Any Alternative to Surgery for Saggy Skin?

Lower part of the face left and right to my chin, my skin is getting soggy with a couple of deep wrinkles, even thoug I look younger than my real age, I think that is changing now. I tried many "miracle" creams and serums. Don't work. I'm thinking of Botox, any suggestions?

Doctor Answers 19

Loose skin around the neck and face

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Generally there are many solutions for a problem, but only one solution that is best. For loose skin around the face and neck a facelift and necklift is usually the best solution that fixes the most for the longest period of time.

Many doctors also augment lost facial volume with grafts as well.

All other solutions will be minimal in comparison.

Most experienced board certified plastic surgeons offer minimally invasive and temporary treatments as well, so they can give you an approximate percentage of expected improvement with each of the contemplated procedures.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Solution for saggy skin of lower face is surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

When the skin muscles and fat of the underneath portion of the chin begin to sag, a neck lift or face/neck lift is a comprehensive solution to this problem. It involves removal of fat underneath the neck, tightening the skin and tightening the muscles underneath the front and the posterior portion of the neck to give the new definition of the jawline. Miracle creams and serums do not work in this area, nor do Botox and dermal fillers.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Fillers are an excellent option for early stages of sagging skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fillers are an excellent option for early stages of sagging skin. Fat transplantation can be used to redistribute facial skin as an option to face lifting. Light based light sources and radio frequency devices such as Titan and Thermage provide modest tightening. Once you are old enough to need a lift, see your dermatologist for a recommendation on who is the best person in your area for face lifting.

William P. Coleman III, MD
Metairie Dermatologic Surgeon

Pesky jowls

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sounds like you are describing jowls, and nasolabial fold prominence. If I am correct, Botox is not useful as a treatment modality.

If your neck is in a youthful condition, you should consider a cheek (mini-face) lift. If your neck has signs of aging that bother you, you shoud consider a lower face lift (cheek and neck).

I do not recommend thread or lifestye lifts due to longevity and efficacy.


Botox, Fillers, Thermage and Lasers might be an alternative vs. surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are many aspects of your face that need to be analyzed. The texture of the skin, the laxity, the amount of fat in pockets, the relative amount of drooping that has occurred. Some patients are adamant against having surgery, and yet I might explain to them that after all the costly nonsurgical treatments I can offer, they will not be happy. Others may be able to avoid a surgical lift for several more years by maintaining volume correction of the face which helps support the sagging areas (although not all patients are candidates for this), Thermage radiofrequency to help tighten the skin, laser resurfacing which can further tighten, and possibly, even Botox as a off-label use to decrease the pulling down vector of the depressor anguli oris muscle helping it lift the corner of the lips which when they are pointed down make us look sad, and even Botox along the neck under the jaw to minimize the pulling down of this muscle (platysma) which may help lift the jowl in some patients. All of these treatments are not done in all patients. It could be very very costly and needs repeating every 4 to 10 months, depending on which filler or Botox treatment is being discussed. There is a lot to be gained by having a surgical procedure done and having the results last for several years so you should still see a plastic surgeon in consultation. Volume depletion over the years, a major cause of facial drooping, is not corrected by lifting and this still can be done in addition to having a lift. At least you know there may be options, but advice for your condition can only be given after a physician examines you.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Non-surgical facelift options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

For what you describe you might consider a combination of Fractional CO2 laser treatments (DOT laser) and fat injections.

The laser helps tighten the skin and give a "mini-facelift" to the lower face.

The fat injections will help camouflage the jowls and fill in the marionette lines.

The best option would be a MACS lift, which is a mini-facelift with dramatic results. Botox will not help sagging skin

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 46 reviews

Treatment of sagging facial skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no subsitute for a facelift as Dr. Placik has said. There are some temporizing measures you can pursue like fillers and Botox. The fillers are more useful around the lower face and the Botox in the upper face generally. Skip the expensive and painful treatments like Thermage as the results are usually quite unimpressive.

Sounds like a facelift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If your skin is saggy, something to tighten it is needed and that is a Facelift. Botox removes deep lines by paralyzing the muscles -- it does not tighten skin. Lasers may help a little with fine lines, but they too do little to get rid of excess saggy skin.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Non surgical correction of saggy skin

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Botox will not tighten skin.

IF your appearance is due to or aggravated by facial volume loss, injectable fillers may provide you with some improvement. However, there generally is no subsititute for a facelift which addresses issues of volume loss, skin laxity, inferior displacement of underlying musculofacial structures and permits differential treatment of each of these components. Of course there are claims of skin tightening lasers but these generally produce a result of 2-3 (on a scale of 1 to 10)when an outcome of 7-9 is required for a significant improvement.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Thermage plus fillers may be a good alternative to surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

To treat your sagging skin surgery is probably the best way , however if you are not ready for surgery then Thermage plus fillers could be a great alternative.

Thermage has no down time and has produced good tightening effects.

The only thing is that the results are not immediate and you will need to wait 4-6 months to see the results.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 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.