Q. I’m only 38, but I feel like my face is falling. The area under the corners of my mouth is suddenly very droopy. What would help this? A mini-facelift?
A. Please obtain a proper evaluation from a talented and experienced, Board Certified Plastic Surgeon but I am happy to point out some options.
You may be 38 but so many factors come into play with the aging process. In the limited views of your photos, it looks like your back ground is European with thinner skin traits and you appear to have moderate sun damage. If you smoke, this will also accelerate the diminish the repair and regenerative process of anti-aging the skin and soft tissues of rejuvenation. Weight loss will also diminish volume and allow the skin to droop or drape.
As the fibrous connective tissues in the dermis and around the fat in the face weaken, the facial skin which is more adherent along the middle will drape or flow in an arc-like waves onto a beach. There are 5 fibrous walls which anchor the skin waves from joining each other creating the folds for which fillers are used to fill.
These folds include:
1. Lateral brow hooding fold
2. Naso-jugal fold
3. Naso-labial fold
4. Lateral commissure crease and marionette fold
5. The neck”fold” ie band
This explains the fold/wave of skin excess you have along the lateral commissure and under the lip, ie. skin and soft-tissue laxity.
On my exam, I would review with you:
– Most of us now begin with fillers to fill the folds and they do add volume but also create a unbalanced appearance to the face by additively gaining weight to the lower face. The maneuver over time actually ages the face and creates new creases or folds in unnatural areas of the lips and jowls.
– I prefer to use fillers to “fill” or smooth the dermal wrinkles around the eyes, nasolabial fold and lipstick creases. Filler in the “white roll” of the lip will also strengthen and outline the lip corners and reduce the lip creases.
– Adding volume to the cheeks will fill and “lift the cheek / naso-labial / jowl complex.
– A facelift or mini-face lift aims at suspending the soft tissues upwardly and the skin in a temporal direction. It does so best along the jawline and closer to the ear in most surgeons hands.
– I find a better option to lift the tissues closer to the mid-face, using the Silhouette InstaLift (SIL). This device lifts at the farthest points along the folds rather than pulls like a facelift from the incision. The SIL provides the non-surgical “lifting” that the SMASplasty and platysma suspension sutures perform in the traditional surgical facelift.
– If you have skin laxity, you may consider combining any of the above with the ThermiTIGHT, a minimally invasive procedure to obtain real skin shrinking by using a Radio Frequency directly under the skin rather than trying to penetrate the skin with laser energy.
– For progressive skin rejuvenation with skin tightening and pigmentation control, find a Certified Obagi ZO Skin Health Team for on-going skin improvement.
I hope this is helpful and gives you some options to discuss with a artsy, talented surgeon. All the best!
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