Too young for a facelift? 33 years old (Photo)

Question

I'm 33, fit (5'7, 135lb) don't smoke cigs or drink but have a saggy neck. Always have, thanks to genetics. The doc at Elite Body Sculpture said it's not a lipo candidate. Should I look into skin tightening, or does this warrant a necklift? Would love to have a snatched jawline!

Suleyman Tas, MD, FEBOPRAS · Answer

Dear glowup23,

Thankyou for providing additional media for better recommendations. I would like to remind you that your age is not of significance as compared to your happiness and overall feeling of how you appear. With that said if you are ready to take this new step in your life then go for it. Furthermore, I would recommend you endoscopic scarless necklift which will eliminate your sagging neck and the results will reflect a young and fresh appearance.

Best Regards, 
TAS TEAM

Semih Yildiz, MD, FEBOPRAS · Answer

Age alone does not decide whether someone is a candidate for a neck procedure; the key is whether the problem is fat, skin looseness, platysma bands, muscle position, or jaw/chin anatomy. In the photos, there appears to be mild softness and skin laxity under the jaw rather than a large fat pad, so I can understand why liposuction alone may not have been recommended. Skin-tightening treatments may give subtle improvement, but they usually cannot create a sharply defined jawline when the issue is deeper neck support or true skin laxity.

At 33, a full facelift is usually more than is needed unless there is clear lower-face laxity. A focused necklift, submental tightening, platysma work, or sometimes chin/jawline support may be more relevant options, depending on the exam. The best consultation should include an evaluation of your chin projection, hyoid position, platysma, skin quality, and whether the fullness changes when you clench or look down, because those details determine whether a nonsurgical treatment, limited neck procedure, or no surgery is the right path.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. A skin-tightening treatment such as RF microneedling is likely your best option for the skin on the face and neck. Rf microneedling uses radiofrequency technology to create micro-channels in the skin while heating the underlying tissue, encouraging the body’s natural collagen production with results lasting up to five years or more.
If submental fat is a concern, you could also consider Kybella injections. This treatment uses deoxycholic acid to dissolve fat cells under the chin to create a more contoured jawline. Another option for submental fat is facial liposuction, which gently suctions away the fat cells to sculpt the neck and jawline. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to suggest the best treatment option to help you achieve your aesthetic goals

Peter Lee, MD, FACS · Answer

Thank you for your photos, We are not sure what a “snatched jawline” is, but question whether that is something that you would really like to suffer.  Actually, your jawline looks pretty good in profile. However, the profile view does reveal that your cervicomental angle has become less acute.  Your overall skin quality also looks pretty good as well.  While a limited necklift is always an option, before your take this step, you might first consider a skin tightening procedure such as Ultherapy, Necktite or Morpheus.

Sam Speron, MD, FACS · Answer

A Mini Facelift or Midface Lift can usually be an option on most realistic patients anytime after the age of 35-40.  It really depends on your anatomy and genetics.  It is best to talk to your surgeon because everybody has different techniques and recovery time is usually based on a number of factors but there's no set number on age.  Sometimes even younger people are candidates because of their anatomy or if they have gone through certain medical conditions.  If we are just talking about a short scar facelift, this can typically be done in the office under local anesthesia.  Usually there are no drains, no outside stitches, and patients can go out in public the same day, although I usually recommend they low for the first couple days.  Most of the initial swelling is from the numbing medicine and your body absorbs it within the first 4-6 hours.  Obviously the body heals with swelling and inflammation and usually that maxes out at two days and then starts getting better.  Most of these patients take no pain medicine and usually feel very comfortable going out in public within a few days.  I usually call my patients the night of surgery and check on them the next day.  If everything is fine the next day, I then let them shower and they do not need a dressing over their incisions. They can usually start using make up after a few days.  At the two week check up, I usually have people start working out and then after six weeks they can do whatever they want.  I routinely tell people to take a few days to a week off work and to hide out but some people are very nervous especially celebrities and I usually tell them to hide out for two weeks.  As with any scar on the human body, initially scars are red, hard and raised and it typically takes six months to a year for them to become a soft thin white line. Additionally with recovery, there're many things we do to expedite healing such as nerve blocks during surgery, oral supplements, skin care and scar therapy recommendations, lymphatic massage sessions that are included in our pricing. I strongly feel that it's very important to have an honest conversation with your surgeon about your particular situation, lifestyle, work environment and specifically which procedures you're having done so that you both have the most honest answer about your recovery and are realistic with expectations and results. Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls. I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.  I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Alan Gonzalez, MD, FACS · Answer

Greetings @glowup23, thanks for your question and showing your pictures. A Facelift is a to invasive procedure for your face. It is very possible to improve the skin elasticity and define the edges of the face or mandibular line with a nonsurgical treatment like Ultherapy. This may be a non-surgical alternative. It is important to consult one or several board certified plastic surgeon for more information and recommendations. Best wishes! Alan Gonzalez MD FACS

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

The surgeon you have consulted with has provided good advice regrading liposuction. In your case, the  volume excess is situated deep to the platysma muscles. It has of course genetic source.

It is not a problem of sagging and you do not need any skin tightening. The volume excess can be treated through an incision under the chin and involves reduction of fatty tissue, lower part of the submandibular glands ( salivary glands)  and part of the digastric muscles which can also be tightened to raise slightly the floor of the mouth.

The procedure is referred to as anterior necklift, short scar necklift, deep plane short scar necklift and takes approximately 1-1.5h

Zoran Potparic, MD · Answer

You seem to have quite nice jawline and no further improvement could be achieved with surgical manipulation. There seem to be some degree of neck banding, possibly lower insertion of neck muscles, that may be looked at? In person evaluation with a board certified plastic surgeon, expert in face/neck lifts, is recommended. Good luck.

Brian K. Machida, MD, FACS · Answer

At the very least, do nothing. At most, non invasive skin tightening. I would not recommend any surgery or minimally invasive procedures, only non invasive skin tightening and no fat manipulation.

Thomas A. Mustoe, MD, FACS · Answer

Your neck lacks definition, and I am confident without the full benefit of an exam that it is a combination of some skin and superficial muscle laxity, some excess fat in the layers deep to the superficial muscle (platysma) and some due to anatomy ( your hyoid bone and shape of your neck is more obtuse rather than more vertical in relationships).  I have seen some moderate skin tightening and effective removal of fat with a laser assisted liposuction, but the best results have been with a surgical necklift with removal of fat and lifting of both skin and muscle with limited incisions around the ears. I do not think you are too young.

Too young for a facelift? 33 years old (Photo)

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