What can I do as a 32 year old female? What are my options for a durable change? Mid-face lift? Inflatables? Chin lift? (Photo)

I am currently looking to solve the following: - Puffy & saggy tired eyes - Lose chin and cheek skin - Crows feet - Skin tags on neck Coming from a long line of women who suffer from face puffiness, and saggy eye lids, I am starting to see loose skin from my 50 lbs weight loss. I'm fit and happy but the cherry on top would be a more alert and firm face. All advice is welcomed. I am currently weighing my options so I can budget accordingly. Thank you so much!

Doctor Answers 19

Early changes

You demonstrate many of the early changes that are often seen at your age related to sun damage, aging, and heredity.  None of them warrant a face lift of any type at this time, and yet many options exist to treat each of your concerns.  A complete examination is essential before making any specific recommendations, and I would specifically want to evaluate your upper eyelid function as a part of that, since to me it appears as if there may be some degree of upper eyelid sagging, or ptosis, which you mention, and correcting that might significantly improve your overall appearance in addition to such treatment options as Botox injections, a good skin care program, light skin peels, and possibly fillers or fat grafts.  Lots to consider; lots to discuss.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 7 reviews

32 yo facial laxity after a fifty pound weight loss!

Congratulations on losing 50 pounds!  Hopefully you have reached your goal.  Generally, in large rapid weight loss patients they can expect improvement in their skin laxity with time.  If not or one is impatient, there are a variety of nonsurgical options when you are only 32 years old.  This includes targeted Botox and filler.  Skin treatments using creams and office based lasers will benefit too.

Because of your age I would start less invasively, if you do decide with a surgical treatment this can be performed naturally and safely.  If you have not reached your weight loss goal I would not recommend this.

The skin tags can be removed at any time.

Find a Specialist you trust in your area and discuss these concerns.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

What can I do as a 32 year old female? What are my options for a durable change? Mid-face lift? Inflatables? Chin lift?

CaptainSin, generally while we never say never, 32 is quite young and usually does not warrant a face lift. The photos are helpful but of course don’t take the place of a face to face visit. There are many options to assist in rejuvenating that do not require a face lift. Injectables are good options to soften folds as well as provide volume. Laser therapies can be very useful to resurface the skin and reverse some of color and textural changes while also tightening the skin and building collagen. There are many options, but most definitely while surgery and lifting the tissue may be needed, more likely other options can likely assist in helping to further rejuvenate your already youthful appearance.

Michael N. Desvigne, MD, FACS
Scottsdale Plastic Surgeon
4.1 out of 5 stars 8 reviews

Lower Facelift known as The Concept Facelift™

Thank you Captinsin for your question and your picture.  You are still very young and a facelift is a procedure which needs a lot of thought, however a lot of younger patients like yourself feel conscious as skin laxity is worse due your weight loss.  A very well done on your weight loss by the way!  The Concept Facelift would be a perfect procedure for yourself.

I have developed a revolutionary local anaesthetic facelift known as the ‘Concept™ Facelift’. This innovative procedure combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days.  If your skin is loose, sagging or creating the appearance of jowls you may be a good candidate.  

I hope your research for the right procedure for you is successful.  Best of Luck, I hope you get an amazing result!

32 year old female? What are my options for a durable change? Mid-face lift? Inflatables? Chin lift?

Hi, non smiling photos of your face from the front and side are the best for evaluating the face. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties. From the photos your cheeks are flat anteriorly (in the front), jowls are present and the chin is weak. These factors combine to create a rectangular shaped face.

Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

What can I do as a 32 year old female? What are my options for a durable change? Mid-face lift? Inflatables? Chin lift? (Photo)

You have many options available. Surgery is a possibility, but there are other treatments available. For the heaviness and puffiness of your eyelids, surgery offers a long term improvement. Fillers and Botox could also be used for temporary improvement. As far as your face and neck are concerned, you might consider fillers (synthetic or fat grafts) as well. A consultation with an experienced surgeon should inform you of your options. You could then make a long term and short term plan. Good luck.

Warren J. Katz, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Mid-face lift? Inflatables? Chin lift?

Your lower eyelid saggy skin and puffy appearance would be corrected with a Blepharoplasty.  Your crows lines could be treated with laser resurfacing if you feel your facial skin is loose and lax, then a Facelift would help with this.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Great surgical candidate but plenty of room to go with non -invasive treatments first

While it's difficult to tell your exact needs and predict outcomes without examining you, it looks like you would be a fantastic candidate for surgery, including upper and lower eyelidplasties and possibly a surgical lift.  However, there are plenty of things we could do without a scalpel and scissors!  Recent changes in pharmaceuticals and lasers have really revolutionized the practice of plastic surgery, pushing invasive surgical procedures further and further down the line.  The foundation behind any plastic surgical procedure is first starting with excellent skin.  As you already recognize, you have significant changes from sun damage and aging, resulting in changes in the collagen, pigmentation, and elasticity of your skin.  I would start with that.   In addition, there is also age-related loss of the supportive ligaments and volume of your face.  You would do extremely well with a filler, such as Juvederm and Voluma, as well as a focal paralytic agents, such as botox.  Although these agents have a limited biological activity, I have found that a number of patient exhibit permanent improvements after regular and repeated use, such that many are able to avoid surgery altogether. 

Douglas Chin, MD
Oakland Plastic Surgeon

Facial rejuvenation

Based on your description there is an array of options to address some of your concerns; fillers, Botox, localized liposuction, eyelid and facial surgery. First you need to see a reputable board certified plastic surgeon in your area for detailed clinical evaluation and an open discussion of your options. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Options are available

but to really know what is best, you should see a plastic surgeon with your list of concerns and allow him/her to provide you a list of options that will provide you the goals you seek.  If you have any excess fat on your body, I find that always more preferable to any filler out there... plus is has the potential to be permanent.  Your lower lid skin is loose and you could have laser, chemical peels, or ThermiSmooth and all would provide you an obvious benefit but each as their own set of risks and downsides.  Your photo did not show any other areas of excess that would require anything surgical.  And skin tags are easily removed as a courtesy with any procedure I do for my patients.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 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.