Do you suggest Botox or fillers? (photos)

23 y.o - my skin at times does not look as good as it once did. I will sometimes have eye bags regardless of how much sleep I get. In addition the lines around my mouth leading up to my nostrils are very noticeable and make my face look almost worn out and give illusion of "droopy" resting face. Seeking tight, firmer face. Hypothetically speaking, would getting Botox in the areas mentioned above & forehead at this age have any negative impact on my face down the road?

Doctor Answers 14

Fillers for depressions on upper cheeks, and smile lines.

Injection of a filler, such as Juvederm Voluma, in the upper cheek depressions will restore youthful fullness of the upper cheek.  If you are thin, even at the age of 23 years, you may have insufficient fat under the skin to maintain a youthful shape of your cheeks. The lines from the corners of your mouth to the nose (called nasolabial grooves) will be lifted, and improve when Juvederm Voluma  is injected in the upper cheek depressions. If the nasolabial lines are not completely corrected by treating the upper cheeks, Juvederm Ultra could be injected directly in the nasolabial area as well. 

In addition, I would suggest a series of chemical peel with salicylic acid or microdermabrasion series to improve the texture of your skin which appears uneven and bumpy in the photos. Please consult with a board-certified cosmetic dermatologist or dermatologic surgeon.

Cleveland Dermatologic Surgeon
4.8 out of 5 stars 20 reviews

Botox and Filler to Elevate Drooping Skin

Thank you very much for your question and photographs. From your pictures, you appear to be an excellent candidate for a noninvasive treatment with injectibles like Botox or dermal fillers. Botox Cosmetic is an excellent option for reducing fine facial lines, cause by repetitive muscle movement and expressions. Used in conjunction with dermal fillers, such as Juvederm or Restylane, you can have a ‘liquid facelift’ that would elevate your drooping tissue and plump lax skin. My recommendation is that you schedule a consultation appointment with a board certified plastic surgeon, who has experience with noninvasive techniques and injectibles. He/she will perform an in-person evaluation and present your options. 

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 108 reviews

Lines and Dark Circles

Thank you for your question. In my opinion you could use a good chemical peel for the dark circles. I would also recommend some sort of filler such as Juvederm/Restylane for the what you call "droop resting face". And since the fillers are not permanent if you did not like the look, it is only temporary. But this is a good choice for your age to boost confidence. Please consult a Board Certified Specialist in your area.

David Ikudayisi, MD
Tampa Internist
5.0 out of 5 stars 1 review

23 year old

Thank you for your question and photographs.  Botox cosmetic is a terrific option for softening lines and wrinkles caused by muscle contracture.  Filler products, injected properly, are a great option for what you describe as "droopy" resting face.  Skin that "does not look as good as it once did" would best be evaluated for possible treatments such as laser treatments or peels.  Best to consult with an experienced plastic surgeon for treatment options.  Good luck.

Fillers to your nasolabial folds

Based on your photos, you are describing dissatisfaction with the appearance of your nasolabial folds and per ioral lines. These areas are best addressed with fillers and not Botox. Fillers help restore volume and re contour areas of the face. The most popular, and safest, class of filler are hyaluronic acid fillers such as Juvederm and Perlane/Restylane. Botox is helpful for dynamic wrinkles, the lines that form when you smile and animate your face. A conservative amount of fillers at this age should not negatively affect your face down the line. With each treatment, there is a very small risk of infection and temporarily you may have some mild bruising and swelling. Fillers are not permanent and you also have to consider cost. Good luck!

Katherine Zamecki, MD, FACS
Danbury Oculoplastic Surgeon

Botox and fillers

Thank you for your question jamie01. Botox is a purified protein used to address wrinkles associated with facial expressions such as the horizontal lines seen on the forehead when one raises the brows and the vertical lines between the brows seen when one frowns. For my patients with volume loss under the eyes I recommend Restylane, a filler that restores the lost volume. For my patients with concerns in the nasolabial folds, I recommend Voluma or Juvederm. Such treatments generally have no negative impact down the road. Please consult with a doctor for specific recommendations.  Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 3 reviews

Do you suggest Botox or fillers?

Thank you for sharing your question and photographs. Based on your narrative you would most likely benefit from well-placed dermal fillers into your cheeks, lower eye, and peri oral region.  Filler will provide you with soft tissue volume, support, and lift.  Starting treatment early will help limit the continued effects of aging that are likely to take place. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Botox and Fillers

A combination of Botox and fillers would work very well for your wrinkles. You should also look into Thermage since this will help you produce new collagen and tighten the skin as well. Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Botox or fillers?

Thanks for your photos and questions. Most often young patients are good candidates for Botox and fillers, but it needs to be done in a subtle fashion. Young people need very little. I suggest you meet with a Board Certified Plastic Surgeon to discuss your injection options as well as skin care. Getting on an aggressive skin care regime EARLY, typically yields the best results.

Sean T. Doherty, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 30 reviews

Facial hollows

Fillers can be placed strategically to improve contour issues. Botox is used for lines of facial animation.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.