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Mid Facelift, Mini Lift or Fillers for Marionette Folds and Slight Jowls at 37?

hello,i m 37 with quite ok skin quality(no deep wrinkles,few fine lines etc.),i always looked young for my age,however,in the last 2 years my face which was always quite round and a bit chubby(depends on my weight) start to look gaunt in the middle and the heaviness became more predominant around my mouth and jowls(plus the corner of my mouth are downwards)which makes me look older and almost "masculine".Which procedure would be the best option for me??

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25 Doctor Answers | Asked by missmagic73 in London

Doctor Answers (25)
Community Comments (0)

Options for treating slight jowls

The jowls and marionette lines are best treated with either a mini lift or a face/neck lift. If jowls are the only problem, a mini lift will usually suffice. If there are neck issues, such as interplatysmal cords or subplatysmal fat in the neck, then a lower face/neck lift must be performed. Cheek implants can also be inserted over the maxilla when a gaunt or hollowed cheek area is present. These could be in the form of either malar or submalar implants depending upon the patient’s... more

Stick with nonsurgical options for facial rejuvenation at 37

Loss of fat in the face is one of the things that contributes to aging, so injectable fillers are often first line therapy. More permanent volume restoration can be achieved with fat transfer. At 37, you should also get a great response to nonsurgical skin toning treatments such as Ulthera or Thermage.

A Mini Facelift is better than fillers for lower face and mouth laxity

Although soft tissue fillers work will to plump the Nasal Labial Fold and cheek I find them less helpful to improve laxity around the mouth and jawline. I think this is related to the fact that the mouth has less rigid tissue (bone) supporting it than does the cheek. A Mini Facelift does a better job (In my opinion) tightening the mouth, lower cheek and jowl area than do filler injections. You are young, with good skin, and a properly done Mini Facelift should give you an... more

Another option for facial rejuvenation

I think you got it right. You lost volume from your face and what you see now is the "skeletonization" of the face and developing a more angular, masculine look. The "chubby" look conveys youth. You are blessed with high cheek bones which gives you the inverted cone of youth. What you are experiencing is fat loss from the face. I personally would skip the temporary fillers, would not subject you to a facelift but do panfacial micro fat grafts to better balance and... more

Mid facelift works for 37 year olds.

Hi. As you can see from all the different answers, this is an art more than a science. But this is my experience. A well done mid facelift (through the mouth, no scars) will correct gaunt look and lift the corners of your mouth.

Forget surgery for now.

Your best option is having hyaluronic acid fillers to address the various hollows in your face. The treatment is entirely non-sugical and will provide benefit for one or two years without surgery. No surgery will address all of your issues or be as effective as having filler treatment. You task is finding the right injector.

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Fillers Versus Facelift for signs of early aging

Dear missmagic- as you can see from the answers there are no clear cut solutions for your issue. The biggest issues I see from your photos are the jowls and indentation of the jawline just in front of the jowl. This deformity is a characteristic sign of aging and very uncommon in people under 40. Fillers could give you a temporary result but they could last up to a year, and you could avoid major surgery. If you want to go for surgery then a lower facelift, not a... more

Mini-face lift or fillers

Thank you for the photo. A mini-face lift will give you a permanent improvement in the areas that bother you. A mid-face lift will not correct the jowls. Fillers are temporary and for these problems, disappointing at best. You are beautiful. Early aging has squared your face a little. You should be thrilled with a face lift result. Best wishes.

Face lift at 37?

Dear missmagic73, I have examined your picture carefully and here are my observations : Noticable jowls, hollow cheeks, deep tear trough grooves and downturned corners of the mouth.Fillers like Restylane can improve, but they are temporary and do not help the big picture outlined above. Fat injection are also limited in the total improvement. In my opinion, your best bet is a face lift based on the MACS lift technique ( developed in Europe by Dr Tonard from... more

Fat grafting for gaunt face

Based on your photos it appears that you may be a good candidate for facial fat grafting or facial fillers (more so that a lift)

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Mid-facelift will improve the fullness and contour in the cheeks while minimizing folds between the nose and lips

A mid-facelift is generally designed to improve the fullness and contour in the cheek area while minimizing any nasolabial folds (between the nose and the lips). It does not address any early jowling. I believe that a mini-lift or traditional facelift is something that you might consider in five or more years. In the interim, fillers are an excellent alternative that is less aggressive; this is sometimes referred to as a “liquid facelift”. more

What to Do at Age 37? Fillers or Minilift or Both

Based on the photograph I see, you have mild jowls, a moderate pre-jowl sulcus, mild nasolabial folds and mild to moderate loss of facial volume. As other Surgeons have noted, there is not necessarily a right or a wrong answer, because fillers and surgical procedures achieve different goals; the best approach depends on what bothers you most, understanding that fillers will not lift the jowls. Likewise, it would not necessarily be wrong to consider a combination of treatments... more

