Sagging skin at 26 - what are my options? (Photo)

Question

I’m only 26 but feel my skin is aging me massively! At my top weight I was 66kg, and am now 60kg so no dramatic weight loss, but I am extremely self conscious of jowls, bags under my eyes, and deep nasolabial folds. It seems as if there is too much fat under my skin, but I have read that weight loss makes these traits even worse. What are my options?

Ali Sajjadian, MD, FACS · Answer

Thanks svcrawf for your question! A facelift at age 26 is generally not considered standard practice but a mini facelift is a less invasive surgical procedure compared to a traditional facelift.  It is intended to treat less severe forms of aging, such drooping skin around the jawline and in the lower face, which includes the jowls. The main distinction between a small facelift and a standard facelift is that the former usually includes less extensive tissue manipulation and shorter incisions.  Instead than treating the entire face and neck, the surgeon concentrates on elevating and tightening certain regions.  Because minifacelift is less invasive, recovery times are shorter. 
Who is a good candidate for a mini facelift?
People who want a more subtle and natural-looking rejuvenation, those with good skin elasticity, and those with mild to moderate lower facial aging indications.
As nonsurgical options,Morpheus and Profound RF are both minimally invasive procedures that can help address jowling and sagging skin by stimulating collagen production.  Radiofrequency (RF) radiation is administered by small needles in both therapies. By heating the skin's deeper layers, the combination of RF energy and microneedling stimulates the body's natural healing process and promotes the synthesis of new collagen and elastin.   One of the main distinctions is that Profound RF often penetrates the skin more deeply than Morpheus8. In comparison to Morpheus8, Profound RF usually requires fewer treatment sessions and has a longer recovery period.   Both devices make shrinkage of tissue and internal lift and are FDA approved.
Both procedures can enhance skin tone and texture while tightening and lifting drooping skin around the neck and jawline.   
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian

Ozge Ergun, MD · Answer

Genetically, your skin has a tendency toward sagging, particularly at the corners of your mouth, which are positioned in a downward direction. Although you are still young, there are two effective options to address this concern.
The first option is a deep temporal lifting procedure, which elevates the lower and midface in an upward direction,  I perform this procedure opposite to gravity to effectively counteract its effects.  The second option is a MACS facelift, which provides a natural and long-lasting lifting effect. If necessary, fat injection can also be performed to enhance volume in the under-eye area.
Additionally, in terms of facial proportions, your lower face is relatively smaller compared to your upper face. To achieve better balance and harmony, a chin implant is recommended.

Ali Cetinkaya, MD · Answer

At 26, it’s not typical to see signs of facial aging like jowls, under-eye bags, and deep nasolabial folds &mdash; but genetics, skin quality, and facial fat distribution can make these issues appear early.
Let’s break it down:
Jowls & Nasolabial Folds:These are often caused not by “too much fat,” but by loss of mid-face volume and ligament laxity, which allow facial fat pads to descend. This can happen even at a young age due to genetics or weak skin support.
✔️ Options:
Mid-face or cheek fillers to restore volume and lift.
Energy-based skin tightening (Morpheus8, Ultherapy, Forma) to stimulate collagen.
In selected cases: Buccal fat pad reduction or subtle lower face contouring (e.g., micro-liposuction or AccuTite).
Under-Eye Bags:These could be due to fat herniation, hollowing, or poor lymphatic drainage.✔️ Options:
Tear trough filler (for mild cases).
Lower blepharoplasty (for fat repositioning or removal).
Skin tightening devices if skin is lax.
General Facial Fat & Skin Quality:Rather than removing fat, the aim is to reposition or support existing fat structures and stimulate collagen production.
✔️ A holistic approach combining subtle volume restoration, skin tightening, and lifestyle adjustments (hydration, sun protection, skincare) usually yields the best results.
Your concerns are completely valid &mdash; many patients in their 20s feel this way, and early, preventive treatments can make a significant difference.

Ali Riza Öreroglu, MD · Answer

To determine the most appropriate treatment plan, a physical examination is necessary. For the jowls, and deep nasolabial folds you’re concerned about after weight loss, **lower facelift** or **mini facelift** could be suitable options. A **lower facelift** addresses sagging in the jawline and neck area, providing a more youthful appearance. A **mini facelift** is a less invasive procedure that targets sagging in the mid and lower face, typically with a quicker recovery time. Both options can help tighten the skin and improve the appearance of the jowls and nasolabial folds. I would prefer to see the whole area around the eye in order to better comment on your lower eyeballs.

Christopher David Jones, MBBS, BSc, FRCS (Plast) · Answer

It is advisable to achieve your target weight and maintain it before considering any treatment.At 26, any sort of face/neck lifting procedure is not recommended.It might be worth considering non surgical fillers to areas of your face that are lacking volume with or without skin resurfacing. A plastic surgeon with an interest in facial aesthetics will be able to advise you.

Gary M. Horndeski, MD · Answer

You would benefit from a lower blepharoplasty to correct the fat under your eyes. You would also benefit from a rhinoplasty to refine the tip of the nose. You may also benefit from a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

You would get good results with micro-needling and radiofrequency to tighten and help tone your tissue. Please go in for a consultation.

Manuel Diaz, MD · Answer

Hello dear. At 26, it's completely normal to be concerned about certain facial features, but it's important to remember that you're still too young for a facelift and don't show significant signs of aging or excess skin. A double chin, bags under the eyes, or nasolabial folds can be due to factors such as genetics, fluid retention, posture, or even stress. Although weight loss can accentuate certain areas of the face, it doesn't mean there's too much fat. There are highly effective nonsurgical options, such as laser treatments, radiofrequency, hyaluronic acid, or facial exercises, that can help you improve contour and firmness without surgery.

Kamol Pansritum, MD · Answer

A mini facelift with a temporal to preauricular incision can help lift and tighten the mid to lower face, addressing sagging in the cheeks, jawline, and nasolabial folds. This less invasive procedure typically involves shorter recovery compared to a full facelift.

Pawel Szychta, MD, PhD, DSc · Answer

At 26, concerns about jowls, under-eye bags, and nasolabial folds are likely due to fat redistribution, skin laxity, or genetics rather than aging alone. Weight loss can sometimes worsen these features as facial fat diminishes.Options to Address Your Concerns: 1. Non-Surgical Treatments:  - Dermal Fillers: Add volume to lift nasolabial folds, contour jowls, and under-eye hollows.  - Skin Tightening: Treatments like radiofrequency (RF) (e.g., Morpheus8), ultrasound (e.g., Ultherapy), or laser tighten skin non-invasively.  - Neuromodulators (Botox): Subtle lifting of facial muscles to smooth fine lines. 
2. Surgical Options (for more significant results):  - Buccal Fat Removal: Reduces fat in the cheeks to contour the lower face.  - Mini Facelift: Tightens early jowling and nasolabial folds.  - Lower Blepharoplasty: Corrects under-eye bags.
3. Skincare and Maintenance:  - Focus on retinoids, vitamin C, and SPF to improve skin texture and elasticity. 
Consult a skilled plastic surgeon or dermatologist to tailor a combination of treatments for subtle, youthful results. Non-surgical options are ideal at your age.

Sagging skin at 26 - what are my options? (Photo)

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