42 years old. Is it time for a facelift? (Photo)

I am 42 and have jowls .. is it time for a facelift? I just had 11/2 syringes of voluma in each cheek but still have these awful jowls. Thank you kindly.

Doctor Answers 54

Fillers do not fix jowls

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Fillers do not help with jowls or neck laxity.   You would definitely benefit from a mini lift.   

Mini Facelift or Weekend Facelift is a minor procedure compared to
traditional full facelift. It is performed to reduce sagging around the
cheeks, jawline and neck. During mini facelift doctor inserts medical
instruments through small cuts in the skin removing the excess fat and
reshaping the muscles. The results generally last from 5 to 10 years. It
us helpful for people in their 30s or 40s who have just started
experiencing signs of aging. While it is performed for specific target
areas, it cannot be targeted at eyes and forehead.

42 years old. Is it time for a facelift?

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Thanks for your question.  I hope that no one told you that Voluma to your cheekbones would elevate your jowls (?).

From your photo you do appear to be a candidate at 42 for a facelift due to the presence of early jowling and some neck descent.  Only you can decide whether these warrant a consultation and possible surgical procedure to rejuvenate you in a natural manner.  It's most important that incisions be made properly to avoid any obvious incision lines and that your facelift surgery look natural.  Fat graft transfer to the face also transfers stem cells that for many patients dramatically rejuvenates the skin without injections or lasers.  Discuss this with your ABPS Bd Certified plastic surgeon to review options and formulate an appropriate plan. Enjoy the information in the attached video above about facelift surgery.

Best wishes,

Jon A Perlman MD FACS Certified, American Board of Plastic Surgery Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Yes: early "maintenance" face lifts are the trend, and skin resurfacing will enhance your results

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The short answer is 'yes,' it is time for a face lift.  Years ago, facelifts were reserve for patients in their later years (50s and up) but today, many patients are requesting procedures to rejuvenate their faces at a younger age, all with the goal of maintaining (rather than restoring) a youthful appearance.  I recommend a "maintenance" face lift for you to address your concerns of jowls and to soften your "lid-cheek junction" which will improve the appearance of dark circles. I would also recommend facial fat grafting to restore volume and contour through your mid-face. My approach would be less aggressive (albeit very meticulous as always) because you have focal areas of laxity and descent.  I also collaborate with my wife, Board certified dermatologist Dr. Noëlle Sherber, to perform laser resurfacing and advise on results-oriented skincare regimen, since surgery is good at lifting but poor at improving skin surface texture, tone and radiance.  Combining the best of plastic surgery and dermatology helps our patients achieve superior results for the long term. 

All my best,

Dr. Rad

Ariel N. Rad, MD, PhD
Washington DC Plastic Surgeon
5.0 out of 5 stars 57 reviews

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Time for a face lift?

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Thank you for asking about your face lift.

  • Your photos are very helpful.
  • Yes, I agree that a face lift would make a big difference for you.
  • There are many kinds -
  • The SMAS (deep plane) face lift is the best standard face lift.
  • The mini-lift does not last as long.
  • My preference now is a minimally invasive composite face lift which combines the safety of the SMAS lift and many of the advantages of the full composite lift.
  • However the most important thing is to find an experienced plastic surgeon whom you feel you can trust and rely on her/his recommendations.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD

Is it time for a facelift?

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You photos show early stigmata of ageing with softening of the neck angle and jowl formation.  No one "needs" a facelift, but I think with your excellent bone structure and lack of excess fat in your face you can expect an excellent result.   Be sure the surgeon is certified by the American Board of Plastic Surgery and review his or her portfolio of pre- and post-op pictures so you can see the types of results that are reasonable to expect.

42 years old. Is it time for a facelift?

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Everyone ages at a different rate. Some patients at 42 have more aging than those much older. It depends on numerous factors including: heredity, history of smoking, lifestyle, sun exposure, excessive exercising, underlying medical health, and significant weight loss.

In the past, it was felt that 42 would be too young to have a facelift. Now most experienced artistic plastic surgeons would feel differently. It really depends more on the extent of aging and the individualized approach that is necessary to achieve a natural appearing improvement. Since every patient is different, the approach to facial rejuvenation (fillers, micro-fat grafts, mini facelifts, facelifts, and combination of procedures) needs to be individualized in order to achieve a natural appearing improvement.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Facelift options including filler, Silhouette InstaLift, skin rejuvenation and tightening

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Dear Positive girl: 

Thanks for sharing your photos! Using only the photos I might suggest:

  1. ZO Skin Health for skin tightening and pigmentation control
  2. mini-lipo-contouring of the jowl
  3. filler or fat grafting to the cheeks and / or
  4. Silhouette InstaLift for a non-surgical soft tissue lift
  5. TCA or Controlled Depth chemical peel

If you have less than an inch of pinch along the jawline, the advantage of a facelift which is to remove skin laxity is lost so consider minimally invasive and non-invasive options. 

With any option, obtain consultation from a well experienced and talented Board Certified Plastic Surgeon. I hope this is helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 103 reviews

Great question, not a simple answer.

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It is unfortunate that your are disappointed after your Volume injections, but it is important to start at the beginning. That would mean a careful evaluation by an experienced board certified plastic surgeon or facial plastic surgeon familiar with all aspects of facial aging who can first and foremost listen to you regarding your concerns, and make treatment recommendations based both on your concerns and your examination. Volume loss is only one aspect of facial aging, and unfortunately patients (and this is not your fault) will seek a simple solution to a far more complex problem. Fillers indeed can play a role, but usually not in a "one and done" sort of approach, and the "lifting" power of fillers is more hype than actual, despite the claims. 

From your photos it appears that you have some changes of aging around the peri-orbital area with loose skin in your upper lids and some fat bulging in the lower lids. You have early jowl formation and laxity in the neck. There are both surgical and non-surgical options for you, the latter being far less powerful and effective than surgery, and should be viewed more in the "maintenance" or "adjunctive" category rather than the "significant change" category. 

Do your research, consider more than one consultation, and avoid the "stop and shop" med spas where a non-plastic surgeon (often not even a physician) will often offer you injections or other treatments without the benefit of a comprehensive evaluation and thorough discussion of ALL treatment options. 

With regard to your original question, the answer does not lie with your age, but with the changes in your face and how you feel about those changes, and what you would lie to see addressed or corrected. Best of luck to you.  

Ram Kalus, MD
Mount Pleasant Plastic Surgeon
4.8 out of 5 stars 24 reviews

Is it time for a facelift?

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Hello.  Thanks for your question.  I believe this is a question that many women wonder about.  It is very difficult to determine what treatments might serve you best from profile (side view) photos only. I do see some mild jowling and some mild looseness of the neck.  Under-eye skin shows some thinning with some decent of cheek fat pads evidenced. Much of the decision of what to do, depends on your priorities. Minimally invasive procedures including lasers and radiofrequency microneedling would almost certainly provide lasting benefit for you.  If you are looking for a more dramatic rejuvenation, I believe that you might be an excellent candidate for some type of mini facelift in addition to fractional laser treatments. I hope this is useful to you; good luck.

David Hartman, MD, FACS
Dover Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Time for Facelift

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From your photos it appears that you have looseness over your lower cheeks, jowls and neck area. You are a very good candidate for a S-Lift procedure that specifically addresses these areas. This procedure has a quick recovery, gives a natural look and can be performed without general anesthesia.  It can be very effective in treating your areas of concern.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.