What is the best treatment for texture and collagen loss? I'm 45 (Photos)

Question

I'm wondering if I have typical progression of jowls for my age? Would prefer non invasive at my age but also wondering if I am a candidate for a mini facelift? I think immense stress over the past 5 years has caused this prematurely. Thank you!

David Hansen, MD · Answer

Getting the mini lift under local with a little iv sedation for complete comfort and also getting the Morpheus and TCA peel done at the same time for the whole face/neck/chest would look amazing.  It is so easy  to undergo and results look so amazing and natural.

David Parizh, DO · Answer

I ask my patients what their top 3 goals are. I then cater a surgical plan to meet those goals. 
There unfortunately is a lot of marketing mixed in. Let me assure you that there are no easy or quick fixes for any problem. If you want long lasting results that do not require a lot of maintenance then surgery is an option. If you want to have mild to moderate results and are ok with more time commitment for multiple treatments (and often times long term more money), then you can proceed with a multitude of nonsurgical treatments. They all have various benefits. However, the above holds true regarding time commitment, cost, and degree of improvement. 
There are many surgical approaches to facial rejuvenation. A facelift will address jowling and deep nasolabial folds. Fat grafting is a good tool to fill volume loss. 
Lasers or peels accomplish the same thing. They smooth out the skin like sand paper. This is also another adjunct in addition to skin care regimens. 
A board certified plastic surgeon, passionate about facial rejuvenation can have an educational discussion to create a plan catered to your needs/goals. I hope you find someone you trust along the way. Best of luck in your search!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Since you are interested in non-surgical options, there are several treatments that may address the concerns you’re referring to. Laser resurfacing can improve the appearance of skin texture and mild laxity by removing the outer layer of skin and revealing the healthier layer below. 
RF microneedling is also a great option for increasing the body’s collagen production, restoring the skin’s elasticity, and reducing the appearance of jowl formation. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your aesthetic goals and treatment preferences to determine the best approach for you.

Jason Emer, MD · Answer

Moxi is a ligher laser and helps with pores, we love it every 4-8 weeks along with peels between at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules weekly, see link) should be started now to prevent further aging. For facial rejuvenation, I would suggest a combination approach of 1) skin care with products and PRP/microneedling 2) PDT light therapy few times a month with growth factors 3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/Halo, Viva, Co2/Erbium 4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill 5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting 6) botox every 2-3 months to stop movement lines and prevent lines at rest 7) deep microneedling RF like Fractora/morpheus8/PiXel8 for tightening of the skin 8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months) Best, Dr. Emer.

Marc Polacco, MD · Answer

Thank you for your question. In general, there are three main aspects to the aging face: volume loss, tissue descent, and texture/color at the skin surface. A facelift is typically the best treatment for brining tissue back into a more youthful position. Filler or fat grafting works nicely for replacing lost volume. Laser resurfacing or microneedling can be effective for improving skin texture and color. I hope this is helpful, and I wish you all the best!
-Dr. P

Zoran Potparic, MD · Answer

Based on these very limited photos, you seem to be a candidate for neck/lower face lift and fillers/fat grafts. In person consultation with a board certified plastic surgeon, expert in face lift and facial rejuvenation, is recommended.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Jowling can vary tremendously from patient to patient. Age doesn't always correspond with progression. You would be a candidate for a mini-lift procedure, but these sometimes aren't aggressive enough to address jowling as opposed to a deep-plane facelift. Less invasive options which may provide some improvement include FaceTite and Morpheus8. The results are not the same as surgery, but there can be nice improvements. Hope that helps!

Leo McCafferty, MD · Answer

It is difficult to tell from your photograph whether you would benefit from surgical options such as a mini lift at this time.  Regardless I do think you would benefit from generalized skin care on the entire face and neck and specifically the perioral area.  This should be part of of any comprehensive plan. I would suggest you see a board certified plastic surgeon experienced in facial rejuvenation and also consult with an esthetician that may be in his/her office to discuss the facial texture issues you describe.  Good luck!

Robert Singer, MD · Answer

The definition of facial rejuvenation varies from surgeon to surgeon and means different things to different patients. In general it is the process to try to reverse the facial appearance caused by aging. It may involve improving the skin texture and complexion, diminishing skin discoloration, minimizing fine lines and wrinkles, contouring hollows, or tightening loose tissue that has lost its elasticity.

There are a variety of procedures, both non-surgical and surgical which can be utilized to achieve these various goals. Fillers, Botox or Dysport, micro-fat grafts, chemical peels, a skin care program, lasers, skin tightening, and surgical lifts are some of the methods that are used to achieve a cosmetic improvement. Each has advantages and disadvantages as well as limitations of what they can achieve. The best technique or combination of procedures depends on desired outcome, individual anatomy, underlying medical health, and extent of aging. There is no one approach that is ideal for everyone.

I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with who has all of the modalities of treatment available. You should discuss your concerns with that surgeon in person.

Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Darryl J. Blinski, MD · Answer

Based upon the posted photos I recommend mini FL/NL SMAS plication with possible My Elevate neck suture technique/ plus HA fillers 4-6 syringes. Fee $10,000. Best to virtual consult with...

What is the best treatment for texture and collagen loss? I'm 45 (Photos)

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