Lower face sagging at 26 - what are the causes & what can I do? (Photos)

Question

Hi I’m 26 and my lower face is sagging and causing low mood. What can I do to help this? What are the causes?

John Michael Thomassen, MD · Answer

In young individuals like yourself, facial droop can occur after weight loss.  You can do a very minimal temporal lift with a small scar in the temple to lift the cheek and correct the marionette lines the form.

Lucian Ion, FRCS · Answer

Hello,

Thank you for your question and for sharing your images. Based on what I can see, you have slight fullness in the lower cheek, likely due to buccal fat, and mild visibility of the labiomandibular (marionette) lines. Here are some non-surgical options to address these concerns:

1.	Injectable Fillers: Using injectable fillers to treat the labiomandibular lines can effectively smooth out these areas, providing a more youthful and lifted appearance. This treatment can help reduce the visibility of marionette lines and improve the overall contour of the lower face.
	2.	Buccal Fat Reduction: To complement the filler treatment, buccal fat reduction can be considered. This procedure removes some of the volume situated above the marionette lines, enhancing the definition of your facial features and reducing fullness in the lower cheeks.
	3.	Botulinum Toxin: Another option is the use of botulinum toxin (Botox or equivalent) to the platysma muscles and the depressor anguli oris. This treatment can produce subtle changes around the corners of the mouth, giving the impression that the corners of the mouth are slightly raised, which can help in improving the appearance of sagging.
	4.	Sun Protection: It’s also important to use sunblock regularly to maintain the elasticity of your facial skin. Sun protection helps prevent further skin damage and supports the overall health and appearance of your skin.

Jason Emer, MD · Answer

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Jacob Tower, MD · Answer

Hello, hope you are well. First of all, the 'sagging' that you see is not something that would be obvious to the casual observer--many would probably disagree that there is a visible issue at all. Having said that, you know your face better than anyone, and as you get older changes in the skin texture and elasticity will be inevitable. You will be the first to notice. The main cause that you can control is sun exposure--any direct sunlight on your skin will gradually cause photoaging unless you protect it routinely with SPF 30+ sunscreen. In terms of 'tightening' your skin and maintaining a youthful jawline, the best options available at your age and with your anatomy are radiofrequency treatments (RF microneedling 'Morpheus8' and bipolar RF 'FaceTite/NeckTite').
Best,Dr. Tower

Nelson Lee Novick, MD · Answer

No need for a "low mood"  We are all the products of our genetics (and it may be something inherited from a grandparent or even great-grandparent we never knew). The issues here relate to volume deficit, which can be quite easily addressed with the use of HA fillers.. First, the upper cheeks acts as a support for the under-eyes and also pull up on the smile line (and to some extent on the marionette lines, as well). So, by restoring volume to the upper outer cheeks with a robust HA filler, we can soften the tear troughs, diminish the smile lines and improve a bit the marionette lines  around the mouth. A robust HA filler can straighten an define the jawline and eliminate the jowls. And, it can be used to straighten the angles of the mouth. In experienced, all of the foregoing can be done in one 30-45 minute treatment session. So, don't despair. Instead, you would be wise to consult a board certified cosmetic dermatologist and best of luck.

Connie Hiers, MD, FACS · Answer

I would suggest minimally invasive radiofrequency skin tightening with Secret for you now. You should get great results. At your age, weight change is the biggest reason for excess skin.

Camille Cash, MD · Answer

A lower facelift is too aggressive for you.  From your photos you could consider Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Lower face sagging at 26 - what are the causes & what can I do? (Photos)

Answers (7)

More Lower Facelift Questions

WE SEND PRETTY
EMAILS

Answers (7)

More Lower Facelift Questions

Muscle remain swollen, painful and keep getting thicker 2 years after platysmaplasty. Any suggestions on why and traetment?

Platysmaplasty left me with pain radiating in my ear, fluid sounds, and bumpy swelling. Advice? (photos)

Smile lines. What other procedures can help? (Photo)

Continued ear pain 10 months after lower facelift, what to do?

Lower Facelift Options / Considerations? (Photo)

Will a lower facelift correct the loose skin under my chin, and lift the corners of my mouth? (Photo)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS