I'm a 38 year old female, what procedure would best address my sagging jowl and cheeks? (photos)

I am only 38 and my jowl and cheeks are sagging significantly. I seem to have a frown effect occurring and my face looks droopy (especially on the left side). I would like my face to look fresh and firm. What is the best procedure for me? Will buccal fat removal help or do I need a facelift? What are the approximate costs for each?

Doctor Answers 10

Best Procedures for Your Jowls and Sagging Cheeks

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Jowling develops when the cheek skin and fat loosen and sag downward with age.  This collects just behind the fold between the nose, the corner of the mouth, and the side of the chin at the jawline.  As your photo shows a squarish shape to your lower face due to accumulation of fat in the lower jowl at the jawline, along with deepening of the so-called marionette fold, I think that you would need at least a lower facelift or short scar facelift to lift up the sagging fat in your lower face.  This would recreate a more youthful heart-shaped look, smooth out the jowl and the marionette fold, and leave you with a  smoother jawline.  Also, some strategically placed stitches under the skin near the front of the cheek can nicely lift up the corner of mouth, therebye creating a more pleasing look.  This surgery could be performed either in an office or other outpatient surgery suite under local anesthesia and IV sedation.  The cost would vary in different parts of the country but would be less than a complete facelift.  

I'm a 38 year old female, what procedure would best address my sagging jowl and cheeks?

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Everyone ages at a different rate. Some patients at 38 have more aging than those much older. It depends on numerous factors including: heredity, history of smoking, lifestyle, sun exposure, excessive exercising, underlying medical health, and significant weight loss.
In the past, it was felt that 38 would be too young to have a facelift. Now most experienced artistic plastic surgeons would feel differently. It really depends more on the extent of aging, your desired result and the individualized approach that is necessary to achieve a natural appearing improvement.

A face including neck contouring would appear to be the most appropriate procedure. Buccal fat pad removal will not achieve a good cosmetic improvement.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

I'm a 38 year old female, what procedure would best address my sagging jowl and cheeks?

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It does appear that your face is heavy in the jowl area.  I believe the best bet for your money would be to have some type of facelift with liposculpting.  This would give you a softer, more youthful look!

Treatment options for sagging jowls and cheeks

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An examination of you would be needed to give you the best advice, but it does appear from your photo that you would be a good candidate for a facelift and liposuction under your chin.  These procedures should address the issues with your face.  Costs are going to vary by surgeon.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Indications of a Facelift Candidate & Costs

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A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.
During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

Price of a #facelift is always a concern when deciding whether or not to have a cosmetic procedure. Patients’ needs and goals vary, so there is no fixed price for a facelift.
These are the contributing factors to the cost of a facelift:
-Surgeon’s fee
-Facility fee
-Medication cost
-Anesthesia fee
Estimated fees may also be found here on Real Self, and the American Society of Aesthetic Plastic Surgery website.

Lower facelift

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I think that a lower facelift with liposuction of your neck would be worthwhile considering in your particular case.  Although you are only 38 years of age, I have performed the occasional lift in patients your age who were quite pleased with their results.

Your needs and desires.

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It looks as though you would certainly benefit from a facelift with tightening of your neck. Prior to any surgery, it appears that you should do your best to establish your ideal weight ( ideal weight in my mind- is the best that you can do - not some ideal weight in a book). Once your weight is in an ideal range, you can begin to focus on the surgical apsects.

Good luck!

Best Procedures for Your Jowls and Sagging Cheeks

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 A  conservative facelift could correct the problem of your jowls and sagging cheeks. There is no magic age for facelift surgery.  It can be performed when needed.  Consult with a Board Certified Plastic Surgeon for an exam, to discuss your options and expectations.

I'm a 38 year old female, what procedure would best address my sagging jowl and cheeks?

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Buccal fat removal is not the right option for you. From the one photo you provide, I would offer you a facelift, submental liposuction and liposculpture. Costs vary between surgeons and facilities. It should also be low down on your list of questions. More important to find a surgeon with a lot of experience in contemporary facelifting who will happily show you results and introduce you to former and current patients. 

Full facelift with liposuction for excess fat and skin.

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A full facelift with liposuction is what you need to remove the excess fat and skin. The cost can be determined after a face to face consultation.  Face forward and profile photos are preferred.   

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 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.