Money is a Factor, What Procedure Do You Think I Should Do First to Improve my Facial Appearance? (photo)

I have had some fillers in laugh lines and under eye area. My lower eye lids have bothered me since my mid twenties, and now I'm 40. Now I have a dull, wrinkled, sagging complexion AND I still need to further address my under eye area. Laser, or chemical peel with more filler? I can only afford to do one or the other in the near future, what would give me the most bang for my buck. If laser, I'd prefer to do in Dec so I have a LOT of time off to recover. Please advise. Gotta do something. Thank

Doctor Answers 2

Prescription Topicals and Under Eye Fillers Are An Economical Combination For Facial Rejuvenation

Of course, in the best of all possible worlds, where economics is not a factor, there would be little reason these days not to avail oneself of all the many nonsurgical approaches to facial rejuvenation. However, when money is a significant factor, a practical approach might consist of addressing the dull skin with a topical prescription regimen consisting of tretinoin, alpha hydroxy acid, and some form of barrier repair lotion.

If finances permitted, I would add a series of in-office glycolic acid 70% peels (or Jessner's , 20% TCA, or salicylic acid 30%), which are relatively inexpensive and can significantly improve color and texture of the skin and soften fine lines. I am incidentally not a big fan of microdermabrasion treatments, which amount to little more than what might be achieved with a home Clarisonic brush,  nor with fractional lasers, the latter tending to be on the expensive side and seldom realizing the marketing hype and promise.

Fillers (my personal favorite for under the eyes being Belotero Balance) can make a significant improvement for treating bags, dark circles and tear troughs under the eyes. 

New York Dermatologic Surgeon
4.8 out of 5 stars 27 reviews

Facial improvement with microablative laser resurfacing

If you are looking for an improvement in the texturing of your skin, decrease in pore size and improvement in sun damage and hyperpigmenation then you should consider microablative CO2 laser resurfacing.  This newest generation of skin resurfacing generally has a short, 6 -7 day recovery period and works quite well with men who are trying to refreshen their appearance.  These lasers are marketed under several names such as SmartXide and SmartSkin.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 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.