I am 36 years old. Do I need a facelift? (Photo)

Question

My forehead and cheeks are sagging and it makes me look very depressed. I have to constantly hold a more uplifted expression on my face to combat the sagging. My eyes look very small because my forehead is almost sagging down onto the brow area. The area around my mouth is extremely droopy, in my opinion, and I have a serious frown if I don't smile. Also, when I smile my eyebrows become very uneven.

Jamil Asaria, MD · Answer

Thank you for your question. At your age, you are probably too young for facelift surgeon. Try and find an experienced surgeon in your area who can assess the benefits of a non-surgical facelift with fillers (injectables). While they are not a direct replacement for surgery, when done effectively, they can provide a lifted appearance which may help significantly.

Jed H. Horowitz, MD, FACS · Answer

If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift. During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.However, if you learn that you are a candidate, this may be helpful. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.The best candidates for #LiteLift are patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

Vincent N. Zubowicz, MD · Answer

Before submitting to surgery I think I would try some fillers. I can see the neck well from the photograph of liposuction can sharpen the jawline as well as improve the profile when fat is in surplus. This is easily done under local anesthesia.

Alejandro J. Quiroz, MD · Answer

To answer 
your question, there is no age that determine  who is candidate for a face lift.  The patient present her concerns areas
forehead, eyes, cheeks etc.. and  evaluation of the area  need to be done by the surgeon to plan the
surgery.  Normally the process of aging
can result in loss of elasticity of the skin 
leaving a droopy cheeks and brows given a much older appearance  that the chronological age  that can be corrected with surgery.

Harold J. Kaplan, MD · Answer

Unfortunately at a young age you have issues that probably require surgery. Some of the sad tired look comes from sagging of your brows which are not symmetrical and some eyelid laxity. There are also issues with jowls and area under the chin in the neck. Fortunately, the solutions are not big surgeries. A limited browlift (modified browlift) and blepharoplasty are smaller surgeries which will help you for many years. Although more photos would be helpful it appears that a minilift and some liposuction under the chin and jawline would also be beneficial. At your younger age you could anticipate long lasting results.

Mark Prysi, MD · Answer

You have significant mid face sagging creating a bottom heavy face with a square look.an endoscopic mid face lift would be an ideal procedure at this time. It will have no telltale signs and look natural.

William Portuese, MD · Answer

A full set of photographs are required  before making any decision about what is needed, due to the fact that the face is a three-dimensional structure. The goal of a face lift is to tighten loose facial and neck skin, tighten  loose facial and neck muscles, and remove any fatty deposits located in the neck. Most patients who undergo a facelift in our practice are in their 50s and 60s. For many examples of what can be accomplished with a face lift procedure, please see the link below

Robert Singer, MD · Answer

No one ever "needs" a facelift". Whether your appearance concerns you enough to do something about it is an individual decision that only you can make.Everyone ages at a
different rate. Some patients at 36 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. There are numerous options to address early aging: fillers
which are temporary, micro-fat grafts which are long lasting but don't
significantly elevate drooping , limited facelifts plus filling of the depressed
areas produce the most aesthetically harmonious and longest lasting result.
Each has benefits and drawbacks.

It really depends more on the extent of aging than chronological age,
although 36 is certainly young for a facelift.

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

Dean P. Kane, MD, FACS · Answer

Dear refreshments:Thanks for sharing your photo. You have described yourself well and may consider surgical, non-surgical and minimally invasive options. It is not your age that is so important in which option is best for you, it is the combination of many factor including your heredity, weight loss / gain cycles, environmental exposure. Each, of course, has their advantages and disadvantages and so it is best for you to consult with a Board Certified, well experienced Plastic Surgeon or ENT Facial Surgeon to discuss what is best for you.Various options for facelifting, minimally and
non-invasive facial enhancements and skin texture improvements are available
according to the skin laxity and areas of lift or tightening you wish or need.
Both surgical and minimally invasive / non-surgical options are listed below.
Surgical lifts would be likened to pulling the
bedspread and or top-sheet of your bed up to the head-board and removing the
excess material.

Minimally invasive procedures such as fillers
provide volume such as adjusting a pillow under the bedspread. Botox and
Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the
bedspread (or skin) continues to fall to the foot of the bed despite fillers,
Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light
therapies, skin tightening products and technologies perform their tightening
and smoothening of the skin similar to sending your bedspread to the dry
cleaners. A more refreshed, even colored, glowing smoother and tighter spread
covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a
jelly-like clear skin filler is used to fill lines, wrinkles and folds.
Juvederm and its longer lasting "cousin" Juvederm Ultra Plus are similar skin fillers, used to soften and fill the
nasolabial ("parentheses") and marionette folds, the brow
("number 11") lines and fill and lift the cheeks and lateral brow or
chin.Voluma is the longest lasting, up to 2 year duration HA
filler. Each one is used to expand or volumize the loss of tissue associated
with expression, weathering or aging. All the fillers come with numbing
anesthetic!.

Non-surgical facial contouring is possible with
fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin
as well.

Scuptra is the latest of the injectibles stimulation collagen
at different levels of the skin adding volume but primarily firming and adding
resistance to the formation of wrinkles, folds and descent.

Botox andDysport too have been found to rebalance excessive facial
expression, provide a non-surgical brow lift and lip lift and reshape the nose,
as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels,
light and laser resurfacing and tightening and will, smoothen and even the
color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture
of the skin, tighten and reduce red and brown uneven pigmentation.

If you can pinch more than an inch of skin
along the jawline in front of your earlobe, you should consider a surgical
option to redrape and remove extra skin. You may consider: a traditional
face and neck lift, short scar face and / or neck lift.

Other areas of skin laxity or fatty excess such as the eyebrows and eyelids
should also be discussed with your surgeon in consultation for your best and
longest lasting options.

I hope this was helpful. All the best!

Vasdev Rai, MD · Answer

Operation of facelift is actually operation of facial rejuvenation. Need for it is not "age dependent" but "need dependent".  Features seen in your photograph will improve with facelift.   In reality you need rather extensive operation to achieve your goals.  First step is always making up ones mind and get psychologically ready for what is needed.  Then have a serious consultation with a real plastic surgeon.

I am 36 years old. Do I need a facelift? (Photo)

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