Best Treatment for Sagging Mouth and Wrinkles? (photo)

The only real “cure” for a sagging face is a facelift, which will set your clock back around 10 to 15 years – a dramatic difference. Fillers can restore volume, but the lift they offer is minimal. Plus, they must be re-administered frequently, which quickly adds up to the cost of surgery over time.From your photo, you seem to have some sun damage in addition to sagging. The best course would probably be laser resurfacing to even out your skin tone and smooth some of the wrinkles, plus a facelift with fat grafting to get rid of the sagging and restore volume to your midface. You might still need intermittent Botox to control the glabellar lines (11s). I hope this helps.

You have asked an excellent and challenging question. BOTOX® Cosmetic is a wonderful solution for the forehead, but it does need to be repeated every 4 to 6 months. After several years, you have in effect paid for a surgical procedure. Around the corners of the mouth, non-surgical correction is best done with fillers that also generally last no more than 6 months. The average well-done lower face lift (not a mini lift) should last on average close to 10 years and will also address the jowls. This is a highly individual decision that really can only be fully evaluated during an in-person consultation. At age 44, many people will try to hold off on having surgery by using BOTOX and fillers for a few years, but surgery does give a better long-term solution for the mouth. It is hard to talk economics without a one-on-one consultation.

A short scar facelift is a great option for many people. The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day, you can shower the next day, there're no scars behind the ears and you can wear your hair up anytime and most patients take no pain medicine. The result is usually the same in selected patients as a full scar facelift but it really depends on your exam.
Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the neck and jowls.
I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of mini facelifts and neck lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. 
I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right. 

If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.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 patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

The key to a natural appearance is to restore a youthful facial shape.  Due to the aging process, it appears that you have developed lower facial jowling, volume loss in lower eyelid area and hollowness in the temple region.  This has reversed the youthful heart-shaped appearance to a slightly more rectangular shape.  As a result, based on the photo that you have shown, I would recommend a customized lower facelift with a more vertical vector, fat grafting or fillers for temple and lower lids. This approach would restore a beautiful and natural youthful appearance. As always, a full in person examination would give your surgeon the best opportunity to determine an exact plan.

In general, wrinkles in the forehead respond best to Botox. For the marionette lines, Perlane or Restylane work fantastic. Choosing to go the surgical or non-surgical route really depends on the individual circumstances of the patient, and an in-person consult would be necessary to determine the best options for you. It appears you would obtain a great result from these treatments, and a facelift may be something to consider down the road. I hope this helps, and I wish you the best of luck!

No question that the most economical way to improve wrinkles is Botox. With that is cost effective considering your age and the fact that there are temporally remedies, something that you have to determine since the results only last 4 to 6 months. Another things to consider is the use of these material are not 100% equal in the results.

Fillers would work great for you. I would recommend Perlane, but Juvederm and Radiesse could also do the trick. I don't use Botox/Dysport in this area as there is too much risk of altering your smile. The fillers should work for 6-8 months and is an easy, safe office procedure. Go for it and good luck.

I think you would do well with a early facelift. . This won't do much for the wrinkles on the fhead that laser could certainly help that 

m I suggest a facelift because this will give you the longest term improvement per dollar spent

Dear Maggie Mae,

     Thanks for submitting your picture. Your picture reveals the followings : Forehead wrinkles, lateral upper lids sagginess, tear trough hollowness, naso labial folds, droopy corner of the mouth, slight jowls. Based on these findings I would recommend the follows : 1. Botox to the forehead and glabella. 2. Partial MACS lift - this partial face lift will raise the lateral upper lids, fill the tear trough hollownes, raise the folds and the corner of the mouth. This procedure is very powerfull, long lasting and economical. Consult with a board certified plastic surgeon who performed lots of MACS lift surgeries.

                              Best of luck,

                                                     Dr Widder