Dr. Dean Kane Q & A.
Q. I have a slight downward turn at the corners of my mouth and vertical fine lines that appear indented just below the corners of my mouth, either side of my chin. The right side of my face is worse, as this is the side I sleep on. Do you think a PDO Thread Lift or Dermaroller would best address this problem? I know the PDO threads only last up to 2 yrs. FYI i do have naso-labial folds which I think can be resolved with filler but this wouldn’t address the lines or downward corners of my mouth.
A. Both a ThreadLift and Dermaroller address different aspects of facial aging. Without a in-person consultation, these may not be my first choices depending on your skin laxity, lack of fullness skin texture and ethnicity among many other variables.
Various options for surgical facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.
Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.
Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.
Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.
The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin” Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin.Volumais the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!.
Non-surgical facial contouring is possible with fillers such asRadiesse, a bone mineral for the nose or cheeks, jaw and chin as well.
Sculptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.
Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!
Dr. Obagi’s new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.
IPL and fractionated lasers such asCO2 and erbium and now RF (radio frequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.
If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.
You may consider: a traditional face and neck lift, short scar face and / or neck lift and ThreadLift.
The recent resurgence of the S-Lift (created in the early 1900’s), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the “quicker” procedure but not necessarily the quicker recovery or the improvement you desire.
ThreadLift was abandoned in the US due to its apparent simplicity but mis-understood value. In my hands with proper patient selection, the results were excellent.
Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills.
Dean Kane, MD, FACS