55-year-old woman with deeply wrinkled face after losing weight. What do you suggest? (Photo)

At age 55 I've lost 40 pounds in the last 8 months and am finally at the goal weight I've wanted to be at all my life, but I'm really concerned about my face!! I never had a regular skin care routine until the last few months, but am now using a 10% AHA exfoliant, Vitamin C, E, and CoQ10 and (non-prescription) retinol products every day (and applying sunscreen of course), but they don't do anything about the deep wrinkles (see pictures). What do you suggest?

Doctor Answers 6

Facial rejuvenation after weight loss

Hello RealSelfer123!

There is more than just one  treatment that can best benefit you (or anyone in general) to obtain optimal facial rejuvenation. Based on your photos and experience, I would suggest a combination of different treatments depending how invasive or non-invasive you prefer your treatments to be.  

I would start with Botox around the eyes, in between the brows,  and the forehead to rejuvenate the upper part of the face. Fractionated Co2 laser would be my next suggestion to rejuvenate and resurface the skin in conjunction with Ultherapy treatments for skin tightening, and to help stimulate and boost collagen. Having dermal fillers such as Restylane, Juvederm, Voluma, Sculptra or fat grafting to the face to replace volume where you have lost some facial fat is also highly recommended. 

Getting on a skin care regimen that is tailored to your specific needs is also important to correct, maintain and protect  the overall integrity of your skin. Many plastic surgeons, such as myself, carry highly effective medical grade skin care products in their office that can be suggested for your individual needs. 

Hope this helps! Good luck to you! 

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

A combination of fillers, Botox, lasers and a good skin care regimen will be very helpful!

Thank you for your question and photos. First of all, congratulations on your weight loss! That's amazing. 

It sounds like you have a good skincare regimen in place but would maybe consider increasing to a prescription-strength retinol and making sure your sunscreen is SPF 30+. Based on the photos you provided, it appears as though you have some volume loss in multiple areas that could be treated with fillers to help restore the volume you previously had. Botox in the forehead and around the eyes will help to soften the wrinkles you are starting to notice. Doing a Fraxel laser will help to improve your skin texture, fine lines, and improve sun damaged skin.

If considering any of these treatments, I recommend meeting with a board-certified dermatologist or plastic surgeon familiar with all of them who can help you decide on a treatment plan that works for you!

I hope this answer is helpful! Best of luck.

Tracy Leong, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 8 reviews

Wrinkled Face After Weight Loss

Hi and thanks for your question! As I see in the picture and based on the history that you provided, the main issue is significant volume loss in your face. As the skin becomes deflated, it will be sagged down and wrinkled. Hence, the primary solution is volume restoration with the variety of fillers that we have at our disposal. You can try stimulating fillers such as Sculptra or instant fillers such s Voluma, Juvederm, Restylane or.. which will be determined by your physician depending on the area of the injection. I hope this helps and good luck!  

Elham Jafari, MD
Irvine Physician
4.8 out of 5 stars 13 reviews

Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juvederm and Sculptra and Fat

you need fillers/ fat or sculptra to give you back your lost volume; laser resurfacing for texture/fine lines and wrinkles and skin tightening such as thermage. I suggest you see an expert for a combination approach.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Wrinkles after 40 pound weight loss

When losing weight, volume is lost in the face. I would recommend Sculptra to replace a large volume loss in your face. Skin tightening with Infini might be required as well. Topicals and chemical peels won't do much for this problem.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

What do you suggest?

Thank you for sharing your question and photographs and congratulations on your impressive weight loss.  The best results for your deep wrinkles would come from a combination of fat grafting to the key areas of the face to restore the volume lost with your 40 pounds followed by a full face and neck lift to remove the excess skin present.  If uninterested in surgical intervention, liberal use of dermal fillers will help "fill" the loose skin to make an improvement.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 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.