with, and have a doctor come up with a strategy that works optimally for your situation. There is an important role in my opinion from my experience treating acne scars with PRP, hyaluronic acid, but it’s not usually done just in isolation, but in combination with other treatments so you get the best possible outcome. For uneven skin, more detail would be necessary to address that issue. For sagging of the mouth, at 21 I don't think there’s a significant amount of volume loss unless it was a significant amount of weight loss, but I think when you meet with a doctor about your acne scars, you can show this area, and decide if there’s any intervention that might be of benefit. I hope that was helpful, I wish you the best of luck, and thank you for your question.