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Facelift Disproportionately Fat Face?

I have what I'd consider a very disproportionately fat face. I'm only 33 and thin yet the corners of my mouth are always turned down along with "marionette" lines. And my lower face is heavy. I have the puffy swollen cheek look of someone who just had dental surgery. When I pull the lower cheek skin back toward my ear it looks so much better. I know it's impossible to know for certain without a picture, but am I describing something that requires a Facelift to fix?

Asked 31 months ago by ccc in midwest

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Facial Contouring or Facelift

Though you are "young for a Facelift," it is only in the sense that we think of Facelift as an operation to improve aging changes. With the many techniques for facial contouring that have evolved into routine "tools" for plastic surgeons, there is a great likelihood you can achieve the improvements you seek. In my own practice, I have had young patients for whom facial contouring procedures proved very gratifying. Without careful examination, it... more

Paul C. Zwiebel, MD

Denver Plastic Surgeon

ASAPS ASPS

Facelift for a Disproportionate "Fat Face"

It is usually not appropriate to do a facelift procedure on a thirty-three year old patient. If the problem is truly a disproportionate fat face, liposuction could be considered an option in the neck area however, I highly discourage liposuction to the face. Facial fat is very important and it is lost naturally as we age. Therefore, I do not recommend liposuction or removal of fat to the face and I do not recommend a facelift for the reason of facial fat only.

Rod J. Rohrich, MD

Dallas Plastic Surgeon

ASAPS ASPS

Chubby cheeks

Fullness in your lower cheeks is a very common trait that is quite difficult to correct completely, however improvement can be made surgically. Without seeing your photos, I'll answer the question in general terms. You are very young to have a facelift, but assuming this is what you're interested in exploring I'm going to address to the question of what surgical option is most likely to be effective. There are few surgeon's that resect Bichat's fat pad during a facelift since it is in a... more

Ricardo A. Meade, MD

Dallas Plastic Surgeon

ASPS

Facelift at Age 33

The majority of patients seeking Facelift are age 50 and older. A person in their 30's is generally not a candidate for a variety of reasons, but most importantly because the aging changes that can be addressed by Facelift are not present. Secondly, Facelift is not usually considered a "facial slimming" procedure. What would be most valuable to you would be a consultation with a Board Certified facial Plastic Surgeon or Plastic surgeon in your area. ... more

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Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Inventory your best facial features

Scan your face and identify your best features, just as you have the areas of dissatifaction, then look at your parents' faces, which will give you an idea of how you will age. As a generality, facial aging either occurs like a deflated beach ball or fat accumulation. The marionette's lines can be addressed with HA (hyaluronic acid) augmentation, the puffy cheeks with judicious Smart Lipo and the relative skin laxity with good skin care and/or make-up. ... more

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Lavinia Chong, MD

Orange County Plastic Surgeon

ASPS

Facelift at 33

Iit is unlikely that at 33 you need a facelift. Again, photos would be great to see to offer a suggestion.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelift for 33 Year Old Bottom Heavy Face

It is difficult to asses you without pictures but most likely you would not be a candidate for a facelift. First of all, patients who complain of excess "fat" in face or neck or any other portion of body should use diet and exercise as means of addressing. In some cases, neck and facial fat is resistant to changes here despite making an admirable effort in slimming down. Facial liposuction is typically a bad idea in a face because it can leave subtle... more

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Facelift for a young cheeky patient

What you are describing is tough. If it were possible to lose some weight, this might be the best solution of all. If not, a facelift might actually be a consideration. A photo would help but please visit some excellent plastic surgeons or facial plastic surgeons and get some first hand thoughts.

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Buccal fat pad removal may be a better option

A facelift is not going to fix disproportionate fat in the face. You may consider buccal fat pad removal (cheek reduction) to achieve the look you want. Make sure that your height/weight proportion is adequate and you are not overweight before embarking on any of these procedures.

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William Portuese, MD

Seattle Facial Plastic Surgeon

Possibly

Descent of the cheek tissues occurs with aging but aging is different for everyone. Depending on your genes your tissues may not have the resilience to the effects of aging and gravity as others may have. What you are describing is the normal aging process just in a younger patient. Although this may be corrected by a facelift procedure I wouldn't recommend that at your age. Many good things can be done with fillers to improve the contour of your mouth and marionette lines. If you get... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Smartlipo and Liposcupture are potential solutions without facelift

In younger patinets with excess fat in their faces SmartLipo or Laser Lipolysis with liposculpture is an option and in fact we performed this yesterday on a 21 year old with a hereditarily large face with double chin. It can effect significant improvement and in some patients buccal fat is removed to slim the face as well. The laser lipolysis cause skin contraction to occur so you do not have to have excess skin removed.

