The Patient's Question: Ten years ago I lost 85 pounds, and I have loose skin under my chin, bags under my eyes, floppy eyelids, and a disappearing jaw line. Also, what's the best skincare regimen for my face?
Dr. Freund's Answer: Congratulations on dropping the weight – I'm sure it makes you feel better inside and out. Many people on this site comment about inner beauty being more important than outer beauty - I totally agree! Experience has also shown me that making yourself look better on the outside can shade your self-perception. When people dress up for a special occasion, for example, they get an inner excitement and self-confidence. Plastic surgery is an extension of those things.
As for your concerns, a facelift will fix the nasolabial folds (lines from nose to the corner of the mouth), marionette lines (lines from the corner of the mouth to the jaw), plus your jowls, cheeks and neck. The key to a natural-appearing facelift is to direct the lift upward, not outward. You can see the difference by positioning yourself in front of a mirror-- pull your cheeks upward and slightly outward -- this will simulate a vertical lift. Conversely, if you pull your cheeks outward towards your ears, you will see the wind blown effect that gives plastic surgeons a bad name and the patient the fake look. A facelift can range from $7,500 to $12,000. Typical downtime is 10 days to 3 weeks.
A lower eyelid lift will eliminate unwanted bulges and wrinkles of the lower lids. This technique can include fat removal or fat grafting. The one concern with this procedure is that removing too fat or skin can lead to severe problems of lower eyelid functions, so expect improvements of the lower eyelids to be moderate. The cost is $2,500. Downtime is 1-2 weeks.
Botox/Dysport are muscle paralyzing agents that will weaken the muscles that cause the wrinkles of your forehead, frown lines and crows feet. This is an office procedure that has minimal downtime (1day at most). Effects last 3-6 months and will require returning to your doctor for more treatments. The cost can run from $100 to $1000.
As far as a daily regimen for skin care, I agree that everything must start at home. For an honest, well-balanced description of the best skin care regimen refer to my new book "A More Beautiful You -- Reverse Aging Through Skin Care, Plastic Surgery and Lifestyle Solutions."
Robert M. 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.