37 y/o unhappy with the gaunt, jowly appearance of my lower face. Derm suggested Ultherapy and sculptra, but I can't afford both. Suggestions on most cost effective way to achieve greatest improvement to shape? Something else you'd suggest? Any other thoughts on addressing the displeasing, almost wavy shape of my lower face?
September 8, 2019
Answer: Ultherapy for jowls, Sculptra for "Gaunt" I agree that both would give you a nice result, but sympathize with your budgetary concerns. This is a common issue for dermatologists; the combo procedure would be best but not practical. The Sculptra will create volume in the cheeks, reducing the "gauntness" that you complain of. If done artfully, the shape of your face should be improved to a more "upside down egg" or oval shape, which is more youthful. Also, it should lift to a degree and give you a less jowly look. However, ultherapy's best results are on the jawline, where it tends to give a better definition and sharper angle. It is good for your skin type and should give you a nice result. However, it doesn't usually give you volume. And there are 10% of patients who don't seem to get a result.I would consider a third option, a combo of Hyaluronic acid fillers and Sculptra. I personally would give you Voluma in your upper cheeks and jawline for definition and lift and some Sculptra to give you some mid cheek volume to make you look less gaunt. As much as I love Ultherapy, I think fillers are more of a sure thing.
Helpful 1 person found this helpful
September 8, 2019
Answer: Ultherapy for jowls, Sculptra for "Gaunt" I agree that both would give you a nice result, but sympathize with your budgetary concerns. This is a common issue for dermatologists; the combo procedure would be best but not practical. The Sculptra will create volume in the cheeks, reducing the "gauntness" that you complain of. If done artfully, the shape of your face should be improved to a more "upside down egg" or oval shape, which is more youthful. Also, it should lift to a degree and give you a less jowly look. However, ultherapy's best results are on the jawline, where it tends to give a better definition and sharper angle. It is good for your skin type and should give you a nice result. However, it doesn't usually give you volume. And there are 10% of patients who don't seem to get a result.I would consider a third option, a combo of Hyaluronic acid fillers and Sculptra. I personally would give you Voluma in your upper cheeks and jawline for definition and lift and some Sculptra to give you some mid cheek volume to make you look less gaunt. As much as I love Ultherapy, I think fillers are more of a sure thing.
Helpful 1 person found this helpful
September 9, 2019
Answer: The choice between volume and tightening This is a really good question and one I am asked often in my practice. We know that facial aging leads to gradual volume loss. It is this process primarily that leads to a changing facial shape and sagging. For this reason, my response is always to start with volume replacement, whether with hyaluronic acid (HA) fillers, such as Juvederm, or with so called collagen stimulators such as Sculptra. Personally, I prefer HA fillers, as in my experience, they are more predictable and reproducible than Sculptra, which relies on the individual response of each patient. HA fillers are also reversible in the unlikely event of a problem. However some patients prefer the more gradual onset of Sculptra. It works by stimulating collagen but it is still essentially a filler. It just works a little differently. We offer both in my practice. I tend to recommend skin tightening treatments such as Ulthera or radiofrequency, when there is already sufficient facial volume. These treatments are designed to lift and tighten by stimulating collagen and elastin production. They do not add volume, they tighten around the existing structure. For younger patients, I usually recommend radiofrequency treatments such as Sublime or Exilis. These patients have more collagen to start with and radiofrequency thus works really well. For more mature patients, I recommend Ulthera. Using both volume replacement, such as with Sculptra and skin tightening, such as with Ulthera makes a lot of sense, as they should work synergistically. If I had to choose just one though, personally I would always start with volume replacement. Best of luck with whatever you choose!
Helpful 1 person found this helpful
September 9, 2019
Answer: The choice between volume and tightening This is a really good question and one I am asked often in my practice. We know that facial aging leads to gradual volume loss. It is this process primarily that leads to a changing facial shape and sagging. For this reason, my response is always to start with volume replacement, whether with hyaluronic acid (HA) fillers, such as Juvederm, or with so called collagen stimulators such as Sculptra. Personally, I prefer HA fillers, as in my experience, they are more predictable and reproducible than Sculptra, which relies on the individual response of each patient. HA fillers are also reversible in the unlikely event of a problem. However some patients prefer the more gradual onset of Sculptra. It works by stimulating collagen but it is still essentially a filler. It just works a little differently. We offer both in my practice. I tend to recommend skin tightening treatments such as Ulthera or radiofrequency, when there is already sufficient facial volume. These treatments are designed to lift and tighten by stimulating collagen and elastin production. They do not add volume, they tighten around the existing structure. For younger patients, I usually recommend radiofrequency treatments such as Sublime or Exilis. These patients have more collagen to start with and radiofrequency thus works really well. For more mature patients, I recommend Ulthera. Using both volume replacement, such as with Sculptra and skin tightening, such as with Ulthera makes a lot of sense, as they should work synergistically. If I had to choose just one though, personally I would always start with volume replacement. Best of luck with whatever you choose!
Helpful 1 person found this helpful