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?

Ali Riza Öreroglu, MD · Answer

Looking at your photos, the changes seem to be most noticeable around the lower face, with some descent of the facial tissues and volume deficiency beneath the eyes.
For this reason, I would consider a deep plane facelift combined with fat grafting to the under-eye area as an option. A deep plane facelift can elevate and reposition the deeper facial tissues, helping to restore facial contours and improve the overall appearance of the lower face and jawline. Fat grafting to the under-eye area can help restore lost volume and create a smoother and more refreshed transition between the lower eyelids and cheeks.
However, I would prefer to examine you in person to assess the degree and distribution of facial laxity, the quality of the skin, and the amount of volume loss around the eyes and face. This would allow me to determine the most appropriate surgical approach and create a treatment plan that provides the most natural and balanced result.

Muhsin Yilmaz, MD, FEBOPRAS · Answer

Yes, a facelift can certainly be an option at 43, especially if your main concerns are sagging around the mouth, cheeks and under-eye area.
When there is noticeable descent of the facial tissues, a deep plane facelift can be particularly effective because it addresses the deeper supporting tissues rather than simply tightening the skin. This can provide a more natural improvement in the cheeks, lower face and around the mouth.
For the under-eye area, however, a facelift alone may not address every concern. Depending on whether the issue is primarily skin laxity, fat herniation or volume loss, an appropriate eyelid procedure or fat grafting may be considered at the same time.
At 43, the goal would generally be a subtle, natural rejuvenation rather than making the face look “pulled.” An in-person examination would be important to determine whether a deep plane facelift is appropriate for your anatomy and how much correction you actually need.

Semih Yildiz, MD, FEBOPRAS · Answer

A facelift can be an option when the main issue is laxity of the lower face, jowls, and neck, but it is not the best single treatment for every area you mentioned. In the photos, the visible concerns appear to be early lower-face laxity around the mouth and jawline, some midface softness, and under-eye hollowing; photos are limited and the skin needs to be examined in person. At 43, a mini/lower facelift or deep plane facelift may be reasonable if there is true tissue descent, but sometimes the better plan is a more targeted combination rather than a larger operation.
A facelift will not directly correct under-eye hollows or skin texture. Those areas may need lower blepharoplasty with fat repositioning, conservative volume restoration, resurfacing, or skin tightening depending on anatomy. The right choice depends on whether the problem is loose skin, facial volume loss, bone support, or surface aging, so an in-person evaluation with facial measurements and skin-quality assessment is the deciding step.

Vipul Gargya, MD, FACS · Answer

Based on your age and concerns, a full facelift is often not necessary. From what you describe, a short-scar face and neck lift combined with fat transfer to the face would likely be a very appropriate option.
This approach focuses on tightening the lower face and neck while restoring lost volume to areas such as the cheeks and under-eyes, which is often what creates the tired or sagging look in your 40s. The goal is natural rejuvenation, not an overdone or pulled appearance, with smaller incisions and a smoother recovery compared to a traditional facelift.
A personalized in-person consultation with a board certified plastic surgeon would confirm the best plan, but this combination is commonly ideal for patients in your age group who want subtle, balanced, and long-lasting improvement.

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.

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.

Albert Yang, MD · Answer

Your face looks beautiful. Very early signs of aging with a little jowls and area under your eyes. A facelift with fat transfer would help .

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.

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

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