Suggested treatment for wrinkles and loose skin around my mouth area? (photos)

Hi Sook123.  Thanks for sharing photos.  Wrinkles & loose skin will look better if you restore dermal volume and thickness.  Profound radiofrequency microneedling increases collagen, elastin and hyaluronic acid.  A single treatment, completed under local anesthesia, can yield dramatic improvement with about 5 days downtime (redness, bruising, etc). The thicker your skin, the less likely it will sag, or wrinkle with muscle movement.  Yes, Botox can soften the muscle induced wrinkling and Juvederm injections can fill in hyaluronic acid gel into the wrinkles to immediately plump them. Topical retinA is irritating around the mouth, but a good stimulus for collagen production. All of these are either temporary, minimally invasive with little downtime, and/or need to be repeated throughout the year. Lasers, like chemical peels, will help increase collagen production by removing the top layers of skin. The Profound, CO2 lasers and TCA peels are all much deeper treatments that carry downtime, yield noticeable early results, and usually are not repeated frequently/within one year.  Generally speaking, the mouth skin is subject to continued movement and easily wrinkled, so there is no one and done treatment-even with a more aggressive treatment, you will still need to maintain your result with continued care.  Hope some of these differentiating points help you!

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.

It is also possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

My congratulations to you for your commitment to looking after yourself and addressing your weight with gastric bypass surgery.  As far as the issues you are facing around your mouth area, there are non-surgical treatments available for you to try first.  I would suggest Botox above your top lip to address the vertical lines and filler around you mouth area to help give you some volume.  You may also want to try a laser treatment to help address the deeper lines.  If, at this point you are not seeing the results you want, I would suggest a consultation with a plastic surgeon to determine if you are a candidate for a lower-lift.Hope this helps.Dr. Philip Solomon

First of all congratulations on your weight loss. Significant weight loss often results in loss of volume in areas where this is desireable (e.g. abdomen, thighs, etc.), but also in areas where volume loss is more problematic (e.g. face).  Loss of volume in the face can lead to wrinkles, jowling and a more aged appearance.  

Filler and/or fat grafting can increase volume for lips, cheeks and nasolabial folds, but jowling is best approached with a lifting procedure with or without fat grafting/filler.  Mild jowling can be improved with Ultherapy (Ulthera), but all jowls are best improved with a facelift or necklift procedure.  

Specifically for your lips, filler can improve the vertical lines that are visible. The jowling can be improved with either Ultherapy or facelift (mini or full depending on the characteristics of your facial skin and SMAS).

Best of luck!

Dr.  Miranda

Thank you for your question. A facelift can address creases along the nose to the mouth edges as well as remove loose skin from under the chin and jaw line. I suggest that you move forward and consult with a board certified facial plastic surgeon to learn more about the cost, process, recovery and results. 

Best wishes,

while a facelift can be very helpful for loose skin under the chin and along the jawline, it really does very little for fine lines and creases around the mouth. The two best options for this are injectable fillers and laser resurfacing.Fillers provide a minimal downtime, but temporary solution. Laser resurfacing requires time off, but provides a long term correction.  I would recommend consulting with a facial plastic surgeon, someone who focuses on facial rejuvenation to begin the process- best of luck!

Thanks for providing photos. I suggest you set up a consult with a board certified plastic surgeon. You may be a good candidate for fillers. There is a new filler called Volbella that is specifically designed for lines around the lip area. Another good procedure may be ThermiSmooth. This is a radio frequency device that helps tighten skin around the lips and eye area. Let you surgeon advise on timing of procedures. Best of luck to you!

Low dose botox will help with the dynamic lines, and with time reduce some of the static lines (lines which stay on you lips even when they are at rest) will also reduce. Dermaroller or laser will help with finer lines. Fillers along the lips (to plump them out) also helps with finer lines, and then for deeper vertical lines I would put a very small amount of filler along the lines, just under their deepest part just deep to the skin, to make them more shallow. 

Thank you for the great question and photos! This area is a challenge -- but there are MANY options. Lifting techniques (such as facelift or midface lift) don't really address the lips and chin area, but may be helpful with extra skin along the jawline and in the cheeks. For texture issues around the mouth, laser treatments (CO2 or Erbium) or microneedling (INFINI) can be used. In my practice, I choose between the 1540nm laser (an Erbium non-ablative laser) and the INFINI (radiofrequency microneedling) based on the patient's skin type, degree of issues, and recovery time desired. Best of luck!

I can understand your confusion because there are many options.  If you want your neck and jowls tightened,  there is no question that a facelift will give you the best result.  Other modalities such as injectables or lasers will provide small improvements.  Many people turn to injectables or lasers to avoid a facelift, but it you really want significant improvement, look into getting a facelift.  Nothing else you try will even come close.

I have done facelifts for aging faces from 35 and up. From 40 to 60 is the common age group for a face lift. After gastric bypass with large weight loss the skin losses elasticity. The jowls of your jawline can best be fixed with a jowl / face lift. Fillers can help but offer very temporary changes. I have had many women with aging faces after major weight loss, a facelift with SMAS is the way to go. Good luck...