In our weekly Post Your Face column, Dr. Robert Freund answers readers' cosmetic surgery questions, and shows them how they'd look if they underwent the enhancement. To post your own face, visit postyourface.com.

The Patient's Question: I need to get rid of the wrinkles in my cheeks and tighten up my cheeks. Also my face just kinda fell apart in the last five years, many wrinkles, very deep...I am an entertainer and it looks awful.

The patient before (left) and after (right) hypothetically undergoing Dr. Freund's suggestions to lift and tighten her cheeks. Courtesy Photo




Dr. Freund's Answer: The usual culprits for the type of aging you describe are sun damage, smoking, stress, and your genetics. Although I will discuss your surgical options, let me first mention some of the things that could have helped limit this damage over the years.

Smoking is the first big no-no. The chemicals in cigarettes reduce blood flow to the skin and help to build up dangerous free radicals (substances that accelerate the aging process). So Rule #1 is to STOP SMOKING!

Sun is another must-avoid, as exposure causes cancer and other skin conditions that make us look older before our time. Now, I love the sun as much as the next guy, so the best advice I can offer here is to wear lots of sun block and apply it frequently. My favorite brands are EltaMD or Blue Lizard (both with Zinc Oxide).

Stress and lack of sleep will also make you look older. If you don't believe me, look at any president at the start and end of his term. Both cause the levels of the hormone cortisol to rise, which in turn accelerates the aging of your skin.

One thing you could have done is to have taken anti-oxidants. These are the substances that fight free radicals and aging. Healthy dietary choices include colorful fruits and vegetables (grapes, tomatoes, squash, oranges, etc...). Good supplements in your health food store include fish oil, flax seeds, alpha-lipoic acid, Vitamin C and CoQ-10.

As for genetics, there is little I have to offer.

Regarding surgery, you could benefit from two procedures:

One to remove the excess skin and tissue from around the eyes and neck (Facelift and Upper Blepharoplasty); and another to smooth the texture and wrinkles of your face (Laser Resurfacing).

A Facelift and Upper Blepharoplasty (upper eyelid rejuvenation) will remove excess skin and fat and also tighten the underlying muscle. Downtime is from 10 days to 3 weeks. Cost $9,000 to $13,000.

Laser resurfacing is a technique to smooth out and rejuvenate the skin. The technique is not perfect and will not remove all of your wrinkles, however, it will likely make some improvement. The latest laser therapy is called the Fraxel Laser. Downtime can be from a few days to three weeks. Cost is $700 to $2,000 per treatment. Plan on a follow up treatment every few months.

Respectfully submitted,

Robert Freund, MD, FACS

The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.