I'm 23 Years Old and my Face Sags. Would a Mid-Facelift Help?

I'm 23 years old and my face sags especially around the mouth. I'm not over weight, I stay out of the sun and live a healthy life style so I'm not sure why my face is like this. I've been to a dermatologist and while they haven't ran any tests they say "its just genetics". I'm curious if It looks like I would benefit from a lift and/or lipo and fat grafting or somthing? Thank you in advance!

Doctor Answers 24

Young Patient Concerned with Sagging Skin

Hi malaka ,

20's is generally too young for facelift surgery, including midface lift. Other aesthetic options to improve one's appearance at this age include such treatments as skin care, laser, light peels, or tretinoin.

Based on the photographs, your jaw bone may be relatively small and unbalanced with the face. This small chin or jaw may contributing to the "sagging around the mouth" that concerns you. Jaw surgery, with or without chin implant, may possibly improve the appearance. In addition, fat injections or injectable fillers may also improve the area.

Only after a comprehensive evaluation by a plastic surgeon can he/she help determine appropriate options for you. Best of luck.

Dr. Chaboki

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 83 reviews

Midface lift versus fillers in young person

I am adding my comments which agree with others - don't do surgery at this age.  I do think that your issues could be addressed with much simpler means - fillers for example.  I also agree that dental - facial issues might be looked at as well - hard to tell from photos about this but worth looking into especially if you have any jaw joint or malocclusion issues (teeth don't fit together right). 

Douglas M. Stevens, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Sagging mid-face in youth may be corrected with volume fillers.

Thank you for posting the photos as they show some flattening and furrowing through the mid-cheek area. This is indicative of volume loss, and , much as a balloon deflating will result in the "shell" descending, the skin will sag as this occurs. This is seen in even young client such as yourself that start to see "aging" changes in their 20's. Having a firm filler such as Radiesse placed high on the cheekbones should give a nice, long-lasting, (12-15 month), lift, without surgery. Find an injector with experience in this injection and you should have a nice result. As you do have some "jowl" evident in the lower face, you may also need a SMALL amount of filler in the furrow just anterior to this to help "disguise" it and smooth the area. Beware of too much filler being placed in the lower face, as this can create an "older" appearance.


Debra Irizarry, MD
Crestone Plastic Surgeon
5.0 out of 5 stars 4 reviews

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Options for prominent jowls in a 23 year old

From the first picutre it appears you have a small jaw which may contribute the the apperance of jowls. Occasionally this can be associated with an overbite. Corrective surgery may require orthognathic intervention. Alternatives include chin implants with prejowl augmentation, as well as the use of fillers. Fillers would allow a reversible and lower risk option with the benefits of reversibility.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 75 reviews

Be more conservative

I think that fillers -especially Juvederm might be a good start-Juvederm is also reversible which is a huge advantage over more permanent fillers like Radiesse.

Also, having a chin implant as an adjunct might me a good option.  It's best to get several opinions in person-to person consultations-you are too young for aggressive surgeries so let's stay focused on a path that's realistic for your age and will give you the resukts inh line with your expectations.

Good Luck!

Edward J. Bednar, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 111 reviews

23 years old and a sagging face

You are young for a face lift to be sure.  You may be a possible candidate for a cheek lift with minimal dissection.

I would also direct your attention to your chin.  This is a bit weak.  If your occlusion is good then a chin implant may be all you need.  You have blocked out your nose, so I can't comment on that.


Is 23 too young for facial surgery?

Thank you for the photos. Two things I notice: 1. you have a small chin and 2. it seems that your left cheek is slightly smaller than your right one. I would start with injectables or fat grafts to balance the asymmetry. You might benefit from a chin implant to balance your profile view.

Facial sagging and marionette lines

Fillers could be your answer or some type of volumizing. I would look to your chin as one area to augment that could help your situation. That is a secret that most plastic surgeons don't know. I would consider a chin implant or some fat injections in your chin area and cheek area. These things are a little early for someone in your 20's but you only live once.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 66 reviews

Juvederm treatment

I commonly address issues like the ones you are complaining of at your age with either Juvederm or autologous fat.  Stay away from any permanent products as the complications down the road can be severe.  you may also benefit from some modest skin tightening using a BBL device.  I would recommend starting with a HA filler such as Juvederm.

Midface lift in young patient

While technically you could benefit from a mid-face / cheek lift, I would strongly advise against it...or at least save it for a later date, like in 15 years.  At this point, careful placement of Juvederm or Restylane to the upper cheeks and under eye areas can enhance your look without the cost and risk of surgery.  All the best, Dr. Vartanian

A. John Vartanian, MD
Glendale Facial Plastic Surgeon
5.0 out of 5 stars 16 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.