Question: Hello, I am a 63-year-old African American woman who looks very, very old. I've always heard it said that "Black don't crack"; and maybe it doesn't, but it sure does sag. For about 10 years now, I have been losing elasticity in my face to the point that I now look older than my 83-year-old mother. This hound-dog look, as I call it, has virtually destroyed any self confidence that I may have had. I am afraid to leave the house. Adults stare at me, and children are afraid of me.

About 10 years ago, I asked my dermatologist, and she didn't think I was a good candidate for plastic surgery. I recently, asked my Primary care doctor for some advise, and she told me I was gorgeous, so I know she's not taking me seriously. Anyway, I don't think I could afford it. I am also afriad of it, because I have heard that it doesn't suit dark skinned people due to the possibility of keloids, infections, etc. Also, am a diabetic; I need to lose weight to get it under control, but I'm sure if I lose weight the sagging will worsen. I also have dental problems - I have been without bottom back teeth for 20+ years, and the teeth I have left are, for some reason, are getting shorter and shorter. Sorry for rambling, but as you can see, I have lots of issues. I really need someone to point me in the right direction, because at this point, I just feel helpless and lost.

Now for my questions: Before approaching a doctor, I feel I need to arm myself with some sort of information. For instance, since this doesn't normally happen to black women (well, at least, not in my family's genes), what are some of the possible reasons this could be happening to me, and what are the most likely solutions. If it is purely cosmetic, are there any stop-gap measures I can take, in lieu of full on plastic surgery? Outside of my primary care doctor and my dermatologist, are there any other specialists I could/should consult? Thanks for your advice.

Sincerely, XXXXXXX