Thank you for the question.
You are 42-years-old and you provided us with your photo of a side view of yourself and
you are stating that you’ve had weight fluctuations related to several pregnancies.
And you are questioning whether or not there is a chance that your skin will sag after
liposuction and at the same time, you have your trepidations about doing surgery.
So certainly, I can assist you with this question based on my own personal experience as a practicing
cosmetic surgeon.
A little bit of background, I’ve been in practice over 20 years in Manhattan and Long
Island helping people with this very problem.
In fact, I am also Board-certified in not only cosmetic surgery but I am also a Fellowship-trained
oculofacial plastic and reconstructive surgeon.
So facial rejuvenation is a big part of what I do and there has been a continuous evolution
over time in how we approach situations like yours.
So the one thing that can’t be done with just photos is a physical examination.
So the question that you start with is you’re concerned of sagging skin has to require physical
examination.
Basically, we have to be able to tell if your skin has the ability to retract and go to
its normal position or will it sag and when it sags, will it be an acceptable amount of
sag.
You see, the traditional approach from a surgical point of view has been to do some type of
lift or liposuction plus a lift.
From the non-surgical point of view and thanks to drugs that are injectable to melt fat as
well as non-surgical thermal tightening devices, those become a center to a non-surgical individual.
As a cosmetic surgeon and with the practice I have, I actually offer all those options.
So when I look at someone like yourself, I’ll just share with you a little bit about personal
bias.
I tend to be more conservative.
I tend not to advocate surgery per se in terms of lifting.
The youngest person I’ve ever done facelift for was 37 and a close second or in that same
range was a woman who was 42 but her face was jowly and her face was very thin so there
was no fat to remove but the skin was very much sagging.
In your situation, an approach that would be non-surgical that may be a good first line
therapy would be possibly liposuction to help you with the jowl as well as a non-surgical
skin tightening device.
In our practice, we have a laser that actually allows me to treat the skin deeper in to heat
up the tissue both the dermis, the backbone of the skin, as well as the deeper tissue
to cause contraction.
Now I chose this device after waiting and figuring out what device would actually deliver
what I want and give me still the hand of a surgeon to be able to apply it in a way
that makes sense to me.
A lot of devices are done by non-physicians and basically they place some type of connection
to the skin and generate heat and most of those devices have been met by a lot of resistance
from patients because of undesirable results and as well as unimpressive results.
But in my hands, I’ve been happy in this particular modality.
And last but not the least, I add fillers in a strategic place in order to create a
jawline effect using something called structural volumizing.
So there is an art into doing this and approaching this and it is never black and white but does
require a physical examination.
I recommend you to meet with several doctors.
I would recommend you to meet surgeons with different modalities in their office just
so you can minimize the bias and see who you are comfortable with and see what works for
you.
One of the things I tell my patients who are considering a limited surgical option or non-surgical
option is it is a relatively low risk and then you can always do surgery at a later
time.
So I hope that was helpful, I wish you the best of luck and thank you for your question!