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Richard Gentile, MD

Cleveland Facial Plastic Surgeon

Face lift in a disproportionate face

Your face is composed of skin, fat, muscle and bone. Disproportion in any of these may result in a face that may lack harmony. You may benefit from enhancing the jawline with chin implants and or liposuction in addition to the facelift.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

You may just need liposuction of your lower face and neck.

Hi! It's hard to be sure without examining you, of course, but you may need liposuction of your lower face. We have used this procedure in selected patients in their 30's and 40's in our practice in Manhattan, with quite impressive results. After liposuction, young skin contracts. You almost certainly don't need a facelift.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Gravity and fat in the lower face

Jowls are those pesky fat pads that migrate from the cheeks into the jawline. They are being pulled by gravity across the jawline and create the marionette lines trailing from the corners of the mouth that enhance the perception of "frowning". The maneuver to make this look better by pulling on the skin toward the earlobes is what leads patients to consider facelifting. There are disappointments in those with excesive weight in the cheek tissue because of the inability to relieve... more

Randy Wong, MD

Honolulu Plastic Surgeon

ASPS

Options

The beauty of aesthetic surgery today is our ability to address concerns with a tremendous number of options which were not available just a few years ago. Our understanding of facial aging and how to approach it has also become more refined. I like the others, who have answered your question, can't give you the answer you need without evaluating you but a few things come to mind when reading your question. Your concerns about the downturned corners of the mouth can be addressed by... more

Robert W. Kessler, MD

Orange County Plastic Surgeon

ASAPS ASPS

Anatomical analysis

All people are made of the same anatomical ingredients (bone, cartilage, muscle fat, skin, etc.). Yet we all look different. You need a comprehensive analysis of your anatomy, as does everyone who is looking for cosmetic changes, to determine exactly why you look the way you look. There is a host of variation to your anatomy that can account for what you are describing. Typically, 33 years old is quite early for skin laxity to play a significant role. Small cheek bones may limit the support... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

See a plastic surgeon who is a facelift specialist.

It is not possible to say for sure without examining your face. Sometimes you can get away with liposuction only. But it sounds like you need both a liposuction and a minilift to tighten the sagging skin.

Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon

Pictures of you would be helpful

Although anything is possible, a true Facelift is something that is rarely needed for someone your age. Having said that, I preformed a "re-do" on a woman that was in her mid 30's! The problem for her was that she received a SMAS lift and without having the dissection expend to the corners of the nose and mouth, the pull on the skin did not provide her a lasting result. One year after her SMAS Facelift, I performed a laser vertical Facelift. One option to consider are skin... more

Michael Kulick, MD

San Francisco Plastic Surgeon

ASAPS ASPS

Might you have a little extra buccal fat?

No one could answer this question for you without examining you. But in general, 33 year old skin is too tight to yield much of a change from a facelift and at that young age, scars would likely not be great. And from what you are describing, it sounds to me that it is at least possible that you would benefit from what is called buccal fat excision... There are little pockets of fat within the lower cheek which can cause bulging in the lower part of the face...almost like a chipmunk with an... more

Steven Teitelbaum, MD

Los Angeles Plastic Surgeon

ASAPS

Please be careful what you wish for

Dear Midwest We have a very simple rule in Los Angeles. If you knock on enough doors, someone will give you what you are asking for. At age 33, it is highly improbable that you actually need a facelift. Will a face lift address your concerns? Sure it is an extremely powerful surgery. However, it is very likely that you could achieve what you are looking for with something far less than a facelift. The filler services are very powerful. Lower face liposuction can also be a fantastic choice... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Puffy face with fatty lower cheeks

It seems like sagging cheeks coming close the corner of your mouth are making you look heavier in the face than you really are. Stand if front of a mirror and pull the cheeks towards the earlobes. If it eliminates that look, then you are a candidate for a facelift. If the upper cheeks are hollow compared to the lower, then you can get a filler like Radiesse or Sculptra to balance out the face and it would look less puffy. Regards