Would a facelift be the best procedure to correct sagging and volume loss? 29 y/o

Question

I'm a 29 years old femal. My face is sagging I feel much older then my age and everyone thinks that im 40 years old. I don't know if i need a facelift. I want to feel me more comfortable. I feel that i lost a lot of volume too.

Alan Gonzalez, MD, FACS · Answer

Hello @Dazzling25704, thank you for your question. At 29 years old, you are likely too young to consider a Surgical Facelifting. Before considering such an invasive procedure, it's important to explore the non-surgical options available to you. Non-surgical treatments such as Morpheus 8 or Ultherapy use radiofrequency energy which helps stimulate collagen production in the skin and ultimately provides improvement of structural features like sagging jowls or marionette lines. These procedures also don’t typically involve any fat loss. Be sure to talk openly with your doctor about all treatment options available so that together you can decide what will work best and make a non surgical protocol according to your goals and needs! Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Pasha Mostofi, MD, DMD · Answer

Hi there. From your photos it appears you have taut skin without any fine wrinkles, and that is a sign of youth. The only thing I think might be giving you the impression that you look older is you have some fullness in your submental region (the upper neck/chin area). This fullness or laxity in this area that might give the appearance of fullness is something that starts to occur from our mid-twenties onwards. When that area looks "full" (for lack of a better term), it takes away from the definition of our jaw line. This is all to say, this lack of 'contrast' between the neck and the lower face may give us the appearance that we look older sometimes. You might be a good candidate for either neck liposuction or a neck lift depending on what a clinician can assess/exam at a consultation appointment. A facelift addresses frank wrinkles, pronounced smile/marionette lines and frank/obvious signs of skin laxity in the lower and mid-face. Rest assured, you don't have any of these signs from your pictures. Other than a consultation for a possible neck liposuction or neck lift, you can consider a more conservative procedure like microneedling with radiofrequency (ie. Morpheus8). This is generally done at least 3 times, 1 month apart (depending on the operator protocol and machine settings). This helps tighten skin and stimulate collagen production in the skin, which is something we lose once we hit our mid-twenties and onwards. Hope this information helps!

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for posting your questions and photos. Based on these photos and your age, there is simply not enough skin/soft tissue laxity to justify undergoing any type of facelift surgery. Instead, I would recommend that you consider a procedure like FaceTite (bipolar RF) to tighten the soft tissue envelope.

Cheers,
Dr. Tower

Cheers,
Dr. Tower

Jaroslaw Tribull-Potapczuk, MD, PhD · Answer

Well, I understand what you mean, but I would not call it sagging. Not yet. Pictures are nice, but let us see your face muscles functioning and the tension of the skin during a consultation in the office. Maybe there are some other procedures smaller then a full face lifting more proper at he moment. Best regardsDr. TribullBerlin, Germany

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are primarily determined by bone structure.
It is the facial skeletal structure that gives each unique person their their unique facial appearance.
There are individuals who have facial, skeletal structure that is aesthetically, ideal and protective from premature aging.
Problems related to the midface are usually related to the shape and slice of the maxilla.
Problems related to the lower 1/3 of the face are usually related to the shape and slice of the mandible.
 if you look at individuals like Carmen Del’Orafice or George Clooney you’ll notice that they have well developed mandible structures and this is protective from showing science of premature aging.
Carmen has had facial aesthetic surgery but it’s able to maintain good looks into her 90s.
This is not because of her skin regiment.
It is primarily because of her bone structure.
A facelift is best at treating true facial aging with the development of true gels and sagging of the platysma muscle.
Individuals who are ideal candidates for this procedure will often have a man that is slightly small, but the procedure does not deliver great results for young individuals who are showing premature aging.
I think most plastic surgeons will recommend avoiding a facelift at your age.
Most plastic surgeons will be soft tissue oriented and soft tissue solutions aimed at treating a problem, which is primarily based on skeletal structure, are going to be partial at best.
For this reason, expect a different providers to have different opinions and there is no one single, ideal treatment.
If you end up having surgical intervention, then recognize that partial improvements are probably the best you can expect from any surgical procedure that doesn’t entertain, treating the primary problem, which is inherently complex, invasive and difficult.
Best,
Mats Hagstrom, MD

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