38 yr old surfer has premature ageing: drooping cheeks & eyelids, 2 surfing scars, and smile lines. What to do? (photos)

Thank you for your question. Yes, you are correct in that the harsh Australian sun is a big contributor to premature ageing for many Australians. This is particularly accelerated for the surface quality and collagen and elastin elements of the skin. I am sure you are sun smart and applying a good facial sunscreen on a daily basis to help protect from the UV rays which is the most essential ingredient for any good skin care regime in Australia. Looking at your images I do not think you are currently a candidate for a facelift, although a personal consultation will always help for the best opinion. Facial rejuvenation should be considered a multimodality approach and combinations of facial resurfacing, dermal therapies, skin relaxers, fillers, elevation of deep tissues and skin removal are all key therapies used at specific time points over ones life. You look great for 38 but you would benefit from incorporating wrinkle relaxers (forehead, glabella, crows feet) and filler in the lower eyelids, cheeks and smile lines. A good skin care regime, chemical peels or laser resurfacing with dermal therapies to improve collagen will help. These need to be done regularly for maximal benefit. From a a surgical perspective you look like a good candidate for an upper blepharoplasty but again a personal consultation with a plastic surgeon will help with this decision. When it comes time for a facelift there will be incision around the ears but in my experience these are nearly invisible and almost never an issue for patients if placed correctly. I hope that helps.RegardsDr Guy Watts

I think one can make a case for a facelift based on what I see in the photograph. However, any plastic surgeon would encourage you to change your lifestyle relative to sun exposure. Resurfacing would be a bad idea unless you plan to avoid significant ultraviolet light exposure.

Hello Aussie surfer,   Are you at the point in your life where you are considering cutting down your sun exposure?  Continued sun exposure will age you despite sun block.  Whatever your decision, you are a candidate for fat transfer to your face.  You might also consider a blepharoplasty.  Both of these procedures have minimal scars. Fat transfer has the unique benefit of improving the skin texture over time.  All the best.