mature couple in front of blue wall

Patient question:
With so many different fillers on the market and new ones coming out every day, how do I know if I should have filler, surgery or just get Botox? And what about the thousands of topicals on the market now?

Gregory Branham, MD answer:

Looking younger is really about looking our best no matter what our age. We all age differently, so what we see when we look in the mirror is unique and requires a customized approach. We need to think of fillers, surgery, neuromodulators (such as Botox®) and other noninvasive modalities as tools in the toolbox. Most often, a successful rejuvenation will require several tools to give the best result because they each play a different role in the process. Texture changes (fine lines and wrinkles), volume loss, and sagging tissues all require attention, and a more aggressive approach combining surgical and nonsurgical approaches typically gives the best result.

In general, the jawline and neckline respond best to surgical interventions such as face/neck lifts and mini-lifts. This is because in these areas, sagging of the tissues is the predominant problem and sagging tissues need to be repositioned with surgery. While the thought of surgery may make you cringe, the newer techniques require less downtime and have you back to your new self in less time.

The midface which includes the cheek, upper lip and lower eyelid area are perfect for fillers and noninvasive procedures that add volume.  In the midface the predominant aging pattern is volume loss. Replenishing that lost volume with fat, filler or implants restores the youthful fullness and support. Knowing the pros and cons of each of these will help you make the right decision for yourself.

The upper third of the face which includes the forehead and crow’s feet area is ideal for neuromodulators such as Botox and Dysport. When the eyebrows drop too much for these to be effective; then an endoscopic browlift can be effective in repositioning the eyebrows and “opening up” the eye without a surprised look. A blepharoplasty or eyelid tuck works best for the excess skin that develops on the upper eyelids.

A comprehensive approach that combines several tools including Botox, skin rejuvenation with peels or lasers, fillers and surgical lifting offers a more natural and complete rejuvenation. Topical skin care products can be used to maintain and prevent further damage and texture change. To learn what treatment is best for your aging pattern, schedule a consultation: 314-996-3880.

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