Facelift for Younger People to Make Face Slimmer and Narrow

When a 25 year old is seeking a more defined face, a facelift is not an option.  A thorough evaluation by a face specialist can help determine what is the best course of action.  The following are treatment possiblities:

Weight loss- In some individuals, weight can be carried in the face.  It is in general a good first step.

Avoidance of gum chewing/ chewy foods/ etc-  Too much stimulation of jaw muscles can lead to an overly wide and square face.  The jaw muscle responsible is called the masseter muscle.

Buccal fat removal- Buccal fat is compartmentalized fat and can lead to a more sculpted facial look, especially in the midface area.

Botox Jaw Reduction- Can lead to a softening of facial features and a less square jaw.

Thanks for your question.  Without photos I cannot give you a specific recommendation.  However there are a number of interventions that can be done to achieve a slimmer appearing face in younger patients.  Typically this does not include facelift however.  Some patients have hypertrophy of their masseter muscle (one of the primary muscles used for chewing), or the parotid glands (the major salivary glands in the cheeks).  Both these issues can be addressed with serial botox injections into the masseter  muscle or the parotid gland.  It may take several treatments to see a significant difference (usually about 6 months).   Another possible cause for fullness in the cheeks is enlarged buccal fat pad.  These can be removed surgically either from inside the mouth or during a facelift surgery.   Any of these issues may be the source of your concern.  I recommend consulting with a facial plastic surgeon to discuss what is the best option for you. 

A Mini Facelift or especially a mid facelift can usually be an option on most realistic patients. It really depends on your anatomy and genetics. It is best to talk to your surgeon because everybody has different techniques and recovery time is usually based on a number of factors. If we are just talking about a short scar facelift or midface lift, this can typically be done in the office under local anesthesia. Usually there are no drains, no outside stitches, and patients can go out in public the same day, although I usually recommend they low for the first couple days. Most of the initial swelling is from the numbing medicine and your body absorbs it within the first 4-6 hours. Obviously the body heals with swelling and inflammation and usually that maxes out at two days and then starts getting better. Most of these patients take no pain medicine and usually feel very comfortable going out in public within a few days.  I usually call my patients the night of surgery and check on them the next day. If everything is fine the next day, I then let them shower and they do not need a dressing over their incisions. They can usually start using make up after a few days.  At the two week check up, I usually have people start working out and then after six weeks they can do whatever they want. I routinely tell people to take a few days to a week off work and to hide out but some people are very nervous especially celebrities and I usually tell them to hide out for two weeks. As with any scar on the human body, initially scars are red, hard and raised and it typically takes six months to a year for them to become a soft thin white line. Additionally with recovery, there're many things we do to expedite healing such as nerve blocks during surgery, oral supplements, skin care and scar therapy recommendations, lymphatic massage sessions that are included in our pricing.I strongly feel that it's very important to have an honest conversation with your surgeon about your particular situation, lifestyle, work environment and specifically which procedures you're having done so that you both have the most honest answer about your recovery and are realistic with expectations and results.Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the jowls.I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations. I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

Each patient's anatomy is unique. Fillers could still be an option, if placed properly by an expert injector. Fillers can definitely be used to change the overall facial shape. Buccal fat removal is also an option to decrease fullness in the lower cheek area. In some patients, there is also enlargement of some of muscle in the face (masseter hypertrophy) which can be decreased with Botox injections. 
A consultation with a facial plastic surgeon or plastic surgeon specializing in facial aesthetics can be very helpful to review the options in detail and for a formal evaluation.
All the best,

Typically in your age group for facial contouring I would use a combination of filler or fat transfer and buccal fat removal. It really depends on your facial anatomy and we can only give recommendations after a facial analysis but above is a common protocol for someone in your age group.You mentioned fillers widen your face. The key is to use them in the right locations that will contour and sharpen the face.Hope this helps.Best of luck,DrC

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 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 patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

We occasionally see patients who are unhappy with the shape
of their face. When this situation arises it’s not unusual for them to be
concerned about their transverse facial width. Many of these patients would like a slimmer face with a decreased
transverse dimension. These individuals occasionally request facelift surgery
in an effort to address this problem. Although facelifts will make the face
look younger they won’t dramatically impact the shape of the face.In your
case it’s virtually impossible to make a recommendation without pictures or a
physical examination. In the vast
majority of patients who have this concern the anatomic deformity resides at
the level of the boney facial skeleton. Correction of this type of problem is
no simple matter and usually requires surgery on the underlying facial
skeleton. In most cases the risk benefit ratio of this type of procedure
renders this undertaking inappropriate.For
this reason, many surgeons try to disguise the deformity by operating on the
facial soft tissues. Under these circumstances, injectable fillers, micro
liposuction and buccal fat pad removal have all been attempted. These maneuvers are associated with minimal
improvement in facial shape and for this reason aren’t frequently utilized. If
you’re concerned about facial aesthetics, consultation with a board certified
plastic surgeon is appropriate. This
surgeon should be able to evaluate your anatomy and formulate an appropriate
treatment plan.

If your jawline is your concern, then it's better to consider something that would modify the jawline itself rather than a facelift. You can consider Botox to relax the masseter muscles, or jawline contouring to target the actual bone.

