What are my options for my face? My skin looks like it's about to fall off and my mouth and the skin around are falling (Photo)

I'm 23 years old and my face started to sag/fall off this way around 4 years ago, i tried gaining weight, but despite my best efforts eating 3k+ calories i could never gain weight or gain the fat back in my face. In summer of 2019, i had perfect skin, my face looked good and i wasn't sagging, then a few months after my skin slowly looked like it was about to fall off. Is a facelift my only option? I got fillers under my eyes and in my jaw a few years ago, but it didn't do much.