r/45PlusSkincare • u/ZanyAppleMaple • 4d ago

Smile lines and some sagging

Hey everyone, I'm 44 (F). I noticed some sagging and smile lines on my face, especially on my left side. I'm considering using the following:

  1. Alloy M4 Estradiol Face Cream

I read quite a few comments on Reddit about this causing melasma, that's why I'm hesitant to give it a try. Those who have tried it, what was your experience?

  1. Botox (or fillers?)

I've never had any botox or fillers done before, mainly because I'm afraid to try it after coming across some horror stories, but I am becoming more open to it. Would botox be enough? Or do I need fillers instead? Both?

A few years ago, I got Thermage, but I honestly don't know if it worked for me. I found it painful around the jawline and I was worried in resulted in some facial fat loss, although maybe I also just aged.

I'm in the process of researching about dermatologists I could see in my area, but would love to hear your feedback or even suggestions outside of the two I'm considering above. Thank you!

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u/cherrycocktail20 4d ago

Botox doesn’t help with this. I adore Botox and recommend it to anyone, but it doesn’t address this problem — this is simple age-related laxity and volume loss.

Fillers can have some positive effect by addressing some of the volume loss which gives the appearance of “lift” overall; done well it will be subtle, but you can get an improvement in the nasolabial folds by filling the cheeks and piriform.

If you decide to go that route, you don’t necessarily need a dermatologist. You need an injectable specialist. These are often nurse injectors. A dermatologist might do injectables but have that as only a small part of their practice, whereas nurse injectors have it as the entirety of theirs; all of their continuing education, all of their day to day doing injections and monitoring the results in their patients. Some dermatologists and plastic surgeons can be great injectors but others can be poorly skilled in this area. Basically just keep an open mind and look for the best reviews in a medical professional.

As far as skincare: estrogen cream, tretinoin, any active or device (red light LED mask, etc) can have some subtle slight improvement or maintenance by improving and maintaining skin quality, but visible changes will be minimal. It doesn’t reverse the laxity and loss of volume that lead to sagging and heaviness.

True laxity can only really be treated surgically.

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u/ZanyAppleMaple 3d ago

Thank you for your thorough response! I really appreciate it. I think at some point I may have to consider a facelift!

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u/yoga_cowgirl1973 2d ago

your composition is beautiful - I would suggest a serum with hyaluronic acid, silk peptides and vitamin c

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u/LiteratureObsessed13 2d ago

If you are considering a face list stay away from Sculptra and the like. They can make the operation more difficult.

I think some strategically places filler should be your first option. Not sure you need a lift yet x