21, What can I do to address facial aging concerns? (Photos)

Question

I am a 21 year old and recently I have noticed that I have aged a lot, I look older than what I am. I think my skin is sagging and my nasolabial folds + eyebags are more prominent than what they used to be.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

Ronald J. Edelson, MD · Answer

The most helpful thing at your age is avoiding sun and smoking  That will age you faster than anything else.  Just basic skincare

Cengizhan Ekizceli, MD · Answer

Thanks for your question.
At 21, noticeable changes like nasolabial folds or mild under-eye puffiness are usually due to facial structure, genetics, or volume loss, not true aging. Skin sagging at this age is very uncommon.
You may benefit from:
Skincare focus: Hydration, sunscreen, retinoids, and a healthy lifestyle.
Non-surgical options: Light filler for midface support (cheeks) can soften folds and improve under-eye appearance.
Under-eye treatments: If hollowness is present, tear trough filler (by a skilled injector) can help.
A professional facial assessment would give the most accurate guidance. No major intervention is likely needed at your age.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics, especially in young people are almost exclusively based on facial skeletal structure.
Is the facial skeleton that determines each person individual look whether attractive or not so much.
Because of this the best treatment options are going to be once that alter rate and give support for the tissues Comparable to what a better facial skeletal structure would do.
Parts of the face that don’t have a strong foundation are going to lead to soft tissues that look like they sag or loose definition.
For example, if someone has a small mandible, they develop a premature double chin, loss of jawline definition, and premature jowls. 
The midface is no exception.
When it doesn’t have good projection, the soft tissues will look shallow and patience will develop bulging of the lower eyelid, fat pads prematurely.
The best treatments are going to be volume augmentation, which are best done with quality filler injections.
 Doing fillers well is an art that takes years to master.
The majority of providers offering facial fillers don’t really do that great of a job so finding the right provider is probably the number one goal.
In the hands of the right provider you’ll be given the right solution and those will be implemented correctly.
This is by far the most important variable, and I suggest you focus your efforts on provider selection as being the most important.
 Finding the right treatment without the right provider is going to be an undesirable experience.
At your age, I would avoid permanent surgical intervention.
To get a better understanding of what facial volume can accomplish consider looking at the website of Dr. David Mabrie, MD in San Francisco.
Real self doesn’t allow me to include website links so you’ll have to Google his name.
David is a facial plastic surgeon whose practice is exclusively devoted to facial volume enhancement using fillers only.
David’s work is the best I’ve ever seen and I consider his outcomes to be the gold standard.
 I don’t recommend everybody fly to San Francisco twice a year to get facial fillers, but seeing his outcomes can be a powerful educational tool to understand what fillers can accomplish in the hands of the right provider.
Best,
Mats Hagstrom MD

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