“I’m 42, when I smile more lines appear. My lower cheeks have bumps or lines, I also want to get rid of acne scarring, and my my crows feet, as well as smile lines around mouth, and circles under eyes. Any and all advice welcomed.” – Real Self  Q&AGreat questions! 42 is a perfect time to get serious about preventative cosmetic treatments. Being preventative now will save save you from seeing many other unfavorable changes in the future. Getting down to it, ​it sounds like your skin is losing some elasticity so that is why you see more lines and why your acne scars may be appearing worse. When you lose collagen and elasticity in your skin the creepiness of the skin can produce fine lines and any scarring that you have will appear worse.  As we age, there are also bony changes and soft tissue changes that occur. The bony changes increase the appearance of dark circles and also cause more lines around the mouth due to the mandible (lower jaw) turning inward and the maxilla (upper jaw) getting smaller. The soft tissue changes result in atrophy of certain fat pads in the face which cause loss of fat in the upper face and actually enlargement, or hypertrophy, of some of the fat pads in the lower face. To help you with some of the issues that you are facing, I think that a volumizing filler to lift your face in the mid face area would help, plus a small amount of dermal filler to help with some of the finer lines more superficially. The fillers will definitely help your acne scarring look better especially with some subcision beforehand (which is a simple in office procedure known to help with acne scarring). Also, with the volumization and reflation of your face (not inflation but reflation) even your under eyes will improve. If your under eyes don’t improve to your satisfaction a very small amount of filler can be added in that area to decrease the hollowness that can occur and also decrease the discoloration. I think I would also suggest some superficial laser treatments that can tighten your skin as well. My favorite lasers to accomplish this are a series radio frequency micro needling treatments and also non-ablative fractionated resurfacing laser treatments. Also always remember not to look at your self for long periods of time, especially in a magnifying mirror. Subtle slow improvements will always get you to your best outcome. 

Interested in any of the procedures or treatments mentioned by Dr. Germain here?

Call our office and schedule a consultation with our expert 843-881-4440

Marguerite Germain

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