Face sagging at 20? (Photo)

Most of the apparent aging in the face portrayed in the photograph is due to asymmetric volume distribution. Treatment should begin with fillers that are easily and safely introduced as office procedure.

Examination of the photographs you provide demonstrates some absence of volume in the region of your midface.  I would suspect, given your age and appearance, that you have a rather low percentage of body fat, so gaining weight will augment the volume in this area. Alternatively, you might consider injection with one of the many types of fillers now available, or a fat transfer, if you are carrying sufficient fat in your lower abdomen or flanks. In your case, I would say a surgical procedure is not indicated.

From the pictures you provided, I would say that your face is not sagging but that there is some volume loss in your cheeks which is causing your issue.  I would not recommend anything surgically but you could be helped with injectable fillers in your cheeks.  This would pull up some of the tissue around your mouth and lead to improvement.  I'm not sure of the cause of the appearance of volume loss in your cheeks, but this could be hereditary or due to low body fat.  

A Facelift at 20 is really not an option.  It looks like you need a filler.  Juvederm will soften the appearance of your smile lines around your mouth and cost only $600.00 per syringe however, you may need two.  Juvederm lasts up to one year, give or take a few months.Hope this helps.

Based from your photos, what makes you appear prematurely aged are a combination of the following:hyperactive muscle responsible for frowningprominent tear trough, smiling line, (nasolabial fold), marrionette linesvolume loss on the mid cheeks, including submalar, subzygoma, and inner malar areaThese issues can be corrected by fat transfer alone or fat stem cell facelift The alternative is fillers and botox, or corrugator muscle resection to correct the frown lines.

Facelift is virtually never an option at age 20.   Botox and Juvederm may be indicated after a very careful exam and thoughtful discussion.   In general, at age 20, the best plan is excellent health, being in great shape, dressing nicely, etc etc etc.   But Botox and fillers can possibly be considered after much thought.  You must realize that Botox and fillers are an ongoing expense for possibly the rest of your life.   You look quite good to me.   In all fairness it is impossible to assess anyone, let alone a 20 year old without the standard 7 views and a live examination.   My Best,  Dr C