Sagging face at 24. Jowls and marionette/nasolabial lines. What can I do? (Photos)

Hello! This may be genetic and also because you have a thin face. Fillers may be helpful for you. Voluma is a wonderful, long lasting filler that we place in the cheek area. This creates a pretty lifted cheek and secondarily pulls up skin from the nasolabial line (line between nose and outer lip) and from the jowl. A different option would be to place filler in the nasolabial crease and along the area between the outer lip and jawline.Surgical option could be as simple as a minifacelift under local anesthesia with incision line around ears. This would provide the longest lasting result without adding volume to the face.I would recommend you seek consultation from a board certified plastic surgeon plasticsurgery.org. Good luck!

If you feel that your face does not reflect how young you feel on the inside, a facelift may be the solution to help you look and feel younger. During your consultation, your doctor will evaluate your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure. Based on this evaluation, he/she will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. Your doctor should make sure you have a full understanding of what results to expect.  Always insist on a board certified surgeon!

Sagging jowls and smile lines in a 24 year old can be treated with fillers, such as Juvederm and Restylane. Some may refer to such procedures as a liquid lift or a non-surgical facelift. Results are temporary and last several months. A lower facelift or mini lift helps to lift sagging tissue and remove excess skin, but is uncommon in younger patients. There isn't a "best" treatment. If you haven't already, then speak with a facial plastic surgeon to review potential treatment options appropriate for you.Best,Dr. Chaboki

It appears that selective fat grafting of cheeks, jaw-line and conservative liposuction of jowls would be one way to address your problem. Nasolabial folds are best treated with fillers. In-person evaluation by an experienced board certified plastic surgeon with good reputation in facial rejuvenation  should be your next step. Good luck.

I recommend a combination approach to get the most improvement. I recommend fillers for the folds and lines, while providing anatomical support with Sculptra to rebuild collagen. Lasers and microneedling/prp can improve texture and tone, while ultherapy and rf treatments can provide skin tightening and lift. I recommend getting a formal evaluation with a cosmetic dermatologist.  You may be a candidate for neck/face lifting in combination with volume or other skin tightening treatments .  Best, Dr. Emer

Though I am hesitant to recommend a facelift for a 24 years old. I have very little confidence in non-invasive procedures that claim skin tightening specially in the face. This is because a sagging face is not only skin laxity, it is fat loss, and fat drooping down and non of the non-invasive procedures would address that.If expense is not an issue you can try the so called non-invasive procedures and see if it works as claimed. ask for success rate, potential risks and complications, what to expect, how much to expect and time frame.same for the facelift.Since the problem is the jowls and face only then a mini facelift.

I believe there are many things to consider to rejuvenate your face.  Ultimately you should seek a real consultation to understand the pros and cons as well as the risks and benefits.  While a neck or facelift would be somewhat aggressive, there may be a role for that.  But with regards to other options that are less invasive, Kybella for your jowls (off-label) and/or neck, a Silhouette lift, full face and neck resurfacing (i.e. CO2, fractional lasers, RF micro needling), or non-invasive energy tightening such as Ulthera, all can be good options to consider.  Budget, realistic expectations, recovery, longevity, and of course, success rate of the practice you are going to, are all important considerations.  Hope that helps.

Hello and thank you for your question. Many patients have similar concerns regarding how to "start the process" of addressing facial aging. Fortunately, there are many products and techniques available to help. The core of a treatment regimen is your daily skin care plan. From there, you will graduate to injectables (e.g., botox, juvederm), skin resurfacing (e.g., laser, RF), and ultimately to surgery (if needed). Of course, you will need an in-person consultation to evaluate you for these procedures. Preoperative visualization with the Crisalix system may help with your decision. Your treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 
Best,
Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

It appears from your photos fat grafting of cheeks, jaw-line and conservative liposuction of jowls would be one way to address your problem.    The nasal labial folds are best treated with fillers.

Hi, I can appreciate how having jowls at 24 years of age would be disheartening.  First, I would like to say that you are not alone and that I have seen numerous patients in their mid to late twenties that have developed early jowl formation.  In addition, there is a solution.    I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that developed "early jowl formation".  I have little trust in non invasive type procedures that say they will correct sagging facial tissues and jowls which I discuss below.  From the photos your cheeks have flat spot in the front with excess fat in the lower face around the "jowls" which tends to accentuate the jowls and marionette lines.  These factors combine to create an oval shaped face. 
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler will create full, round cheeks that will feminize the entire face.
 The reality is that regardless of age, when the face has "jowls” these represent  sagging facial tissues which are the primary indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
 It's important to keep all of the "heavily marketed" non-invasive skin tightening procedures in the proper perspective.  Non-invasive techniques typically shrink the skin several mm's.  There are 25.4mm's in one inch.  The minimally invasive facelift described here can remove 2 to 3 inches of skin which equals 50.8 to 76.4 mm's or up to 25 times the amount of loose skin provided by non invasive techniques.  That reality should always be front and center in the decision making for prospective facelift patients.  It should also be noted that non invasive techniques have no ability to properly dissect, elevate, trim and re-suture the SMAS layer making them one dimensional at best. In my experience and humble opinion fat transfer (fat injections) offers far less of a reliable and predictable volume to shape facial features than an "off the shelf" dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, jaw line or lips.