Q: Dr. Eppley, Hello!  I’m 46 but I feel like I look 76 years old.  I don’t know if a filler or mini facelift would be the answer. I just want to smile without all the wrinkles. I have tried lasers, dermapen and ultherapy. I’ve tried fillers but am not happy with the results.  Thank you for your time.

A: You certainly don’t look 76 but I can see your concerns. What you havhe done is prove that nothing short of a surgical procedure would be of benefit. Non-surgical treatments like injectable fillers, energy-devices for skin tightening many other options have their place in facial rejuvenation. But there does come a time when what they can do is beyond their capabilities. Your own experience with them has proven their limitations in anything but the most early signs of aging.

You have reached the point where, if you are going to do anything, it must be surgical which involves skin removal and tissue tightening. And you don’t really want to waste time and money on limited procedures such as many of the so called ‘mini facelifts’. They also have their role in facial rejuvenation but the results they provide will be ‘mini’ and short lived also. What you need is a lower facelift to completely tighten the neck and get rid of the jowls. Ideally this should be combined with laser resurfacing over all other facial areas that are not undermined from the facelift procedure. Anything less will end up with disappointing results.

Dr. Barry Eppley

Indianapolis, Indiana