43, sagging of face. Is a facelift right for me? (Photos)

Question

Hi, I'm a 43 old female who is oncerned with the sagginess of my face, specifically, the areas around my mouth, my cheeks and under my eyes. Is a facelift an option?

Mark Beaty, MD · Answer

Thank you for sharing your concerns and photos. At this stage, I wouldn’t recommend pursuing a surgical procedure, as I don’t see signs that would warrant a facelift or other aging-face surgery. Your skin quality and facial volume appear to be well maintained.

For prevention and subtle enhancement, I’d suggest focusing on regular skin maintenance treatments—such as facials, light chemical peels, and microneedling—as well as preventative options like neurotoxin injections. A consistent skincare regimen that includes daily sunscreen is also key for preserving your results long term.

Remember, the goal is healthy, natural aging—not perfection. You’re in a great place to maintain what you have and slow the aging process gracefully.

Athanasios Christopoulos, MD · Answer

Getting a facelift will improve the skin laxity you have on your face. On the other hand, however, I believe based on the photos I see that the amount of sagging is not that significant, and you could potentially postpone it for a later time. Of course, deciding the right time is a personal matter for you, but I believe the opinion of an experienced and honest plastic surgeon will help you decide.

Raffy Karamanoukian, MD, FACS · Answer

Unlike other tightening treatments, Ultherapy only requires a single treatment every one to two years and has long-term effects in skin stimulation and collagen production. Ultherapy is ideal for men and women who are experiencing mild to moderate skin laxity and desire a noticeable and long-term skin tightening treatment without the complications and risks of more invasive surgical procedures. Ultherapy can be combined with dermal fillers, Botox treatments, chemical peels, skin tightening lasers, and skin facials. Our plastic surgery and cosmetic center in Santa Monica offers Ultherapy as a complement to other skin treatments and cosmetic rejuvenation procedures.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Gary M. Horndeski, MD · Answer

You are a poor candidate for a facelift. Your face does appear to be sagging significantly. I would recommend a brow lift. Your eyebrows are slightly below the orbital rim and you have a very high forehead. The brow lift will decrease the vertical height of the forehead, pull down the hairline and raise the eyebrows to the level of the orbital rim.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Lexie Wang, MD · Answer

I do not see much of true sagging that really warrants the potential risks of a facelift at this time. I would focus on revolumization and collagen building, esp at your age.

Alejandro Nogueira, MD · Answer

I recommend you rule out rejuvenation facial plastic surgey by now and during at least a decade from now, your look is superb, youthful and any surgey would surely lead to undesired results and a guaranteed disappointment.

Darryl J. Blinski, MD · Answer

Based on a series of very well posted photos, you have the option of having a mini facelift with neck lift, and muscle replication. You also could do a minor anterior facelift with the Endo lays treatment. Best of virtual concert with fees will range from $5000-$12,000 depending on which option is chosen Again best of virtual consult.

43, sagging of face. Is a facelift right for me? (Photos)

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