Q: 34 years old with saggy eyelid and cheeks. Are there any more permanent options than fillers or Botox at my age?
I am 34 years old. I had upper and lower jaw surgery four years ago, which reduced the size of my face (by a few milimeters only!). As you can see, I have excessive skin around my face that is now hanging. I would like something more permanent than fillers or Botox. People usually think I am almost ten years younger than I am, but if you look closer you see I am aging beyond my age. What are reasonable options for my age or skin? Thank you in advance.
A: Thanks for sharing your photos. They are helpful and they illustrate the concerns you have for skin and soft tissue laxity following a volume reduction of the facial boney skeleton. Like a clothes hanger that has been reduced in size, the overlying clothing will droop. Consider:
- Additional volume (filler) to the cheeks, like shoulder pads on the hanger may help.
- Shrinking the clothes to fit the smaller hanger is also a option; particularly in a younger patient with greater collagen and elasticity.
- Suspending the clothing higher than the hanger with suspension threads.
- Consultation with a Board Certified Plastic Surgeon who’s focus is on non-surgical, minimally invasive and surgical options to compare for your needs.
- Start a retinoid skin care program to stimulate skin cell turnover and collagen production with associated skin tightening and skin preparation for laser or chemical peel skin tightening
- Sculptra injectable to stimulate skin and soft tissue collagen tightening.
- Radiesse, a bone-like filler along the upper edge of the medial, middle and lateral cheek to raise the soft tissues
- ThermiTite, a radio-frequency skin tightening option
- PDO or Silhouette suspension Thread Facelift of the skin and soft-tissues with associated collagen tightening
- While you are younger than the usual facelift candidate, I do believe a face and neck lift may provide for you the best face skin and soft tissue redraping and longest lasting results.
I hope this helps. All the best!