Dr. Konstantin Vasyukevich, MD

Dr. Vasyukevich notes that non-surgical options for neck tightening or lifting are often temporary or have limited effect. Thread lifts are an example of a temporary option, involving threads placed under the skin to achieve tightening. However, results typically last only a few months, or up to six months, with a year being an exceptionally good outcome. Thread lifts need to be redone every six months to a year. Regarding Ultherapy (also referred to as Althera) or Thermage, he states they have a very slight tightening effect on the neck area. While he has observed Thermage to be effective for some individuals, possibly depending on how it was performed or specific patient anatomy, he generally considers Thermage a 'waste of money' and notes that very few people currently use it for tightening the neck or face, as it is largely 'not used anymore.' Patients can try Ultherapy or Thermage, but should not expect all sagging to disappear.

Dr. Vasyukevich states there is no single ideal age for a mini facelift, as suitability varies by individual. However, people typically begin considering it in their 30s, with the most appropriate time period being from the 30s to early 40s. A mini facelift can be performed before age 30 for specific reasons, such as significant weight loss or prior facial surgeries that reduced volume (e.g., buccal fat reduction, jawline shaving). It is designed to reduce early signs of aging like jowls around the jawline, lines, shadows, and a little extra neck skin, which often appear in the 30s.

Dr. Vasyukevich states that collagen supplements (drinks, powders, or pills) do not work to make skin tighter or more youthful. The collagen ingested is unrelated to the collagen under the skin that provides tightness, and it will not go to the correct place to form the collagen needed for plump, youthful skin. While not harmful, they are not useful for the skin.

Dr. Vasyukevich confirms that using a neck patch can make your neck look younger by limiting neck muscle movement, which stretches the skin and contributes to aging. However, for a neck patch to be effective, it must be worn during the day (as people don't move their neck much at night) and applied every day or for most of the day, for a very long time, to see effects.

Dr. Vasyukevich explains that a ponytail facelift, also known as a micro facelift, is a very small type of mini facelift. It's typically performed on younger individuals and designed to provide a very slight lift around the face, similar to the effect of a tight ponytail. The incision is very limited, placed underneath the hair and around the ear.

Dr. Vasyukevich notes that Xeomin is very similar to Botox and works just as well for wrinkles, frown lines, and lines around the eyes. In his experience, Xeomin starts working slightly differently: it begins stronger and works at 100% efficacy right away, very quickly. Botox, conversely, starts softer and builds up over a day or two. The longevity of both is practically the same. A key practical difference is storage: both need to be reconstituted with water before use, but Xeomin cannot be stored for long after reconstitution and must be freshly made before injection, whereas Botox can be stored in the fridge for weeks without losing potency.

Dr. Vasyukevich strongly advises against vaping marijuana before surgery. While switching from smoking tobacco to vaping tobacco generally doesn't cause problems, vaping marijuana does. This is because marijuana is dissolved in oil, not water, and vaping it causes oil particles to enter and clog the lungs, potentially destroying them. Anesthesiologists are very concerned about patients who vape marijuana due to the risk of breathing problems and significant difficulty in administering anesthesia. He recommends against it.

Dr. Vasyukevich explains that both temporal and full brow lifts are performed endoscopically. A temporal brow lift uses a single incision in the temple area to elevate the corner of the brow, suitable for those who prefer a lift in that specific area (simulated by lifting brow corners with fingers). A full brow lift elevates the entire brow, including the medial part, with incisions made in the middle, ideal for individuals who want their entire brow elevated (simulated by lifting brows with four fingers).

Dr. Vasyukevich explains that it's common to look great in the mirror but dislike photos. This is because mirrors often have flattering lighting, and people subconsciously make subtle facial movements (like a slight smile or raised eyebrows) that make their face look better. In contrast, a picture often captures the face in a natural state, highlighting aging changes and volume loss that the mirror tends to hide, especially in a flattened, two-dimensional image.