Q/A: I have a lot of sagging of my neck skin but I don't want a facelift. Anything else I can do?

Long Island Cosmetic Surgeon, Dr. Marotta Response: The only procedure that is truly effective in eliminating sagging neck skin is a well done face and neck lift. In addition, sagging in the neck can be due to more problems than just skin. Sagging muscle, glands and excess fat can all deleteriously effect the aging neckline. Some problems with the aging neck are more than skin deep and only surgery can correct all these issues. For minimal skin laxity in the neck, I have found fractional ablative CO2 laser, the Active Fx (Ultrapulse Encore) to be the most effective non-surgical treatment for wrinkled neck skin. It improves skin texture, fine horizontal wrinkles, and tightens neck skin.

Q/A: At 31, I have developed signs of premature aging with hollow eyes and sunken cheeks -- Should I have fillers, fat injections or a midface lift?

Fillers like restylane, juvederm, radiesse or perlane can be very effective in restoring midfacial volume in the cheeks and restoring youthful fullness in a young person who feels they have prematurely aged. Hyaluronic acid fillers like restylane or juvederm are currently the only safe fillers in the periorbital region but must be done by an experienced injector. Artful injection is required to create a natural looking eyelid/cheek junction. Alternatively, microfat transfer can provide more lasting improvement that is softer but requires more downtime than fillers. I think either would be appropriate for you from what I can tell from your picture. I usually reserve an endoscopic midface lift for patients with fuller cheeks that show evidence of drooping like hollow eyes, a deep nasolabial fold or buccal fat herniation. An endoscopic midface lift with fat repositioning of the orbital fat, buccal fat, and malar fat pads can be very effective in these situations to restore facial volume and lift a sagging face.