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

The Patient's Question: I tried Titan laser treatments to stimulate collagen and it helped but not enough. I'm 69 and concerned about sagging jowls, folds by the nose, low brows and eyelid folds. I also think I should have a small chin implant to balance the face.

Post Your Face Sagging Jowl

Before (left) and after (right) hypothetical treatment. Courtesy Photos

Dr. Freund's Answer: First, please understand that in-office procedures like Titan laser treatments can only go so far. At your age, it's essential to have a daily regimen that cleanses without drying, and renews or protects the vital layers that provide strength and elasticity to your skin.

Here are 7 must-dos:

1. Wash daily with a non-foaming cleanser (Cetaphil)
2. Exfoliate twice a week with a Buf Puf or a mild facial scrub with salicylic acid.
3. Moisturize with any product that you like. I have no particular favorite.
4. Wear sunblock that contains zinc oxide (EltaMD or Blue Lizard)
5. Apply Retin-A (must be prescribed by your physician in order to be dosed properly) to thicken the skin, slow the loss of elasticity, even out the blotchiness and reduce your risk for certain types of skin cancer. Don't use it in the sun.
6. Apply anti-oxidants to help fight the production of free radicals (those bad chemicals that damage cells and make us age prematurely. Revale, Vitamin C (Cellex-C) or Prevage are all good.
7. Take Vitamin C or Fish oil and eat lots of colorful fruits and vegetables like grapes and strawberries that have loads of natural anti-oxidants.

As for in-office skin treatments...chemical peels or laser resurfacing will both tighten, firm and even your skin tone. Peels are less expensive ($150-300 per treatment versus $600-1,000 for a laser) and probably offer the same amount of improvement.

If you want surgery, the photos show how a facelift would lift the jowls and tighten the neck (A). An upper eyelift would also freshen your eyes (B). A chin implant will not make you look any younger but it will make you look different. If you've always disliked your chin, then an implant is a fine choice. It will cost about $3,000.

To learn more about the skincare or surgery, please refer to my book "A More Beautiful You - Reverse Aging Through Skin Care, Plastic Surgery and Lifestyle Solutions."

Respectfully submitted,

Robert M. Freund, MD

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.

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