Concern · Overall facial aging
I don't have one specific problem — why does my face simply look different?
What you may be noticing
Not one thing you can point to, but a general sense that your face looks different than it did — not necessarily worse in any single detail, just different overall. This is a common and legitimate way to arrive at a consultation, and it doesn't require a single named complaint to be a valid starting point.
One face, several layers changing at different rates
Facial aging happens across multiple layers at once.
Skin quality changes, facial support evolves, volume redistributes, and different areas of the face age at different rates. There is no single universal package that addresses all of it — the plan follows from which layers are actually changing, and by how much.
What Dr. Lancho assesses
- Global facial proportions
- Skin quality
- Pigment/vascular change
- Texture
- Laxity
- Volume distribution
- Structural support
- Priority areas
- Previous treatment history
Clinical reasoning
The question isn't what could be treated. It's what should be treated first.
Skin quality
Tone, texture and clarity often set how "aged" a face reads before any structural change is even considered.
Pigment & vascular change
Discoloration and vascular change can be present alongside structural aging, or can be the dominant contributor on their own.
Lines & movement
Dynamic and static lines each carry their own logic, and neither is automatically the priority over the other layers.
Laxity & support
Loss of firmness and deeper tissue support change facial contour independent of skin quality or volume.
Volume & balance
Volume distribution is assessed as its own finding — not assumed simply because the face reads as less full than it once did.
Treat for today. Plan for five years from now.
Treatment approaches
The goal is not to treat every visible sign independently.
Depending on which layers the assessment finds are actually contributing, an approach may draw on skin-quality, pigment- or vascular-targeted, firming, volume, or regenerative treatment. Knowing what to treat — and when to stop — is as much a part of the plan as the treatment itself. Some findings are prioritized; others are deliberately left alone because treating them wouldn't change what the face actually needs.
When combination treatment makes sense
Where several layers are genuinely contributing, Dr. Lancho may consider a staged, sequenced plan — each treatment given a defined role and a defined order, reassessed over time rather than delivered as one fixed package. Sequencing also protects against treating layers that haven't actually changed yet.
What treatment can — and cannot — change
Results depend on which layers are actually contributing, the treatments selected and individual biology. Not every visible change needs to be addressed at once, or at all — restraint is part of the plan, not a limitation of it, and the objective is a face that continues to look like itself over time.
Related treatments
Skin-quality and resurfacing treatment — Considered when tone, texture and clarity are the dominant contributor.
Chemical Peels · REJURAN · Microneedling
Firming and structural-support treatment — Considered when laxity or deeper tissue support is the dominant contributor.
Sofwave · Thermage FLX · Ultherapy PRIME
Movement and volume treatment — Considered when expression lines or a confirmed volume finding is the dominant contributor.
Botulinum Toxin · Dermal Filler · Biostimulators
Where pigment or vascular change contributes meaningfully, laser- or light-based treatment may also be considered. The combination that applies depends entirely on which layers the assessment finds — this list is not a package to work through.
Before your consultation
Bring the sense that something has changed — not a list of fixes.
You don't need to arrive knowing which layer is contributing, or in what order it should be addressed. That's what the assessment is for.