Q: What can be done for droopy ear lobes? 

A: Like most things, more time equals more droopiness for just about everything on our bodies. Regarding earlobes, earrings cause even more sagginess, and heavier earrings logically cause the problem even faster. 

But even without earrings, earlobes will sag over time. Earlobes lose their volume with aging and consequently become saggy – much like a beachball that loses air. 

The simplest treatment is to use a small amount of a hyaluronic filler. This expands the earlobe to a more youthful shape, reducing the sagginess. 

If the sagginess exceeds what can be corrected with a filler, then the excess skin can be excised. 

Lastly, wrinkles from excess sun exposure causes loss of elasticity and can be treated with an ablative laser. Sometimes a combination of treatments must be used to get the optimal result.

Q: My son has a weak chin.  Can anything be done about it? 

A: Chin implants have been the mainstay treatment for decades, providing the mandible is not too deficient. In these cases, the mandible must be advanced, and this also aligns the teeth. 

Chin implants are a cosmetic treatment, and they come in different projections, shapes and lengths. The treating surgeon must make these determinations and take necessary measurements to provide the proper implant. 

Recently, chin injections with fillers have been used very successfully to augment the chin. The advantage of an injectable filler is that the injection can be accomplished during an office visit in about 10 minutes with minimal to no recovery time needed. The mandible can also be injected with a filler and to create a more defined jawline. 

Q: My upper lip seems to have disappeared.  Can anything be done about this? 

A: As with any patient, the treatment must be individualized. Some people have very little lip volume to begin with, but even those with ample lips (meaning the red part of the lips called the vermillion) diminishes with advancing age. 

This shrinkage is from a combination of thinning and lengthening of the cutaneous lip (between the vermillion and nose), loss of volume, and loss of elasticity, which in addition results in wrinkles.

If the cutaneous lip is too long, it covers the teeth excessively and the lip turns under making the vermillion look smaller – not a youthful look. 

A “buck-horn lip lift” excises a carefully measured buckhorn shaped horizontal width of skin just under the nose, shortening the distance between the nose and upper lip. This turns the lip up exposing teeth as in a more youthful person.

For wrinkles, a combination of an ablative laser, as in a CO2 laser, with PDO threads to increase collagen and elastin production, and even fillers can be used. A good professional cosmeceutical skin care line should be used to diminish future wrinkling.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com