Would radio frequency or a filler be better for my skin and facial volume loss? (photos)

Question

Hello I'm 26 and have noticed some facial volume loss in the upper cheeks and nasolabial folds in the past two years. I'm not sure if skin laxity/sagging is the main issue, or if it's from volume loss. I'm wondering what the best procedure would be for this.

Michael I. Echavez, MD · Answer

You do not appear to have any significant skin laxity and this would be unusual at age 26.  I would say that dermal fillers could potentially be of benefit to you to improve your issue.  There are a variety of fillers that could be used for this purpose.

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Amelia Damse, DO · Answer

You have some early volume loss in the midface (cheeks). Usually addressing this area improves the prominent nasolabial folds as well. This is easily improved with a little filler in the midface. Hope this helps!

Nelson Lee Novick, MD · Answer

The kind of cheek flattening and the secondary development of smile lines and tear troughs related to volume loss seen in the photo is usually easily amenable to correction with the use of injectable robust HA fillers, such as Voluma XC or Restylane Lyft. What you mis-perceive as laxity is actually skin sagging due to the loss of the supportive volume underneath. Consequently, fillers, which correct volume loss issues are most appropriate. Addressing the presumed laxity would not be expected to produce satisfying improvement. Make sure that you consult with a board certified cosmetic dermatologist and be wary if the supposedly latest and greatest fraxel laser or RF device recently purchased by any particular venue is being hawked to you. Hope this helps.

Camille Cash, MD · Answer

You will likely have the best result from a combination of treatments.  Fillers can be used to restore volume loss and improve facial contours.  Morpheus8 treatments use RF technology combined with microneedling to improve overall skin tone and texture.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Kathleen Griffin, MD · Answer

Hi there! It does look like you have some volume loss in the cheek and under eye area. Some cheek/under eye filler could help lid the face and potentially even take care of the nasolabial folds too. You could also consider doing radio frequency microneedling to help stimulate your own collagen and prevent further volume loss. Hope this helps!