It is not unusual as women get into the middle to late 40’s for age related changes to catch up with them and begin manifesting.  Of course a healthy diet and hydration are always important to the body and in turn the facial appearance.  Additionally, as menopause occurs or approaches changes in hormone levels can affect skin quality and tone leading to a more rapid progression of aging.  All of these things are big topics and are better addressed in person.  However, we tend to look at facial aging with three main points in mind: 1) skin quality 2) gravitational effects 3) volume loss.  Skin quality can be improved through sun protection, the use of good skin care products like PCA, and the addition of therapies such as Botox, Restylane, Juvederm and Fraxel laser.  All of these are listed on this site with more information.  The second element, gravitational effects on the face, need to be corrected through the use of surgical procedures.  At 46, we usually try to limit the procedures to minimally invasive office procedures that have a quick recovery time.  The third element is volume loss.  This can be addressed through the use of facial fillers such as Restylane, Perlane, Radiesse and Juvederm or through the use of autologous fat.  As you can see there is much that can be done to reverse the signs of aging.  We would love to be able to have the opportunity to tailor a personalized plan for you.  Please spend some time educating yourself on our site and please plan to come in and have a personal conversation.

Ed Buckingham

Your question regarding light chemical peels after a facelift is complicated.  A facelift is really intended to lift sagging fat pads and skin.  It can have some improvement for facial lines that are deep, but it really doesn’t treat the skin itself.  Chemical peels on the other hand do treat the skin.  For example a chemical peel can help to reduce fine lines and brown spots, while that is not the role of a facelift.  So to think that a chemical peel will maintain your facelift results is really misleading.  What a chemical peel can do for you is to improve the tone, texture, color and fine lines in your skin.  Whether it is a series of light chemical peels or a surgical peel, either can help the skin appearance significantly.  Light chemical peels are done as frequently as every 3-4 weeks.  The surgeon’s peel is usually only done once every several years as long as you maintain your skin with good skin care, sun protection, light peels and perhaps Botox.

Please feel free to call us if you would like to discuss this further.  We would love to talk to you.

Ed  Buckingham

Dysport is very similar to Botox.  Dysport is another sub-type of botulinum-A toxin.  It can be used anywhere that Botox can be used.  The dosages are a little different, but that is for me to worry about.  The cost is essentially the same as Botox.  The onset of Dysport may be a little quicker and the longevity is about the same.  The procedure to inject Dysport is exactly the same as well as the recover.

Please let us know if we can be of any other assistance.

Ed Buckingham

The answer to your question regarding Fraxel laser use on the neck and chest is a definite yes.  Fraxel laser is a fractionated laser.  This means that rather than the treating the entire outer surface of the skin at one sitting the laser treats microscopically in a tiny dot-like fashion, which leaves untreated skin, at a microscopic level, between the laser treated skin areas.  This allows for much quicker healing and also allows the procedure to be safely performed on areas of the body which did not have the same characteristics as the face.  Ablative therapies such as chemical peel and laser which can be used on the face cannot be used safely on the neck and chest.  Fraxel laser however definitely can.  We would be happy to see you in consultation to provide you with more specific information to your concerns.  There is also additional information on our site regarding Fraxel laser as well as other treatment options.

Ed Buckingham

There are not any permanent fillers available on the market in the U.S. currently that are F.D.A. approved for facial lines.  Artefill was available and you may be able to find some around, but the distributor in the U.S. went bankrupt and so it is no longer available.  A new distributor may pick up the product in the future.  The only other permanent filler available is liquid silicon.  It is approved for retinal detachments, but some physicians are using it for facial lines and lip augmentation.  I personally do not use silicon and have seen complications from it.  There are some who support its use, but there are significant potential long term complications to consider.  I do not recommend it.  Its just not worth it.  Sounds to me like you are on the right track with your current use of Restylane and Juvederm.  You could consider Radiesse for the smile lines as it is a little longer acting and may build some permanent collagen, but it is not good for lips.  There is a permanent implant available for the lips,but it is relatively new and its longevity and patient satisfaction has yet to be determined.  Hope this helps.

Ed Buckingham