Facelift and fillers

I would have to say that one treatment does not supercede the others but may be complimentary to each other. Fillers and a mini-lift may be just the right thing for you.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Procedures are not exclusive: they are complimentary: mid-face lift, mini lift and fillers

These procedures are not exclusive: they are complimentary: mid-face lift, mini lift and fillers. They all would help address the concerns you have. The mini-lift would benefit the jowls, the mid-face lift would help the loss of cheek fullness and fillers would soften the tear trough and marionette lines. However much could be accomplished with fillers.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Minimally Invasive Facial Rejuvenation

Hello, I have reviewed your picture and concerns. At this time, I feel you will benefit from a more minimally invasive treatment plan. As a start, I would suggest facial fat grafting due to the fact that your facial aging is a result of facial volume loss. Facial fat grafting provides a minimally invasive means for facial rejuvenation in the younger population. Fat augmentation to correct the periorbital hollows (circles under eyes), nasolabial folds, marionette... more

Several good options

At 37 you may not want a midface or MACS lift yet and you can achieve an excellent result in revolumizing the face with fat transfer or Sculptra injections, both of which will also improve the overlying skin tone and texture. Botox will improve the downturning at the corners of the mouth, and HA fillers such as Juvederm and Restylane can also help for this area and the NL folds. Finally Ulthera, Accent RF and other skin tightening procedures can also add measurable improvement to the... more

Facial Aging options

I would begin with a topical cream like retin-a with kojic acid and hydroquinone. This is inexpensive and will even your skin tone and improve fine lines. You could continue this for several months until your skin tone is optimized I would maximize non-surgical options prior to surgical as you are young. Fillers are good in the nasolabial folds and maxillary eminences. This will give you a bit of a lift. A facelift is the most power... more

You could start your facial rejuvenation with Injectable Fillers.

I reviewed your concerns and your photo. You appear to have prominent lower eyelid grooves, marionette grooves, and a small jowl. These three areas could be addressed with a well-performed Injectable Filler treatment. You could achieve non-surgical facial rejuvenation with little or no downtime. I hope this is helpful for you.

Eric M. Joseph, MD

197 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Mid Facelift, Mini Lift or Fillers for Marionette Folds and Slight Jowls at 37

Thanks for the posted photo. My recommendation based only upon your posting and photo is a mini face/neck SMAS lift + Stem Cell Fat Transfer with PRP injections (approx. 10 to 15 cc's). Best to you from MIAMI Dr. Darryl J. Blinski, 305 598 0091

Fillers vs. facelift in the young aging patient.

You probably need fillers, but if there is excess skin then you need a mini facelift as well. It doesn't look like a midface lift is what you need. See an experienced facelift surgeon for a discussion of the pros and cons of both.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Treatment of facial aging in the young

You could use fillers or a MACS Lift. You have descent of your malar areas (upper cheeks), face and eyelid causing the line under the eye, the sunken (gaunt) area in the mid cheek, the nasolabial folds, marionette lines and jowls. Injections will hide or disguise much of this, but it will take quite a bit of filler to do this. Besides, to disguise the area below the mouth and jowls, you may look more masculine, as the jaw becomes boxy with fillers. Personally, I think you are an excellent... more

Solutions to facial aging

All the procedures you mention have a place in facial rejuvenation. Each patient and his or her anatomy must first be carefully evaluated and analyzed. What treatment is chosen is dependent on what your goals are, what you can tolerate or not tolerate, what side effects are acceptable, and other issues like longevity and costs. There is no single answer to your question.

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

You are a bit early for surgery, but should do great with fillers.

Typically a patient with your facial appearance will need several different fillers to create a great result. We will use Radiesse in the area of the cheeks under the lids (but not in the lids) to create the midface lift effect. Then Juviderm will be used to restore the upper lip and the corners of the lower lip above the marrienette line. Finally Radiesse will be used in the naso-labial folds and the marrienette lines. This is all done at the same time. Depending on how... more

Nathan Mayl, MD

7 reviews

Fort Lauderdale Plastic Surgeon

Looking older with sagged skin at 37

From the photos, the jowls appear a bit saggy and the right cheek appear somewhat flat in the anterior section. IMHO, this is the single most important factor in how the face ages in women. Fillers like Perlane and Radiesse can be used to fill in the nasolabila folds, marrionette lines and the area below the anterior cheeks to soften the enture face. A minimal incision face lift can also be done in addition that would tighten the underlying SMAS muscle and trim... more

Early facial aging

Your photo shows early signs of aging including cheek descent and jowl formation. You could buy time and use fillers (liquid facelift) or do the more definitive thing which would be a facelift.