53 y/o female - What are my options to correct dimpling, lip lines and fat pockets in the lower face? (photo)

Question

Hi! I’m a 53 year old female. I really dislike the lower portion of my face. My lip lines are awful, my chin is dimpled and I have little fat pockets underneath both sides of my lower lip. I had co2 laser done about 5 years ago and I feel that it made it worse. I take good care of my skin. I also have almost a line indentation that runs above and alongside my jawline that I’m not sure how to address. Do you have any recommendations for any of these issues?

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

"By injecting a small amount of Botox, Dysport, Xeomin, or Jeuveau into this area, the muscles will relax, causing the hard, deeps lines to smooth and improving the lines and wrinkles. Neuromodulators take 2 to 4 weeks to start working and lasts for up to six months. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer
"

Nelson Lee Novick, MD · Answer

There is no substitute for an in-person examination that allows for palpation and manipulation of the tissues in question, but at least from the one photo provided, it would appear that the use of microdroplets of Botox placed in perioral region would help to diminish or eliminate motion-related vertical lines. If the vertical lines have etched and creased the skin and are present at rest (static lines), then the use of a low viscosity, cohesive, malleable HA filler can elevate and smooth these. In a similar fashion, motion-related dimpling of the chin can be suppressed with small boluses of Botox and a more robust HA filler can be used to elevate and smooth any dimples and depressions that persist at rest. A profile photo of the jawline is necessary in order to evaluate this area. You would be wise to consult with an experienced, board certified cosmetic dermatologist and be very leary of any Dr. Google & Dr. Instagram recommendations for this or that expensive "bells and whistles" fraxel laser and RF gizmos, as the hard science to back up the use of these devices unfortunately lags woefully behind the heavy marketing and advertising to promote them. Best of luck.

Randal Haworth, MD, FACS · Answer

Based on your picture, it looks like you would be a great candidate for a facelift, which aims to improve the lower two-thirds of the face (plus the neck). The incisions are generally placed inside and around the ears. The procedure rejuvenates the face and neck by removing selected localized fat bulges (e.g. jowls) while resuspending others (the malar fat pads along with the nasolabial folds) and tightening deeper sagging structures (e.g. muscle and connective tissue-SMAS), concluded by a skillful redraping of the skin.

Of course, an « in person » exam is necessary. It is recommended to consult with a skilled board certified facial plastic surgeon for the best outcome.

Best of luck !

53 y/o female - What are my options to correct dimpling, lip lines and fat pockets in the lower face? (photo)

Answers (4)

Answer: Facelift

Answer: Facelift

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Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.

53 y/o female - What are my options to correct dimpling, lip lines and fat pockets in the lower face? (photo)

Answers (4)

Answer: Facelift

Answer: Facelift

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Recommended reading

Everything you need to know about CO2 Laser

Our mission is to create a world where every investment in modern beauty is Worth It.