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

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!