thank you for the question. you are 42-years-old and you provided us withyour photo of a side view of yourself and you are stating that you’ve had weight fluctuationsrelated to several pregnancies. and you are questioning whether or not thereis a chance that your skin will sag after liposuction and at the same time, you haveyour trepidations about doing surgery. so certainly, i can assist you with this questionbased on my own personal experience as a practicing cosmetic surgeon. a little bit of background, i’ve been inpractice over 20 years in manhattan and long island helping people with this very problem.
in fact, i am also board-certified in notonly cosmetic surgery but i am also a fellowship-trained oculofacial plastic and reconstructive surgeon. so facial rejuvenation is a big part of whati do and there has been a continuous evolution over time in how we approach situations likeyours. so the one thing that can’t be done withjust photos is a physical examination. so the question that you start with is you’reconcerned of sagging skin has to require physical examination. basically, we have to be able to tell if yourskin has the ability to retract and go to its normal position or will it sag and whenit sags, will it be an acceptable amount of
sag. you see, the traditional approach from a surgicalpoint of view has been to do some type of lift or liposuction plus a lift. from the non-surgical point of view and thanksto drugs that are injectable to melt fat as well as non-surgical thermal tightening devices,those become a center to a non-surgical individual. as a cosmetic surgeon and with the practicei have, i actually offer all those options. so when i look at someone like yourself, i’lljust share with you a little bit about personal bias. i tend to be more conservative.
i tend not to advocate surgery per se in termsof lifting. the youngest person i’ve ever done faceliftfor was 37 and a close second or in that same range was a woman who was 42 but her facewas jowly and her face was very thin so there was no fat to remove but the skin was verymuch sagging. in your situation, an approach that wouldbe non-surgical that may be a good first line therapy would be possibly liposuction to helpyou with the jowl as well as a non-surgical skin tightening device. in our practice, we have a laser that actuallyallows me to treat the skin deeper in to heat up the tissue both the dermis, the backboneof the skin, as well as the deeper tissue
to cause contraction. now i chose this device after waiting andfiguring out what device would actually deliver what i want and give me still the hand ofa surgeon to be able to apply it in a way that makes sense to me. a lot of devices are done by non-physiciansand basically they place some type of connection to the skin and generate heat and most ofthose devices have been met by a lot of resistance from patients because of undesirable resultsand as well as unimpressive results. but in my hands, i’ve been happy in thisparticular modality. and last but not the least, i add fillersin a strategic place in order to create a
jawline effect using something called structuralvolumizing. so there is an art into doing this and approachingthis and it is never black and white but does require a physical examination. i recommend you to meet with several doctors. i would recommend you to meet surgeons withdifferent modalities in their office just so you can minimize the bias and see who youare comfortable with and see what works for you. one of the things i tell my patients who areconsidering a limited surgical option or non-surgical option is it is a relatively low risk andthen you can always do surgery at a later
time. so i hope that was helpful, i wish you thebest of luck and thank you for your question!
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