Wrinkles in front of ears. What's the best treament for a 50 year old male? (Photo)

I have found great success in using Sculptra combined with fractional co2.  To maintain the results, adding Ultherapy or Thermage.  The co2 has to be quite aggressive in settings and the sculptra you need multiple treatments (vials).  A minifacelift would help as well and hides the scar in the ear line.  Fractional radiofrequency (Elos) has been working well in my hands as well.  There are many options.  Maybe a second opinion with a cosmetic dermatologist or plastic surgeon will help.  I wish you the best of luck, Dr. Emer.

The photos show a normal preauricular crease and wrinkles associated with facial aging. As you have seen, Sculptra in this area will not be helpful.  Fractionated CO2 laser could be effective at very high settings.  However, the best option for this problem is surgical, as this redundant skin is typically removed in a Mini-lift or Facelift procedure.