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I am a 43 year old lady who has lived in the sun for many years.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 27 January 2011


I am a 43 year old lady who has lived in the sun for many years. The skin on my face has lost most of it's elasticilty, fat and I generally look tired and much older than my age.

My eyes are very bad, my eyelids are heavy and sagging and the areas at my temples have no fat left, leading to further sagging. The best route forward? Suggestions please.


In a situation like this I typically advocate a two-pronged line of action which involves on one side improvement in the appearance of the skin and on the other side change of the volumes and tension in the skin.

It is obviously something that would be a lot easier to clarify during your consultation when degrees of the problem can be evaluated in more detail. In addition, a lot of the problems that you describe are the result of a combination of sun damage and smoking, and if this is the case both of these negative factors should be removed. This obviously does not mean hiding from the sun for the rest of your life, but rather incorporating a program of sun protection for your skin.

With regards to the rejuvenation of the volumes and laxity, your description suggests that a facelift with upper and lower blepharoplasty may be necessary to operate the strong improvement, and this can be complemented with a degree of volume restoration using fat transfer.

With regards to the skin texture and colour, depending on the degree of changes that need to be corrected, the treatment can be escalated from a combination of skin creams (Obagi protocols), and chemical peels or fractionate laser resurfacing. This can be amplified with lighter maintenance treatments.

Less invasive, but also less effective treatments include a combination of injectable fillers, botulinum toxin and the skin treatments mentioned above.

As I have highlighted in the beginning, at the time of the consultation it is possible to have a more customised treatment plan as well as clearer understanding of the recovery period involved and the associated risks.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street

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