Sagging face. Should I consider a facelift? Could fillers be enough? (photos)

Also I still have another 40 pounds to lose, so I think it's going to get worse. I was only 20 pounds more at my heaviest. I'm 30

Doctor Answers 38

Sagging face. Should I consider a facelift? Could fillers be enough?

Hello blondie1234,

In your case, I would recommend you get within 10-15 pounds of your ideal weight before considering treatment.  The reason is that if you continue to have weight loss, what looks good at one weight may not look good at a lower weight (skin may sag a little more if surgery was done or fillers may look noticeable if they were done). 

As far as treatment options, fillers would help to soften the transition between your jowls and mouth area.  But it would not get at the underlying problem.  What you are doing in your first photo is essentially what is accomplished with a surgery.  Age is just a number and it is common after massive weight loss to need surgery to remove the sagging tissue. 

I'd recommend you consult with a facial plastic surgeon or plastic surgeon to go over your surgical and non surgical options. 

I hope this helps and good luck. 


The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Weight Loss and Facelift

The good news is that you are losing weight, and THAT you should be applauded for! The bad news is that as you continue to lose weight, your body (and face) will continue to "deflate" and droop even faster and more significantly. So yes, the laxity of your neck and jawline will unfortunately worsen as you shed the weight.  My general recommendation to patients regarding weight loss is this - if you plan on losing more than 25 pounds, then it is a good idea to lose 1/2 of the weight before having a facelift. Anything under 20 pounds of proposed weight loss I consider noncontributory to you ultimate result.

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 53 reviews

Facelift

Even though you are very young, due to your weight loss you would benefit from a face/neck lift.  I would recommend you complete your weight loss goals before proceeding.  Fillers will not correct jowling, neck bands, or cheek descent.  However a combination of a lift with fat grafting may be most beneficial if you loose too much facial volume as you loose more weight. 

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Sagging face. Should I consider a facelift? Could fillers be enough

Congratulations on your weight loss. I recommend that you continue to lose weight until you reach your goal weight. At that time, you should then consult with a board certified plastic surgeon to discuss the possibility of a face lift vs. fillers. In my practice, people who have lost more than 60lbs tend to have saggy skin around their face. However, you are very young and may have skin that recoils more than an older patient's skin would. Good luck.

Would a facelift help or just fillers?

Thank you for your photos and questions - and congratulations on your weight loss! The most practical advice I can give at this point is to continue to meet your weight loss goals and once completed, re-ask the question. Things will likely change with additional weight loss and thus any recommendations made now are thus extremely tentative and likely to change. That all being said, depending upon your exact goals, it is possible that fillers alone may give you the results you desire, or a surgical procedure may be recommended. Facial rejuvenation is quite nuanced and detailed so I would suggest a formal consultation with a board certified plastic surgeon. Good luck!

Filler

Hello and thank you for your question and photos.  Congrats on your weight loss! Seek a consultation with a board certified plastic surgeon to address your concerns.  You may want to consider Voluma for mid face volume.  Best of luck!

John Ward, MD (retired)
Phoenix Plastic Surgeon
4.9 out of 5 stars 66 reviews

You Would Benefit From a Facelift

First, you should get as close to your goal weight as you reasonably can, but also be realistic in getting to a weight you can maintain over time. There is nothing worse for the aging process than wide fluctuations in weight. You have jowls, which are not going to be corrected by fillers, and although you have considerable submental fat, liposuction to that area would leave loose skin. I have done a number of lower facelifts on younger patients who have lost weight with gratifying results. Even though you are 30, you have enough skin excess to benefit greatly from surgery. I hope this helps. Best of luck.

Wait & See After Your Weight Loss

First, congratulations on your weight loss journey. Ideally, you should be at your "best" weight prior to any cosmetic surgery. This is especially true for a facelift. Volume loss in your face will leave you with more excess skin and a more deflated look in your cheeks. Fillers are great to replace lost cheek volume and to soften the nasolabial folds and marionette lines. The best option for you would be to wait until you obtain your stable best weight. A facelift can be done and fat transfer can be done at the same time to replace lost mid-face volume and to improve the nasolabial folds and marionette lines. Best wishes.

Lose the weight before a facelift

Yes, lose the weight before your facelift.  Then, a full assessment can be done to see whether or not a facelift is even needed or if you just need fillers and Botox.

Facelift after weight loss

Thank you for your question and congratulations on the weight loss!  I would recommend waiting to get an evaluation until you are at your ideal weight that you will be able to maintain.  Unfortunately, as you continue to lose weight, the skin will become more droopy as it has become stretched out due to the excess fat.  The skin will have lost some of its tone and elasticity, so may not be as tight after the weight loss.  Therefore you may need a facelift to regain that youthful look and tighten your skin.  Its best to have the surgery when you are at your ideal weight and not earlier or else the skin could become lose after you lost more weight.  I recommend speaking to a board certified plastic surgeon in your area.  All the best,

Keshav Magge, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 29 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.