A Facelift at 36? Will Fillers Make My Face Sag? (photo)

At 36 you do not need a facelift!  That does not mean that someone out there wouldn't agree to perform such a surgery.  The fillers are helpful because you can have multiple areas addressed in a way not possible with surgery.  Using fat instead of fillers?  This is certainly more profitable for the surgeon because it entails surgery rather than the use of expensive filler materials.  However, you need very precise treatment to achieve the best result.  This is difficult to accomplish with fat.  The most important thing is to find a very experienced injector to perform your treatment.

A person’s age is best guessed by the appearance of their face. 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.

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, individualized for each patient, 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 non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™

Despite being young you do have jowl formation which may be hereditary and you would do well with a mini-facelift like a LiteLift or MACS procedure. In general face exercises do NOT help keep the face looking younger and in some instances will accelerate the wrinkling process. You may also have a weak chin (microgenia) which could be corrected with a small chin implant but evaluation with your chin not pointing down is needed to determine this.

Here is a primer on how your face ages and why one or more approach is required for the best result: Please note that you age by three factors - sagging (through gravity and time), loss of volume (counteracted by fillers), and skin texture (determined by environmental and genetic factors). Your fillers should enhance your effect of the lifting if placed appropriately by addressing one of the causes of aging..Most often one of these factors are more out of balance than another and therefore your procedures should customize for what is most needed. Often fillers alone can "stall" the inevitable as they only correct one aspect of aging.

Facelift and Skin resurfacing procedures (laser, Ulthera or Thermage ) and fillers are synergistic so as long as you wait until the Sculptra injection site is soft you should do fine. Not a problem and there is no problem with the timing for a facelift. Sculptra, Radiesse, Jeuvederm, Restylane, your own fat (fat transfer) and other fillers address volume issues, resurfacing procedures corrects surface flaws associated with aging and face lifting addresses the sagging loose skin. Resurfacing procedures address skin texture, color variation (e.g. sun spots)- so all three are synergistic and complementary. It is very common in my practice to do all three approaches to rejuvenation at the same time

 

One of the challenges we face is that of patient expectation and a decision about facial rejuvenation timing. It is not a numerical decision, "I am 36 and I can't need a facelift yet!" It is actually a matter of architecture of your face combined with the texture changes of your skin.  The photos depicted are of course, not the same as an evaluation in person.  If jowling is of concern that a series of Sciton laser Skin Tyte treatments, once a week for six weeks will be of great benefit.  This non-operative infrared laser technology has the most benefical effects, and the more youthful the person is, the better the skin tightening phenomenon.

If your main concern is some flattening and volume loss around the eyes and in the mouth and marionette lines, called facial lipo-atrophy, then a marvelous improvement of volume that is the most long lasting is the use of autologous (your own) fat transfer.  This minor surgical procedure harvests fat and stem cells and allow for a high rate of "take," namely about 90% of the fat cell volume seen clinically at 3 months after transfer is seen in the 1 year and 5 year follow-up.  It would be a wonderful measure in improving the features I've seen depicted in these photos.  Other fillers have some of the benefits, but nothing beats structural fat!  The short answer is that volume has a reasonable effect of elevating the laxity seen and alleviating most of the midface and lower facial laxity.  The younger and more elastic the better.  But will it be enough to satisfy your goals? That requires our careful discussion not appropriate for this forum. 

That leaves the decision about taking the loose skin and marionette lines and having a mini-face lift effect easily seen when you pull your face in the mirror each morning and night at your bathroom mirror.  There is no substitute for asking you if that makes you happy.  If it does, then simply acknowledge that the cards you have been dealt (vis a vis your mother's heritage is manifesting in you) will give you a better look and make you feel great when you look in the mirror if you have a facial rejuvenation! A mini face lift will solve most or all of the problems you've identified, the ones I have enumerated and won't leave you guessing about the outcome while you heal.

Of course this answer doesn't have the benefit of seeing you or discussing your particular circumstances that allow me to make other recommendations that fit your goals, recovery needs and budget.  That is what the consultation process is for, to tailor your goals in the context of my expertise.

It is relatively uncommon that a 36 year old experiences the type and degree of aging that would require a facelift to fix. A facelift is effective at addressing jowling and laxity in the neck and creating a nicely defined jawline. From the pictures that you have provided I don't see howling and I can't get a good assessment of your neck. You do have some atrophy of the cheek fat which has created some hollowness. You also seem to have a slightly retrusive chin with fullness in the neck underneath the chin. I would consider fillers in the cheek, nasolabial fold, and tear trough as well as lipocontouring of the neck and a possible chin implant. I would visit with at least two qualified and experienced surgeons and get a comprehensive analysis. Good luck!