I’ve lost 125 lbs since my RNY and am seeking advice about treating sagging skin on the face. It’s really bothering me so I know eventually I’ll have something done. I’m wondering what other WL patients have done to treat sagging skin on the face. I.e.: lower face lift? full face lift? Fillers? Radiofrequency treatment? Micro needling? Any advice would be most welcome and greatly appreciated!!!

It will depend on a few different things but age is probably the biggest second only to budget. Is your face sagging or is it volume loss? For sagging only surgical methods really work to achieve the lifted tightened look. For volume loss you could use filler. If you’re young enough the non surgical treatments like RF may work to a degree (but not comparable to a facelift) but the older you are the less likely, and no one wants to waste money on things that don’t work. I’m sure you’ve seen a ton of videos but I think these are good at explaining the differences between different procedures. I hope it helps ❤️
BTW I don’t have sagging just loss of volume (thanks to WLS & COVID ?) And I’m doing biostimulators with a pro, manual microneedling at home and I have ALWAYS used retinoids.

Edited July 3, 20233 yr by GreenTealael

I lost tons of volume in my face post surgery. So I had more sculptra treatments. It has been used since the 1990s for AIDS patients for face fat volume loss. It helps me a lot and I'm in my 60s. The results aren't overnight, it takes 6 weeks at a time for your body to make the collagen so one has to be patient. I once had Radiesse but sculptra looks more natural since it is my own collagen instead of the filler. I used to only have to get 1 vial a year to top it off but now I will have to have maybe 2 or 3 vials a year since I lost so much face volume this time around. It can get expensive. It's like $800 a vial.

I finally broke down and had a facelift. Honestly, I think that's probably the only permanent solution - but I'd hold off awhile because sometimes things shift around during year 2 or 3 and you look less gaunt. As far as full vs lower face lift, it just depends on your situation. Another WLS patient and I went to the same plastic surgeon. He recommended a lower face lift for me, and a full face lift for her - so it depends on the sagging (where it is and how much).

1 hour ago, Tomo said:

I used to only have to get 1 vial a year to top it off but now I will have to have maybe 2 or 3 vials a year since I lost so much face volume this time around. It can get expensive. It's like $800 a vial.

that IS pretty expensive. My facelift was around $7000, so it wouldn't take too many years for the cost of the vials to catch up to that. (I'm also in my 60s)

I’ve not gone down the surgery route but have tried a few things. Some worked, some didn’t. You gotta do what makes you feel happier & more comfortable with. I did find that my face, like my body, settled after my weight stabilised so I didn’t look quite as gaunt & tired. Eating a broader range of foods probably helped a bit too.

Had filler in front of my ears - was sunken because there was no fat there at all.

I did quite a number of RF sessions. Can’t say it did anything specifically but I enjoyed the process. Didn’t see improvement after IPL treatments either.

Did 4 sessions of micro needling RF (Secret RF) earlier this year & it’s given the best results. I tried it not for saggy skin but acne scaring & other improvements were a bonus. I have more defined cheekbones. My lip lines are more shallow so less lipstick bleed (yay!). My skin is very soft, and tone & general texture has improved. I still have my marionette lines though one side is a little shorter & there’s a little break in them. I still have the little poochy droops on my jaw near my mouth but they’re smaller. I’ll do it again next year for maintenance & to see if I get more improvement. (Tip - you need 20% topical anaesthetic & you should only be red for a few hours. Any longer means your practitioner was too harsh & may have done damage.)

Botox/Dysport - forehead, chin, between the eyes & a little in my crows feet. I go down the under dose, natural route so my face is still very mobile & expressive.

Also have regular facials (alternating between glycolic peels, collagen masks, etc.) which I think maintains the benefits from other procedures & routines.

Bought the Nuface micro current device - a waste of money. Yes your skin is softer & plumper after but the gel primer you apply first is hyaluronic acid! After 4 months of daily use (takes 15+ minutes) I gave up & just used the gel. Got the same result.

I’m almost 58 now & think I look pretty good for my age. I mean I should have some wrinkles & skin laxity by now. I use hyaluronic acid, collagen oil serum, day & night moisturisers, a vitamin C serum, retinol & sunscreen. You don’t have to spend a lot. I use a mix of drug store & mid range brands.

I'm starting targeted C02 Cryo therapy next week. A friend runs the business and wants to document my progress for advertising to local bariatric patients so she's offering it free to me. Otherwise, it's pretty pricey. I still have a ways to go with my weight loss, but she wants to treat me as I lose instead of waiting to see how much loose skin I'm left with at goal weight.

Despite the cost, people are willing to pay. She can't keep up with demand and recently had to hire a second tech. The before and after pictures that I've seen are amazing. Face , batwings, tummy etc. I'm willing to give it a go. Hopefully with good results.

i've had fillers:

cheeks: 3-4 times (love it!)

naso-labial: 2 times (second time i looked too puffy so didn't want to do that again)

chin, under-eye: once each, didn't like the look.

last time i did fillers (cheeks) was last october, and it's still very pleasing to me.

i also do botox regularly, every 3-4 months, on my forehead & between my eyebrows.

...and i have botox on my masseter (jaw) muscles every 9-12 months.

...oh, and i tried botox on my neck once, but didn't see any significant improvement so didn't do it again.

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Also tried 3 rounds of micro-needling on my neck, but again, deemed it not worth it so stopped.

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If i wasn't such a historically BAD scar-er, i'd get a facelift today, but alas, I am. ?

On 07/03/2023 at 14:43, catwoman7 said:

I finally broke down and had a facelift. Honestly, I think that's probably the only permanent solution - but I'd hold off awhile because sometimes things shift around during year 2 or 3 and you look less gaunt. As far as full vs lower face lift, it just depends on your situation. Another WLS patient and I went to the same plastic surgeon. He recommended a lower face lift for me, and a full face lift for her - so it depends on the sagging (where it is and how much).

Ohhh! A facelift! This is on my list! Would you mind sharing pics and your surgeon? DM if you prefer ?