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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??

Doctor Answers (29)

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 excellent result.

Note that it is not uncommon, after a Facelift, that you can benefit from Soft Tissue Fillers placed over the cheek and beneath the Nasal Labial Fold to improve over all Facelift results and facial rejuvenation.

Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

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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 rejuvenate the face. I would not call it a stem cell facelift (this is more a marketing term than science). We know that fat injections are technique dependent and might need to have more than one session for the best results. How long does the fat last? If done appropriately, it can last many years. I have patients who are out over 7 years from the procedure and still have full cheeks and look great. As you see there are a lot of options. You need to find a board certified plastic surgeon who is well versed in all the surgical and nonsurgical options and is not a "one trick pony". Good luck, you should achieve great results since you have good bone structure.

George Marosan, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 9 reviews

Mid facelift works for 37 year olds.



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.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

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
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Surgical and Nonsurgical Options for Marionette Lines and Nasal Labial Folds


The treatment of facial aging should be individualized based on the patient’s aesthetic goals, anatomic findings and social situation.  No two patients are exactly alike and because of this appropriate treatment depends on the patients specific anatomic needs.  In your case, multiple options exist for correction of your problem.

A mini facelift would address many of your concerns.  This procedure would address skin laxity, jowls and nasal labial folds.  Unfortunately this would require a surgical procedure, significant expense, a recovery period and potential complications.

In someone who’s only 37 years old, a temporizing maneuver might be more appropriate.  In this case, injectable fillers might represent a solution to your problem.  This approach would need to be repeated at intervals, but would buy time and avoid surgery in the short term.

Consultation with a board certified plastic surgeon would be appropriate.  This surgeon should be able to formulate an appropriate treatment plan.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 73 reviews

Addition-Subtraction paradigm for facial rejuvenation

I think some liposuction along the jowls and neck and fat grafting to the mid face would be a minimally invasive approach to improve the shape and volume distribution of your face.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.5 out of 5 stars 32 reviews

Options for Early Facial Aging?


There are numerous options to address your concerns: fillers which are temporary, micro-fat grafts which are long lasting but don't elevate drooping that produces the "heaviness" that feel is appearing, limited facelifts plus filling of the depressed areas produce the most aesthetically harmonious and longest lasting result. Each has benefits and drawbacks.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of each operative procedure would not be in your best surgery. I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) or if you live outside of the Unites States a member of the International Society of Aesthetic Plastic Surgery (ISAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

That will allow you to make the best decision for your particular needs.

Robert Singer, M.D., FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.5 out of 5 stars 14 reviews

Age 37 a bit young for a facelift


With good skin tone and no obvious loose skin or wrinkles I would not recommend a facelift. You should get good results with a combination approach, skin care, botox, fillers (or fat grafts). A facelift will come later when really needed.

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.