I'm 28, lost 50LBS, want to fix my lower third heaviness. What surgery would you suggest to achieve this? (Photos)

Question

These are surgeries I'm considering, would either of these work? also open to other surgery suggestions. Most importantly, is my edited after photo achievable with the suggested surgery? Thank you so much for any feedback. -high-smas/subperiosteal endoscopic midface lift -endoscopic assisted SMAS facelift with anterior tragal access, focused on reducing lower third heaviness.

Semih Yildiz, MD, FEPOBRAS · Answer

At 28, lower-face heaviness is often more about anatomy than true aging. Chin projection, jawline shape, bite/dental support, submental fullness, skin thickness, and cheek volume all affect how heavy the lower third looks.
A facelift is usually not the first answer at your age unless there is unusual laxity. Depending on the exam, options might include chin augmentation or genioplasty, submental liposuction, jawline contouring, carefully placed filler, or orthodontic evaluation. I would choose the least invasive plan that addresses the actual cause.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear bellababb,

Thank you for your question. Congratulations on your weight loss. That is a major accomplishment.

Based on your photos, I do not think a traditional facelift would be my first choice at age 28. You appear to have good skin tone overall, and your concern seems to be more about facial shape, lower face fullness, and cheek-to-jawline balance than true facial aging.

The key question is whether the heaviness you see is coming from descended soft tissue, residual fullness in the lower face, muscle and bone structure, or simply the way the photo edit changes light, contour, and proportions. In younger patients, it is often not a facelift issue in the classic sense.

A midface lift or SMAS-type facelift may help in selected cases, but those procedures will not always create the sharper, slimmer lower third that patients are hoping for. In my opinion, your edited result may be difficult to achieve predictably with those operations alone. That does not mean improvement is not possible, but it does mean the exact “after” image may not be a realistic surgical promise.

Depending on your in-person exam, the better discussion may be around facial balance and contouring rather than simply lifting. That could include careful evaluation of chin position, jawline definition, buccal fullness, submental area, and cheek support. In some patients, a chin implant, chin augmentation, submental contouring, or other targeted procedures can make more sense than a facelift.

So overall, I would be cautious about jumping into a facelift-style operation this young unless there is clear evidence of tissue descent on exam. I think the best next step would be an in-person consultation with a board-certified plastic surgeon who has strong experience in facial analysis and facial rejuvenation, so the plan is based on what is actually causing the lower third heaviness.

Warmest regards,

Dr. Stephenson

Gary M. Horndeski, MD · Answer

You are not a surgical candidate for any type of facelift as you are too young and the results would be poor. However, you may be a candidate for a lip lift. I do not recommend a bullhorn lip lift as it can result in the "bunny look" since it removes more central and nothing from the corners. I do recommend an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000. This will create improvement of your lower third face.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

I see no reasons for any lifting based on these photos and short of in person evaluation. It is possible that a small volume augmentation in the areas around eyes/cheeks, chin and jawline could be considered? Possibly temporal brow lift to change shape of your brows? Good luck.

I'm 28, lost 50LBS, want to fix my lower third heaviness. What surgery would you suggest to achieve this? (Photos)

Answers (4)

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