I want to tighten my skin, jowls, & most of all to improve wrinkles & sagging in my cheeks.
What's the best procedure?
Do I get a CO2 Laser Peel? A mini facelift? If I need both which do you try first?
Thank you for your question!
You submitted several photos and it’s very helpful and you’re asking the question that
you want to improve the sagging skin, the jowls and the wrinkles and you’re debating
whether or not laser versus a mini lift would be of value to you.
Well, just to give you a little bit about my background, I’m a board certified cosmetic
surgeon practicing in Manhattan and Long Island for over 20 years. I have a background specialty
training in oculofacial plastic and reconstructive surgery so I can tell you that cosmetic approach
to facial aging is something that has been the center of my career for over 20 years.
So you’re asking basically about two separate issues. When you talk about wrinkles, you’re
talking about skin quality. When you’re talking about sagging, you’re taking about
descent. I wrote a book several years ago about facial aging and about looking natural.
And I can tell you that it’s very important for you to really zone in on what your priorities
are but I would suspect that they are all priorities because they are all interrelated.
So for the jowls, for the sagging skin, you’re basically going to have to do some kind of
face lifting procedure. There was a time, this is going back 20 years, when CO2 laser
first came out that the buzz was that CO2 laser would eliminate the need for facelifts
and that was pretty absurd because CO2 laser can tighten skin but nothing can tighten skin
enough to lift sagging jowls and cheeks. Move the clock forward 20 years later and the same
false claims are being made by all kinds of thermal energy devices that create allegedly
surgical results. But as one can observe by the many disgruntled patients who have had
these thermal devices, it’s not working and it’s not turning out to be the case.
The pillars of facial structure have to do with the underlying structure of the skin
called the SMAS or superficial musculo aponeurotic system, the skin itself and of course the
tissue quality. As we get older, we lose bone, muscle and fat and so everything has to be
done in a measure way to try to optimize your look for your stage of life. No one’s going
to mistake a well lifting volume enhanced 70-year-old for a 30-year-old. It’s not
just going to happen. But you would look good for your age zone and I would refer to as
the indeterminate age.
So I would say that most likely you would benefit from some type of lifting procedure
and you can have CO2 laser or other thermal based treatments at the same time to help
overlap the treatment so you can overlap the recovery period. But I think that given the
relative depths of the lines that you illustrated through your photos, I think that the combination
approach would be of value.
Now this is in the absence of a physical examination and it’s so critically important to be able
to examine and feel the skin quality, the texture and have a dialogue in order to really
come to a more definitive plan. So I recommend that you meet with qualified, experienced
cosmetic surgeons who have a lot of experience in facial aging procedures and get a sense
of their style and the way they do things.
In our practice, we do our procedures in our own facilities in our office with local anesthesia
with very LITE™ sedation so recovery is definitely enhanced that way and we have become
well-known for that. These are little things that are meaningful to patients when they
are making decisions about surgery so desired outcome, the surgeon’s style and what they
consider aesthetic. There are people who prefer and exaggerate aesthetic and they don’t
overlap with my aesthetic style so I prefer a more natural aesthetic. And then the way
I do surgery, I do the surgery in a way so that my patients heal faster and recover faster
so that’s where the local anesthesia LITE™ sedation has this tremendous value to our
patients.
So again, meet with a doctor that resonates with you and I think that you would be pleased
to see a result once you’ve begun this journey. So I hope that was helpful, I wish you the
best of luck and thank you for your question!