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Female: At 41 years, I'm experiencing premature aging, nasolabial fold, heavy jaw. What facelift treatment is recommended? I'm 41 years old. I'm experiencing premature aging. I have nasolabial folds, heavy jaw area and downward facing mouth corners. I consulted a couple of doctors through emailing my pictures. Some recommended mid facelift, others the lower facelift. I'm also looking into going to Mexico to have a full facelift. What is the best option to restore youth and make me look more oval shaped rather than rectangular face?

Dr. Amiya Prasad: Thank you for your question. At 41 years old, you feel like you are experiencing premature aging and you are prepared to undergo some kind of face lifting procedure, and that you've had some correspondence with doctors. Some are recommending lower facelift, mid facelift and that you're considering going to Mexico to have full facelift. Just to understand the situation as well as to understand what are the indications for lifting is so critical in making this very, very big decision. Now I tend to be conservative, and I wrote a book a few years ago called "The Fine Art of Looking Younger". And at 41, I can tell you just to understand what the principles are of facial aging. There's volume loss and then there is sagging or descent.

When we talk about the early 40's, usually we're not dealing with very much sagging and descent. Now, in my practice, my youngest patient I've ever done a facelift for was 37. Another patient was 42. It's not impossible but it's rare that someone this young considers a facelift. You describe the nasolabial folds getting deeper and that you have a heavy jaw, but with the photos you've submitted, the one thing that I did not see was I did not see any jowling.

For example, the patient of mine who was 42 who I did a facelift on, she was of Irish descent. Her skin was very loose. She started to have some jowls. She happened to be the mother of a two-year-old and everyone thought she was the grandmother, but when I examined her, I lifted the skin and I saw that jaw line would really improve from lifting.

With the photos you submitted, it doesn't look to me like you have any jowling. It doesn't even look like you have any cheek descent. I would caution you. Now of course the one thing that we can't do in reviewing photos is we can't do a physical examination. So a simple test of just lightly pushing the skin can give you an idea of how much laxity there is. I would venture to state that you have more of a situation where you have volume loss rather than actual descent, and that addressing volume loss would be better for you than doing a lifting procedure.

So I think that when you do your research, meet with doctors in person, get a proper physical examination, understand that although you can push things up, it's not not going to necessarily be surgically possible to lift as much or as aggressively as you are lifting with the mirror. We also call it the mirror lift. There is a certain amount of give and a certain amount of elasticity that has to be accounted for. For most of my patients in my practice in their early 40's, we talk about volume correction. This includes fillers such as Radiesse, Restylane, platelet-rich plasma to help improve skin quality, and in some cases, we'll even do fat transfer. We're talking about more volume loss rather than descent.

My recommendation is to meet with qualified, experienced cosmetic surgeons in person and get some of opinions. You may wanna even try some of these fillers first, and this way, you get an understanding of whether or not the results are satisfactory to you. I hope that was helpful. I wish you the best of luck. And thank you for your question.
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Am I Too Young For a Facelift?

Dr. Amiya Prasad discusses why facelifts are rarely advised for people in their early 40s and how facial aging at this time is normally about loss of volume.

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