KaramMD Journal

What if Plastic Surgery is Not an Option?

woman pinching and pulling face

What do you do if having a facelift or other type of plastic surgery is simply not an option? Sometimes, plastic surgery is out of the question. Whether it’s because of location, lack of access to a specialist, lack of financial resources, health concerns, or a philosophical choice, the reality is that surgery is inaccessible for some. 

I often ponder what advice can I give to those that consider plastic surgery to be completely off the table but still want to look as young as they feel? I explain this in detail in my video, and below. Essentially, just because plastic surgery isn’t an option, it doesn’t mean you can’t achieve natural-looking, younger skin and combat the signs of age.

What causes the face to start looking older?

50% of aging is your skin quality. The other 50% of aging is the structure of your face, which is dictated by sagging and volume loss. Aging is caused by three categories of change that happen simultaneously. The first is about skin changes, and the second two are about changes in your facial structure:

  • Skin aging: What does skin aging look like? The skin is thinning, losing its vibrance and luminosity, forming lines and wrinkles, becoming discolored, and beginning to look dull. 
  • Volume loss: As we age, facial pat pads diminish in the temples, under and above the eyes, around the chin, in the lips, and in the cheeks.
  • Skin laxity or sagging: Skin laxity allows the features of the face to start to sag downward. This appears as a sagging jawline and neck. The midface begins to come downward, causing nasolabial folds. The corners of the brow begin to come down, and you get fullness and sagging around the brows. The eyelids begin to sag and appear heavy or hooded, and bags under the eyes appear. For some, the upper lip may start to lengthen. Generally, the face starts to look longer.

However, while there is a range of plastic surgeries you can have that more effectively address the second two factors of age, there is a way to address volume loss without surgery.

What can be done to address volume loss without plastic surgery?

You can manage volume loss with a modest use of temporary fillers, which are designed to replace the lost volume in the temples, around the eyes, and the lips. However, be careful not to go overboard and put too much volume into the face. Too much filler, too much non-anatomical volume, and you wind up with “pillow face,” an unnatural, puffy face we unfortunately see a lot with public figures and celebrities, causing people to be afraid that that will happen to them if they use these fillers. Keep filler use minimal and subtle.

Can anything be done to address skin laxity or sagging without plastic surgery?

Some people think fillers can help address sagging and achieve a lifting effect. Not true. If you try to use fillers to lift the face, you’re going down the wrong road. Not only will fillers not lift the face, but you’ll come out the other end looking unusual or weird. 

What about lasers or microneedling to help with sagging?

Lasers are good for skin conditions, but generally speaking, lasers, microneedling, Thermage, Ultherapy, and other treatments like these can refresh the skin but don’t actually achieve a lifting effect.

What about thread lifting?

Threads can help lift the facial structure and are the closest we have come to a non-surgical solution to lift the features, but they have complications, and they are temporary, lasting 3-6 months. 

So if none of these really work, what are you left with?

Quite honestly, you are left with accepting that your skin will sag normally with age, and that is okay!

Don’t waste your money and energy on trying to lift your features with treatments and products that don’t really work. You can replace some volume loss with the careful use of fillers. Use these modestly and subtly, maybe once a year, but it’s your skin that will help keep you looking young.

Focus on the skin and make your skin bright, supple, and beautiful. Remember, 50% of looking youthful is the quality of the skin. 

No-Facelift Skincare

Actually, no plastic surgery is going to do anything to improve your skin. Plastic surgery addresses structural concerns and sagging, but it won’t make your skin beautiful and radiant. So if you’re not planning to have surgery, period, your anti-aging focus will be completely on skincare. Without plastic surgery, out of the three aging factors (skin laxity, volume loss, and skin quality), what you can really control is your skin. 

To reverse the signs of age in your skin or keep it looking youthful, it comes down to the following three steps. If your management of these three points is consistent, you can walk back the signs of age and achieve the luminous, beautiful skin you once had. Or if you’re younger or your skin is still vibrant without significant signs of aging, these three steps will keep it that way for the long term.

Protect Your Skin From the Sun

The sun is the greatest accelerator when it comes to skin aging. You can prevent or pause the aging effect of the sun by protecting yourself with a proper sunscreen. This keeps your skin looking younger and more supple. Use sunscreen with an SPF of 30 or higher. Ensure your sunscreen includes a barrier block or a pure chemical block, protecting against both UVA and UVB rays. Look for a mineral-based, broad-spectrum product that includes zinc and titanium oxide at 6% or above. 

Occasionally Have In-Office Treatments such as Lasers, Microneedling, etc.

Lasers, microneedling, and RF therapy boost collagen production, which in turn allows the body to rebuild the skin at a cellular level, and in some cases, resurface the skin by removing dead cells at the surface, revealing youthful, fresh skin below. There is a wide range of non-surgical treatments that you can utilize from time to time to achieve a dramatic boost in skin health and rejuvenation.

Daily Use of the Proper Active Ingredients in your Skincare Routine to Rejuvenate the Skin 

Use skincare products that include the following anti-aging ingredients listed below. Each one is vital for beautiful, refreshed skin. Each ingredient helps to reverse or prevent signs of age, renewing dead, dull-looking skin and reducing wrinkles and hyperpigmentation. The right skincare products are incredibly important for achieving and maintaining luminous, youthful-looking skin.

Must-have skincare ingredients to look for in your products:

  • Retinol
  • Vitamin C
  • Hyaluronic acid serum
  • Lipids
  • Niacinimide 
  • Peptides
  • Non-hydroquinone lighteners
  • Growth factors 

Trifecta: All-In-One Skincare

To help my patients achieve the beautiful skin quality that plastic surgery can’t achieve, I searched for products that include all the right ingredients for beautiful skin in a simple skincare routine. Once I realized what I was looking for didn’t exist, I spent five years researching and formulating my own skincare line, the Trifecta. The Trifecta is a simple, three-product skincare routine with the vital ingredients required for luminous, healthy, radiant skin.

Amir Karam MD

Board Certified Facial Plastic Surgeon
Founder / Creator of KaramMD Skin

Dr. Amir Karam is a renowned facial cosmetic surgeon and an authority in his field. With over two decades of experience helping patients achieve a younger, refreshed appearance. In addition to surgical procedures that sculpt a youthfully-defined facial shape, Dr. Karam takes the quality of the skin into account.

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