. Okay, here's our ask me Dr.
Regani question of the day.
Yes.
I wanted to find out what the best treatment is to treat Jos
or, um, a face that seems to be falling around the mouth area.
Um, so yeah, without a facelift.
Okay.
There you go.
It's what I do all day long.
This is, Every single person that comes, sits in the chair in front
of me is going to ask this and remember, this is what I do every day.
It's what I teach, it's what I learn, It's what I study.
So many people are getting information on people.
From people on YouTube on different platforms.
They don't see patients, they don't do this every day.
If you're doing this every day, you know this is a real struggle and
the lower face is the tough one.
We can do a great job of the upper face.
Whenever they talk about the lower face.
It's a conversation.
The reason is, yes, they're sag and that's what the person sees,
but it's oh, so much more complex.
It's also bone loss in the face's.
Why I often talk.
Collagen supplements, vitamin K two, D three.
Whatever you can do to maintain the bone in the face bone, especially
for the female, plays a big role in the lower face and the jaw.
Just look at my videos on how much bone we lose in the jaw.
So the more you maintain the better healthy diet, healthy lifestyle, but no
matter what that said gets you now, she said without surgery and what I'm gonna
do today, surgery is a good option by the.
If there's a lot of sag, a lot of joing people will need surgery
to get the result that they want, however, 99% of people will say, I
don't have 50 grand to spend on it.
I don't have the downtime, nor do I want to be cut.
So watch my videos on the facelifts.
However, non-surgical, The easiest way to answer to this, my top three and
understand every clinic struggles with this and every surgeon struggles with
it, even surgically because, There's only so much you can do cuz there is a facial
nerve there, which affects expression.
You can't just go suck this stuff out and you can be still
left with loose skin if you.
Number one, treatment for the lower face is still addressing the upper
face, the temples, the high cheeks, the pre area, and so many people don't use
collagen simulators and biostimulators here, but that pulls the face back
then replacing what is lost with bone to the extent that you can with fill.
Calcium fillers, Sculptra, Um, you can use specific hyaluronic acid
fillers and that will not only hide the jowling, but it will also if you
do it in the right layers, mimic bone.
Okay?
So that straightens the jawline out and then you can
use some fillers through here.
But fillers can wide the lower mouth, so you see people look funky
because too much filler was used.
That's why I use easy gel or platelet rich Fibrin.
Platelet rich fibrin gel all around the.
And for vertical lip lines.
So that's number one.
And the most common and the most accessible to most people.
Number two, I use radio frequency microneedling and external
radio frequency heating.
One uses suction and contours, and for me it's a vira, uh, facial contouring.
FC applicator.
We do a series help shrink the fat cells.
Alternatively, or with.
R f microneedling.
So that's where the needles go in on my device only the tip is hot.
And think of it as you're burning fat away.
Okay?
So se three sessions of that.
And I also do the submentum with it, and that's how I dress that lower face.
I'll give you a third that you have to be mindful, but you can
also dissolve fat in this area.
And by that something like PC dc.
So phosphorylcholine, deoxy, collate in many countries.
Or in the United States and Canada we have a Cabella Cabella in the
US Canada, we call it be Kira.
Uh, and they dissolve that.
Understand you can also dissolve the mylon around the facial nerve.
Um, and what that does, it's temporary.
Usually it comes back within six weeks, but you get Aroy
smile for a period of time.
I've had a little bit.
Um, I say four or 5% of people will get it cuz you're putting
it right where that nerve is.
Whereas Cabella is really meant to be sub when the nerve is not present.
But, uh, in the studies and trials, it's always come back, but this
is the area that it will happen.
That's where the nerve comes right above the jawline here and it gives you, when
you smile, you get a crooked smile.
Everything has a side effect.
You see now the best treatment's going.
All three of those together.
If you have significant jowling and you do not want surgery, optimizing
the upper face, um, fillers along the lower face, and then dissolving
some fat and using RF technology.
Most of my patients will do a little bit of.
All of those, not any of one thing, but that is what gives you the natural result.
But that's why everyone's five to $10,000.
Cuz when you add those things up in the United States in Canada and you
do it in a sterile manner safely with state-of-the-art devices,
understand the devices cause cost, the clinic a hundred to $300,000.
So those things need to be paid.
. But if you're going to get it done properly and you're getting a series
of treatments and you wanna look natural and you don't want surgery,
that's about the normal cost.
These days, when you start to go down in cost, people are, Well,
I'll just do the filler part.
It's okay, but it might not be optimal.
Well, I'll just do the dissolving part.
Great, but you haven't replaced the bone or the fat.
Uh, okay, I'll do that, but not the RF.
Microneedling great.
Wouldn't you rather get rid of some of the fat then you need less fill.
Less easy gel and less of everything else.
So when you do little things, that's how you get the natural result.
But yes, it costs more and money is a problem.
Aesthetics is expensive.
Um, but safety is utmost importance too.
So it's just that balance.
And you can, The nice thing about nonsurgical, start with one, say I, a
lot of people say to me, Hey Rajani, give the number one thing we're gonna start.
And then I know you've recommended the two other.
I'll then add it.
So money is a thing, of course, and you have to budget for this,
but for those who are older, I can tell you it is . A plastic surgeon
lives across the street from me and he's done thousands of face looks.
He's retired.
And he said to me, I said, Oh, my back was out.
And he said, Rosa, you're old.
I go, I know.
He goes, It's when you get old, he goes, it's like a contact sport, okay?
And it is.
And the amount of maintenance you had to do at 20 was almost
nothing at 40, a little bit by 60.
I mean, it seems like your whole life is maintenance.
Maintaining your body, maintaining your healthy lifestyle, living
and for those who still have to work, like myself, I love my work,
but um, it's hard to eat right?
Be healthy and do all those things cuz I'm always on the road.
So, yes.
There is a lot of maintenance of getting old, but we're blessed to be
able to be here, to get old, to say, Hey, I'm complaining about my back.
I'm complaining about my face.
Those are small complaints in life.
So pick your top treatments.
Pick away at what's comfortable for you.
And add them and work up to it.
It's not surgery.
You don't have to decide everything at one day.
Minimally invasive gives you that opportunity.
Have you treated your Jos?
What's your number one treatment?
That's how I do it.
Every practice will be a little different.
Stay tuned.
Keep your skin and body beautiful, healthy and vibrant.