Is my face sagging? (Photo)

Question

I was recently told that my face is droopy/sagging. I am 21 and thought I looked young but apparently I “could never pass as a teenager.”The areas that were said to be dropping are my cheeks and left side of my face . I was also told that my neck was dropping as well . I have had lines since I was teen but they have gotten more prominent . Are all these judgements accurate ?

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Frankly, I am very distressed to hear your story. One of the first principles any medical student learns in school is "Primum non nocere," which is Latin for "First, do no harm."  I firmly believe that, particularly when it comes to aesthetic issues, an ethical doctor should NOT impose his/her sense of aesthetics on the patient. Instead, a patient should first describe what specifically bothers him/her and only then should the physician explain what can be done to address the problem(s). If the physician jumps to pointing out what he/she believes are issues, a patient, as in your case here, may then begin to fixate on and obsess over issues that hitherto did not bother him/her at all--as you are now, are or can have his/her self-image shaken (as has clearly happened to you)--and can begin to obsess over this--in which case, the doctor has broken the primary rule and caused harm. In my own practice I refuse to answer the question of "What can done for me?" until the patient explicitly tells me first what specifically bothers him/her. A doctor should address aesthetic problems, not create them. You do look young, a bit of asymmetry between one side of the face and the other is quite common, and, at least from the photos, nothing particularly jumps out at me necessitating any intervention. Hope this helps and best of luck.

Oakville Plastic Surgery &amp; Medspa · Answer

When I look at your face, I would not label you as sagging. You have a beautiful heart-shaped face that I create with filler, in much older women who have saggy faces. 
The most interesting part is you are not smiling in the pictures you submitted. For a random person who is actually saggy and isn't smiling in their photos, the non-smiling photos tend to highlight the sagginess. This is because when we smile, the cheek muscles lift the face and the chin is elongated, decreasing jowling. Despite the face that you are not smiling, you STILL do not look saggy.
Enjoy your youthful beauty!

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