Question:
I would like to add volume to my cheeks and fill in my nasolabial folds and lines on my chin and mouth. Would I be better off with a lower face lift and possible fat transfer or fillers like Sculptra, Radiiesse or Juvederm?

Dr A’s Answer:
Based on your photo and good health you have lots of good options. Your choice will depend on your budget, healing time availability, willingness to assume risk, and personal feelings about what bothers you.First, I think there is quite a lot that can be done with non-surgical treatments. For your smile lines and glabella, area between the eyebrows, I would suggest 3 cc’s of Restylane. or similar combined with Botox or Dysport to the area between the eyebrows. You would follow this up with a 1cc touch-up about 9 months later and regular Botox/Dysport maintenance. You should expect that the Restylane will rebuild collagen in those creases and provide a great long lasting improvement. I see great opportunity for improvement in treating the glabella area as I expect your eyes to open and brighten with that.

Second, I would suggest you look at doing a facelift. Your jawline and neck stand to benefit greatly from this procedure. You may also consider a brow lift and/or upper eyelid surgery. The photo is looking up at you a bit and it is hard to say for sure about the eyes and brow. Also, the Botox may help lift that area, especially if you treat to cause more brow elevation. It is hard to say from this angle, but your lower eyelids may also benefit from filling.

I don’t see any compelling reason to do fat transfer. Your cheek area and temples do not seem depleted in this photo. Perhaps in the lower eyelid/cheek junction area you might benefit from volumizing which could be fat. Restylane, or Tear-Trough Implants. Fat transfer has issues with survival that make it a flip of coin as to whether it will work or not.

Finally you might consider some skin resurfacing procedure to brighten, smooth, and clean up age related color changes.