What procedure is best to stop early nasolabial folds and jowls? (photo)

Question

I am 30 years old and am beginning to see early signs of nasolabial folds and jowls. I tried fillers in this area about 6 months ago but did not really see a change. I’ve come across thermal and energy lasers in my research but have seen so many bad reviews of peoples facial fat wasting away due to them which would be a nightmare. I would love to just be able to slightly tighten up the area (30yr old LA girl problems :). Any advise would be greatly appreciated!

Kimberly Butterwick, MD · Answer

You don’t have pronounced nasolabial folds and so I wouldn’t treat them yet. However, when you’re ready, Restylane Refyne or Defyne are perfect in that area because they’re very flexible and move naturally when you laugh, frown, or otherwise emote. To keep your skin its best, I’d start you right away on regular chemical peels and medical grade skincare system, plus sun protection, of course. Please find a board-certified dermatologist to start preventing the signs of aging from showing up on your face. 
Many millennials like you are starting early in facial rejuvenation, not just to look better but to prevent or slow down an aged appearance. It is in fact easier to prevent a deep wrinkle than to treat it once it’s there.  Fillers are actually the easiest, less expensive option in most cases. 
You may not have liked fillers because the wrong filler was chosen. Restylane Refyne would be a good choice for you because it is smooth in fine lines and it’s very flexible, so it moves when you laugh or frown, and it feels very natural. At times, a little to the cheek or lateral face will actually pull back the nasolabial fold and will help it to look younger. Another procedure to do a few times in your 30s is to tighten the face with Ulthera or Thermage. In an experienced, top notch dermatology office, you will not have fat loss or other problems. These devices will work well in young women and will help to slow down the loss of elasticity and offset the tendency to sag. Lastly, it’s not too early to start on skin quality with a good medical grade skin care regimen, plus sun protection. An occasional low-level laser like Clear and Brilliant or IPL (intense pulsed light) can help with early brown spots, pores, redness and texture.

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

Jason Emer, MD · Answer

For nasolabial folds, I recommend a combination approach to get the most improvement with fillers for the folds themselves and to provide anatomical support with Sculptra for collagen building. Lasers and microneedling/prp will improve texture and tone while ultherapy/rf treatments will provide skin tightening and lift. threadlifting can be done as well to lift the area.  I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

What procedure is best to stop early nasolabial folds and jowls? (photo)

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What procedure is best to stop early nasolabial folds and jowls? (photo)

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Everything you need to know about Skin Tightening

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