It is very difficult to answer your question without seeing your pictures – you should consider posting images showing your areas of concern - it would be very unlikely that a lift is your answer

Hi JC8222,

It's unlikely that a facelift at age 25 will give you the results that you are seeking.  When you are looking at before and after photos of facelift results, it is true that the squarish looking faces of older women appear more heart-shaped or triangular as you have pointed out.  When these facelift patients were younger, their faces were already heart shaped, and with normal aging the sagging of the cheek fat and skin down the sides of the face protudes past the triangular point of the chin which causes jowling or sagging of the jawline.  This makes them look square and more masculine.

For men, this squaring off of the jawline can actually make men look more masculine and sometime better with age, as long as they don'e have a significant amount of sagging neck skin under their chin, which offsets the improvement.  This can make a baby-faced man (heart shaped face) look more square and they look more masculine with age.

From a front view, the jowling (sagging of fat/skin below the jawline) does make the face look squarer at the bottom contour of their chin and jawline, but on an oblique or 45 degree angled view, you will see that these patients have sagging fat protruding below their jawline, somewhere between the back edge of the jaw (angle of the jaw) and the chin, usually closer to the chin.  This sagging jowl is what facelifts are designed for.  Facelifts do not liposuction fat from the sides of the face, nor does tightening the skin compress the muscles, glands, fat, and other soft tissues of the face to make the face look thinner. 

I'm guessing that you have tried simulating the look of a facelift on your 25 year old face and it appears that your lower face got slimmer when your pushed your cheeks upwards.  Since facelifts are essentially a procedure to take the "slack out" of a sagging face with some excess skin, your 25 year old face which is already wide, will unlikely have any "slack" and instead has excess soft tissues which is going outwards from the sides of your face to make your lower jawline appear wider.  If you don't have much slack or sagging, the most likely result of a facelift is that you will look mostly the same, but with facelift incisions around the front of your ears.  

Facelift at 25 is not the answer.  A square face on a 25 year old is usually due to structural issues, pushing the lower jawline outwards and making the lower face look wider and thus square.  Bone, muscle, glands and fat can make this area of the face wider.

The simplest problem would be if this were from having too much fat in this area paired with not being your ideal weight.  If you feel you are 15-20 lbs over your ideal weight, then simply reaching your goal weight with the monitoring of a physician, dietician, or other professional, should narrow your face without needing any needles or surgery.  If you are already at your ideal weight, or try this first and it doesn't give you the results that you want then consider the cosmetic procedures which will cost you money.

Some people simply have a wide lower face right at the angle of their jaw.  These people may have issues with grinding their teeth, require a tooth guard at night, enjoy chewing on hard things, and maybe even have some TMJ issues or jaw joint pain or clicking.  If these patients have significant bulging of their jaw muscles at this location, the masseter muscles, then botoxing the lower edge of the muscle will reduce the volume right at this "corner" and make the face look rounder and more heart shaped.  This will cause some fatigue with chewing initially and can take several weeks to see the results.  The botox maintenance may be every 6-8 months, but may vary depending on the patients usage of the muscle, and their natural tendencies to use the muscle.  If it can break their habit of over-using their muscle, which people often bite down or grind when they are stressed out, or they simply love chewing gum, nuts, ice, etc.  If these habits are reduced when the patients muscles are weak, potentially the need for botox to maintain the results could be reduced.

Prominent bone at the corner of the jaw is the toughest to treat.  This is major jaw surgery, which is performed from the inside of the mouth, and a reciprocating saw is used to reduce the corner of the jaw.  This surgery is common in Asian, in particular Korea.  The surgeon's out there have the most experience with this type of surgery as compared to most American surgeons.  This surgery has more potential risks and complications.  Also, the results can sometimes look unnatural, since the corner of the jaw looks "chopped off" or too straight which looks weird in a different way from the square jaw.  If the patient is willing to take the risk and likes the aesthetic of the results, then these are the patients who will go for the surgery.

Lastly for discussion purposes, but really "firstly", there are some medical conditions of the parotid gland which can make the sides of the face look puffy like a chipmunk.  This should really be ruled out first.  If there is inflammation of the parotid glands, which are saliva glands on the sides of the face, this can cause the saliva gland to swell up.  The parotid gland overlies the masseter muscle, so it can also add bulk to the size of the face similarly to the muscle hypertrophy.  If the patient has one sided swelling, which is intermittent, these people may have a stone in their saliva duct similar to a kidney stone.  When the stone blocks the opening the saliva backs up and makes the gland swell up like you are blowing up a balloon.  When the blockage is opened the swelling will go down.  If the person has swelling on both parotid glands, then it is unlikely that they have simultaneous stones blocking their glands, so the more likely scenario is some kind of inflammatory process which is affecting both parotid glands.  A common diagnosis is Sjogen's Syndrome which is when our own immune system attacks our glands.  This can cause swelling of the Parotid glands, but the more common complaint is dry mouth along with increased cavities and other issues from not having enough saliva in our mouths.  Sjogren's syndrome can also affect our eyes, and in men, their fertility.  Essentially it is attacking glands which help us secrete fluid, saliva, tears, etc.  This inflammation can make these glands look bigger from the immune system's attack.  The most common age for Sjogren's syndrome is in older women, but can occur at younger ages.  

Before jumping into any cosmetic procedures, since we are still physicians before plastic surgeons, if a patient has a skin cancer, or other medical condition (autoimmune disease, bleeding issues, anesthesia issues, etc.) that we find during our initial consultation, those should be identified and treated before continuing on their cosmetic journey.  Sometimes if the medical issue is identified, it may affect whether or not to perform the cosmetic procedure, or even effect the outcome of the surgery.

Best,

Dr. Yang