Endoscopic Midface Lift, MACS Lift or Other Procedures for Tired Face (Age 24)?

I'm 24& really bothered with my face. I look old& tired. I have thick skin and there are also acne scars on my cheeks. A surgeon I've talked to told me to have CO2 laser for scars, another one suggested Sculptra -but I'm afraid it'll make my face look even bigger (and I've heard fillings cause cists, is it true?) And another surgeon suggested a midface lift. MACS lift also seems helpful in my case. It may be early for these but I don't see any point in waiting to get older when I'm so unhappy...

Doctor Answers 15

Facelift at age 24?

As you can see from my colleagues' answers, there's always one (or more) in the crowd who will give you what you want, rather than tell you the truth and what you don't need. I must say that I am in the majority that do not recommend facelift (of any kind) for you! But any and all of us should, if we saw you in person, do our best to understand what bothers you and try to come up with a plan to try to give you the best advice--even if that advice is to NOT undergo the requested procedure.

Although you are certainly allowed to describe your facial appearance in any way you see fit, I am not sure why you choose the terms "old & tired." Facelifts are for loose and saggy, and you exhibit none of that! Your nasolabial folds are prominent with you smiling, as they are for all of us, but you don't have jowls of any kind and you have a nice jawline. (And a pretty smile!) Your eyes are just out of view, but you may be a bit exophthalmic, as you do have visible lower orbital rims (or prominent orbicularis oculi muscles) giving a mild "dark circle" look in the eyelid-cheek junction. This is NOT helped by any kind of facelift. You may want to have your family doctor or internist check your thyroid hormone levels as part of a general physical prior to seeing a Dermatologist for your acne. BTW, do not start Accutane if you are planning any kind of laser resurfacing (which IS an appropriate recommendation once any active acne is addressed) and unless you are using two kinds of birth control. Laser resurfacing or a buffered phenol peel can help reduce the "dark circle" look of the lower eyelid area that may be part of the reason for "tired."

Laser resurfacing IS an appropriate option for improving (but not eliminating) your acne scars. You may want to consider subcision and fat pearl or dermal grafting for deeper scars prior to laser resurfacing, or even excision and precise suture closure for the deepest scars. Even the best laser resurfacing cannot completely remove or eliminate scars that extend below the mid-dermis, so dealing with the deep ones with the methods described (first) will give you the best overall result after resurfacing. Do your homework about physicians offering laser resurfacing. Ask what laser they own (or lease), how often they use it, how many cases they have done, where they obtained their laser training, and the pros and cons of their laser vs. others. See their before and after photographs; talk with one or more of their patients. All to often there are physicians who take a two-day training course, get their hands on a laser, and "fire away" at patients, often without really understanding the basic biophysics of laser-tissue interaction! I know, since I have taught these courses for over two decades, and far too many attendees care little about safety and obtaining experience, but rather want to know "What are the basic settings, where is the trigger, and how much can I charge?" Then off they go to their marketing campaign to get patients to pay off the laser lease or purchase!

You are right to be wary about the Sculptra recommendation--you do NOT have facial wasting, hollow cheeks, or need for filler of any kind, even in your nasolabial folds. I do NOT recommend buccal fat pad excision, Mesotherapy or Lipodissolve for your cheeks, or any kind of liposculpture, SmartLipo, or external non-ablative treatments such as Thermage, IPL, or PhotoFacial. There will always be someone who will sell you something because you are unhappy and vulnerable. Just say NO!

My dear, you are a pretty girl with acne scars. Get those dealt with and start enjoying life! If you are depressed, seek help with that as well--you are too young and attractive to be unhappy with yourself! Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

How young is too young for facelifting? 24 is.

The image you posted (thanks) tells part of the story.   Even though you are smiling I detect a somewhat full cheeked look, along with acne scarring.  IF the active acne is behind you for sure, and there have been no lesions for some time, CO2 laser is helpful.  Consider buccal fat removal for a more sculpted, less jowled look.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Fractionated laser, skin care, restylane to reshape

I would suggest fractionated laser, a good skin care regimen, and restylane hyaluronic filler to reshape the face.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

No Facelift at 24 try 1540 Non ablative Erbium laser for Acne Scars

You have a full young face with nice cheek volume. A Facelift will only give you more scars and may even make your cheeks to full. You are young looking for your age and your face will mature with time and you will feel better about your face.

Don't have CO2 resurfacing it can make acne scars worse.

Non ablative 1540 Erbium laser treatments are best for scars and can produce very nice results if done properly.

Endoscopic mid facelift vs. Laser skin resurfacing at age 24

I would not advise you to have an endoscopic brow lift or facelift at this young age for your complaints. Your photograph shows some acne scars that would best be addressed with a comprehensive skin care regimen to treat the acne. After this is under control a laser skin resurfacing procedure would be advantages to help with the acne scarring and skin tone. See a good dermatologist first and then consult a facial plastic surgeon specializing in laser resurfacing. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Facelift at age 24

Given your complaints and photo, I certainly would advise against any facelift (midface lift; MACS lift etc.). Acne scarring is difficult to treat but commonly involves skin resurfacing (laser, peels, dermabrasion), and medical skin care. Sometimes, tiny alliquots of injectable fillers can improve depressed scars. In addition, collagen induction therapy ("medical needling") has been successful in some surgeons' hands.

For the remainder of the face, it would be important to analyze your aesthetics in repose (not smiling) and truly understand your anatomy and your concerns. Facial balance is the final goal; but a midface lift is certainly not what I would include in a possible menu of procedures.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

First things first

From your picture I can see you are struggling with the acne problem. Do first things first, start with the skin and the acne problem. See a board certified dermatologist and get some advice on how to treat the acne. It is amazing how much better you can feel getting the acne problem under control. The solution can be as easy as just stop drinking milk.  Once it is under control, then see a board certified plastic surgeon to handle any residual scarring from the acne and find techniques to brighten up your face. Hope this is helpful. Jon I Sattler, MD Board Certified Plastic Surgeon

Jon Sattler, MD
Glendora Plastic Surgeon
3.5 out of 5 stars 22 reviews

Facial resurfacing

In a patient's 20's one should almost never need a facelift.  I would begin with non - invasive skin resurfacing with either a peel or laser.  This will improve the quality and texture of the skin.  Make sure your surgeon is certified by the American Board of Plastic Surgery.

Samer W. Cabbabe, M.D.

Board - Certified Plastic Surgeon

St. Louis Plastic Surgery Consultants


Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
4.9 out of 5 stars 59 reviews

Facelift surgery at 24 years old

There are many options to recontour your face, but I would recommend against having a midface lift, facelift, MACS lift, or other rejuvenation procedure when you are 24 years old. The reason is that these procedures have been designed to lift tissues that have been dragged down by gravity over time back to their original positions. If you already have very prominent and heavy cheeks at 24, raising them higher may not provide you with the aesthetic result you desire. 

You may be able to use fillers and other non-invasive techniques to improve the appearance of your face at this time. Botox can thin the lower face if used appropriately, and everything from lasers to dermabrasion to micro-needling for your acne scarring. 

You don't need to wait to look better, but rejuvenation surgery at 24 may not be the best answer for your cosmetic concerns. Best of luck - J Chow, MD

Jen Yuan Chow, MD
Pasadena Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Facelift surgery at age 24

There are many options for recontouring the face and improving skin tone.  Some of these choices are age related.I would opt for more non-invasive choices for you at this time.  For acne scarring and improving texture I favor a micro-needling technique.   I would not recommend a face lift at this time in your life.

All the best,

Tal Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

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.