Saggy Face At 48. What Can I Do? (photo)

You are a great example that aging occurs in 3 dimensions.  Not only do you have sagging skin, but you have significant volume loss to the face.  I believe you would benefit from both a lift and fill of the face.   Depending on your concerns, you could have a neck or facelift to define the neck and jawline.  For the remainder of the face, you need volume.  This could be achieved during surgery with facial fat transfer or facial implants.  You could have volume added to the face with in office fillers.  It is a personal choice which approach to take.  You have many options so a consult with a few doctors would be helpful.

Thank you for your question. A Facelift will improve the sagging of the cheeks, jawline and neck in particular. Because you do not have full hair, care and expertise is necessary to hide your Facelift Scars.

Only a Facelift or Neck Lift will tighten your neck line.

Filler Injection such as Perlane, Sculptra or Radiesse or Fat Injection will give you a nice improvement in your cheeks without surgery.

However only surgery will improve your neck.

Thank you for you question and the photos. You are going to get many different answers for your question.

You could get a lot of benefit from fractionated resurfacing followed later by filler or fat transfer.

Others will have differing opinions.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.