Thank you for your question!
You stated in your question that you’re 46 and you’re asking for a plan to age gracefully.
With your question, you submitted multiple photos with and without expression as well
as view under your chin and you state that you have concerns about everything from tired
looking eyes, sagging skin in the jawline and jowls as well as dull-looking skin and
you’re looking for recommendations and a plan.
You certainly want to avoid looking unnatural.
Well, at least in this question, you do state very specifically that you’ve always had
concerns about the definition of your jawline and I think there’s an opportunity here
to actually focus in that area.
To give you a little bit about my background, I’m a board certified cosmetic surgeon and
a fellowship trained oculofacial plastic and reconstructive surgeon.
And in been practicing in Manhattan and Long Island for over 20 years, I’ve focused significantly
on facial aging changes.
In fact, I wrote a book several years ago about to help consumers, people like yourself,
learn more about options and still look natural.
I think that one of the interesting things that we are experiencing for years now is
that as accessible as cosmetic procedures have becomes, the proliferation and accessibility
of a lot of information also has people exposed to a lot of undesirable cosmetic procedure
results that make people naturally fearful about what they would like if they do a procedure.
It’s amazing how in 20 years, with almost every consultation, not only the persons expressing
their desired outcome, what they want but they also very clearly describe what they
don’t want.
So unfortunately, thanks to the tabloids and television, we’re seeing a lot of celebrities
and pseudo celebrities not looking as natural as one would hope.
So the concept of a plan is very important.
As a specialist and someone who offers everything from skin care products to minimally invasive
procedures to advanced surgery, daily serving as a role of being a primary care doctor for
beauty.
So when I look at your photos and like every patient I speak to, I always say you have
a lot of concerns.
What are your priorities?
Where do you look first when you look in the mirror?
And that usually reveals the hierarchy of what they want to deal with first.
So let’s talk about the jawline.
Well understanding that sometimes when people, especially a lot of women who feel like they’re
starting to jowl or lose jaw definition, assume appropriately that they need some type of
elevation because they’ll lift and they’ll see that jawline looks sharper and they think
that’s the right way to go.
Well, although I do a lot of facelifts, I can tell you that there is a time and place
for everything and it depends a lot on skin laxity.
In your situation, being in your mid-40s, I can tell you that a lot of people will actually
not necessarily have to do lifting but rather do something to address volume loss.
And the point of that is to understand what happens in facial aging.
There are two things: there is loss of bone, muscle and fat which is significant and sagging
– sagging of skin and soft tissue and muscle.
So in a situation like yours, to just focus on the jawline, we could possibly consider,
again this is in absence of a physical examination, a procedure called the Y lift.
In our practice, we perform this Y lift procedure which is kind of a hybrid procedure in a way
of combining the minimally invasiveness of fillers or injectables with the structural
improvements that occur with surgery.
So what does that mean?
Well, understand that the bone structure is a structure that sets the foundation of our
faces.
The concept of Y lift involves the placement of long-lasting fillers such as Juvederm,
Ultra Plus under the muscles, in a very elegant way with minimal discomfort, almost no pain
or swelling.
You can actually restore cheek bone structure, jawline structure.
It can actually do a lot and at the same time, look very natural.
So there’s a method and there’s the artistry.
And as an artist and I always try to look at someone and see what they look like a few
years ago when they were much younger and try to restore the balance.
You know there’s something called the golden ratio and it has to do with the different
aspects of an attractive face and I found with Y lift, a little bit of cheek accentuation
and jawline accentuation, can certainly go a long way.
So that being said, with that, that addresses one issue.
So when you think about it globally, you have to come up with your own list of things you
want to do and of course, work with the doctor of how many things you can do at one given
time.
You always have to match priority with feasibility and of course, expense.
So with that being said, I think opportunities also in terms of skin quality, someone like
yourself, we often use something called platelet-rich plasma (PRP).
Platelet-rich plasma is derived from your own blood and it used to stimulate your body’s
collagen.
It helps to improve skin quality in a way that actually restores glow to the skin and
this is also something that’s unique in the way skin rejuvenation is approached.
For surface issues, we often use something called Hydrafacial or glycolic acid based
technology that infuses glycolic acid into the skin as well as hydrates the skin.
So certainly, I think that with your situation, speaking as if someone like yourself comes
to our office, if you’re concerned about jawline definition and overall structure then
within one setting, we can do a combination of Y lift and Hydrafacial which is a common
thing that a lot of people who travel to New York City will do.
They’ll come by our office and get the Y lift and Hydrafacial and then go out to dinner
the same night which is really nice because these procedures are not procedures that require
significant downtime or recovery so that’s pretty nice and at the same time, there’s
a nice impact and result that can last for several years.
So that being said, meet with doctors and meet with people that have the ability to
do a lot of different things.
Very often, people end up, let’s say a dermatologist, and the dermatologist will only offer what
is within the scope of what a dermatologist typically likes to do.
Very often it’s laser and non-surgical procedures.
And then you can go to a spa, you’ll only get spa procedures.
So I feel like what we have accomplished in our practice is that we have everything under
one roof and we’re able to really provide comprehensive care with no bias because of
any limitations.
So meet with doctors, cosmetic surgeons, cosmetic specialists who perform a variety of procedures
and come up with a plan and idea and envision what your outcome will be with the doctor.
You know, these consultations require time.
You know, this is something that I really believe strongly in.
Spending time with patients, learning who they are, learning about their medical histories
and just formulating a plan and getting to know people and having a long-term relationship
to me is the optimal way for everyone to get a satisfactory result in whatever somebody
does or patient does.
So I hope that was helpful, I wish you the best of luck and thank you for your question!