Q: I lost 30 pounds a couple of years ago and my skin is sagging. I workout a lot and building muscle has helped but not with my face.

*This is Sitting up

*This is leaning forward

Dr A’s Answer:


First off, congratulations on losing the weight. That takes hard work.

There is a lot of mis-information about fillers and how they “lift”. Fillers are important and useful, but they do not lift, at least not when used in any reasonable quantity. For the most part, fillers “push”, they don’t “pull”. When used in the upper face, they often give the illusion of a lift, but the lower face will still hang just the same. I would suggest that you look at a lower face lift to address the jowl and neck tissues, as well as the laxity you see when leaning forward. I would not do any lifting of your forehead since this will accentuate the upper eyelid hollows. I would suggest some filling in the cheek and temple area. This is probably best done after you have healed from the lower facelift. And finally, you might consider laser skin resurfacing. This will smooth out many of the wrinkles, especially those around the mouth. While it won’t make your skin more elastic, it will build collagen and make it smoother, brighter, and more robust.