Jowls, Waddles and Folds

Level 1

Exposure to the sun’s ultraviolet light leads to lax skin, which is also caused by a decrease in collagen production.

Aesthetic Plastic Surgery recently rolled out a new device, the Venus Freeze, which combines multi-polar radio frequency with a pulsed magnetic field. Compare it to Thermage, which when it was first introduced used radiofrequency energy to tighten skin and stimulate new collagen.

Unlike early Thermage, the newer technology is touted as pain-free. “There’s no downtime,” Lonergan says. “It’s 100-percent nonsurgical.” The device also treats wrinkles and cellulite. A series of treatments is needed, and maintenance treatments are often recommended.

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Level 2

As we age, we lose fat in our face. Coggins compares youthful skin to a person wearing two sweaters and a jacket. But as we get older, we lose the sweaters and the jacket just hangs on our frame.

Fillers, which plump up the skin, are ideal for adding volume in certain places, such as the hollow that appears under the eye as the skin slides downward.

But fillers are not an affordable option if you need significant volume. For that consider fat transfer or fat injections, during which fat is removed from one area, such as the belly or buttock, and placed into another area, such as a hollow cheek. “There’s no cutting or suturing, and it doesn’t feel like surgery,” says Dr. Christopher Saunders, who has offices in Wilmington, Newark and Chadds Ford.

Find a skilled surgeon to do the procedure. “It’s really sculpture,” Coggins says. “You have to know what you’re doing.”

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Level 3

Sometimes the only way to shed loose skin is to remove it and reposition the face to its youthful position, which means a partial or full face-lift. In the old days, tightening skin left thin-faced women looking like a “horror show,” Coggins says. Nowadays, surgeons may inject fat into areas to create a youthful curve.

Surgery tends to deliver the desired results, Saunders says. “You can spend a lot of money on other treatments and if you’re disappointed, that can be upsetting.”

But, he agrees, not everyone has the time, money or desire to go through it. And depending on the patient’s age and skin, not everyone needs it.

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