Thank you for your question.
You submitted your question with several photos.
And you stated that you’re 42-years-old and that you are taking videos to follow the
progress of your Botox® and you became somewhat concerned about the appearance of your jaw
and your neck area.
And you’re looking for some guidance as to what to do in this situation with the photos
you submitted.
Well, I can certainly share with you my current approach to helping patients like yourself
every day in my practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And helping patients with rejuvenation and improving their facial appearance both surgically
and non-surgically has been the foundation of my practice and has certainly evolved for
many years.
So when I look at photos like you submitted, what comes to me first automatically is first
provide an explanation as to what you might be experiencing.
Now if you feel that this is a change or there is a certain shock to seeing this appearance,
well you can appreciate that this is based on a volume loss that is essentially genetic
in nature and that volume loss is mostly at the bone level.
As we get older, the bone or the foundational structure of our facial anatomy diminishes
in volume.
And a lot of times people feel that their skin is getting more loose and they keep pulling.
And at 42, I can tell you that someone like yourself, more of your facial aging change
is volume loss than it is sagging.
So essentially, when you think of aging, you think of volume loss and you think about laxity.
And so a lot of my colleagues especially those who do a lot of facelifts like myself, you
almost automatically feel that it is best to lift and improve the jawline and the neck
angle.
And although that is certainly a valid consideration, I would say that it is not taking into account
the volume loss.
And a lot of times, my colleagues are trying to compensate for volume loss by doing fat
grafting.
And the challenge there is that it is placed under the skin at a level that is not at the
bone.
So in our practice, what I do for someone like yourself is a procedure called Structural
Volumizing.
Structural Volumizing is actually a non-surgical procedure and it’s with a use of a long
lasting hyaluronic acid filler such as Juvederm Ultra Plus or Juvederm Voluma.
Now what we are essentially doing, what I am doing when I place this filler is I’m
not placing it just below the skin in a way that traditional fillers are typically placed
but rather I’m placing it at the bone level.
When you place it at the bone level, you are addressing the true underlying issue of facial
aging which is bone loss.
When that happens and it’s done in a certain way, you can actually get results that can
be not only comparable to a facelift but in many ways, exceeds the results of a facelift
because there is volume and definition that you would not be able to get no matter how
aggressively you lifted the face.
So I have certainly appreciated the remarkable effect and benefit that I have been able to
achieve.
And it’s a real change in paradigm from what I was doing for so many years where I
would work so hard to find the optimal lift that would be as tight and maximal at the
same time looking natural to get the jaw angle definition, the neck definition.
But for people in this age range and in the 40s typically as well as into the 50s, this
Structural Volumizing has really become a great strategy to helping people restore or
even enhance an area such as the cheekbone, the jaw angle and the jawline as well as the
chin.
It almost looks like you had facial implants but instead you had injectables done in a
course of less than 30 minutes and it’s a kind of thing where there really is no downtime.
So I think that since you've already had Botox®, you can learn about Structural Volumizing
and this strategy and I think you’ll find yourself very pleasantly impressed by the
potential outcome.
And again, it does take proper consultation.
And when I do my evaluation, I take photos from multiple angles and I look at things
at different angles so that I can strategize the volume that would be appropriate to create
the outcome that I want to achieve with my patient.
So meet with a doctor who performs this type of procedure and see if this is a way to help
you feel better about the appearance of your jawline and neck.
So I hope that was helpful, I wish you the best of luck and thank you for your question.