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Midface Lift or Other Procedures for Sagging Face (Age 24)?

Hello. I am reposting my question with more pictures. I am 24 and my face looks old and sagged, applecheeks are almost lost, nasolabial folds quite prominent, lower eyelids unnaturally droopy, there seems to be too much skin yet hollows in the middle of my cheeks (also under my eyes when I laugh). I want to have a younger looking face and tighter cheeks, but do not know what to do. Thanks for your time.

Doctor Answers (26)

Facelift and Acne Scarring

+3

Hi Eleiria-

I would recommend beginning with subcision of the acne scarring and filler augmentation. Subcision is release of the acne scar attachments under the skin. This will create a more uniform space under the skin in which to place the filler.

I do not think Facelift surgery will meet your goals.

Sincerely,

Tom Kaniff


Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Heavy skin from acne causing drooping at age 24

+3

Thanks for the photos.  I am impressed with the variety of recommendations you have received from my colleagues so far, and many are excellent points to consider.  Because your skin has been thickened and weighted from the apparent acne inflammation, I don't know how much improvement you will see with volume replacement alone.  This could work against you by adding more weight to your cheeks.  I suggest a variation of the minimal access cranial suspension (MACS) lift that has been useful in my practice for adding structural support by encouraging collagen around the subdermal web of sutures anchored to the temporal fascia.  The concept builds long term support against gravity and your future aging with strategic placement of strong and flexible suture material. 

Randy Wong, MD
Honolulu Plastic Surgeon
5.0 out of 5 stars 15 reviews

Facelift in a 24 year old?

+3
From your pictures, it is apparent that you have lost volume (fat) in your face. This might be genetic or due to weight loss. There are also very apparent acne scars around the cheeks. I would recommend adding volume to your face to remove the tear trough, nasolabial, and marionette lines. This can be accomplished with a temporary filler or autologous fat injections (permanent). I would also recommend facial resurfacing with fractionated CO2 laser (Active and Deep FX). Hope this helps.

Frank Agullo, MD
El Paso Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Sagging face and midface lift

+2

I would strongly recommend a laser resurfacing procedure which would give you excellent improvement of the facial scarring from acne as well as a fat transfer to revolumize the nasolabial folds, cheek and tear trough region, as well as the mentolabial folds (corner of the mouth).  I think this would give you the best result overall and save you from needing any surgery at your age that is over aggressive and unneccessary.  After those treatments you would be able to make an honest assessment if anything further would be beneficial from the standpoint of facial peels, skin care and other touch up maintenance options.  Best wishes!

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Facial Fillers (Liquid Facelift) and 1540 Non ablative Erbium laser scar treatments will give you the best result not a Facelift

+2

A Facelift will not give you the result you are looking for. The hollowness and cheek changes that bother you are best treated with filler injections with a strong long lasting filler like Perlane or Radiesse. These fillers can also be used to plump the deeper acne scars.

The 1540 Fractional Non-ablative laser can help the acne scars-it is the best laser method for plumping scars but it takes at least 4 treatments 6 weeks apart.

A Facelift will not correct the problems that bother you and it will add new scars to your face.

Please focus and spend some time trying to find a reputable Board Certified Plastic Surgeon who is experienced at using Facial Fillers. Ask the doctor how many patients they have treated with fillers and ask to see photos of their results.

Many younger Plastic Surgeons have a great interest in and experience with the newer facial fillers and can get very nice results.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

24 is too young for a facelift.

+2

You pictures don't reveal anything that justifies a facelift.  Sometimes in younger patients with deep acne scarring a modified facelift can be performed to help the appearance.  I don't think these procedures help all that much but are occasionally employed.  Enjoy your youth while you still have it.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

Sagging face at age 24

+2

I do not recommend a facelift at your age.  I think that some skin resurfacing will improve the overall appearance of your face.  A lot of the hollowing you talk about also seems to be from your acne scarring.  I recommend you see a plastic surgeon in consultation so he/she can examine you.  More importantly they will be able to discuss your particular anatomy and help you formulate realistic expectation about what procedures would be appropriate for you and how much improvement they would give you.

Dr. Cat Begovic M.D.

Catherine Huang-Begovic, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Sagging midface at age 24 is best treated with cheek implants

+2

The best treatment for nasolabial folds is injectable filler such as Restylane or Juvederm.  Unfortunately, it is only temporary and lasts approximately 4-6 months.  The buccal fat pad atrophy and hollowing of the cheek area can be best addressed with malar or submalar implants.  This will augment the cheek area and create a youthful appearance.  

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Options for 24 year old

+2

I do not recommend surgical facial rejuvenation for you.  Rather, as many of my colleagues have stated, a multi-modal non-surgical approach would likely help with your concerns including: skin care with topical therapy/laser treatment, fillers just as juvederm, or perhaps fat micrografting.  

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 114 reviews

Treatment of Facial Changes in a 24 Year Old Female

+2

The changes youn describe are very unusual in a 24 year old lady. Consult with an experienced Dermatologist to determine if you have some unusual skin condition. If there is no skin pathology cheek implants, fat liposculpture, or fillers such as Radiesse are all reasonable alternatives.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 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.