28, female, lower face drooping - Should i get a face lift?

Question

28 y/o female, noticing facial sagging, exag naso folds. I have gotten 2ml of cheek filler, 2ml of chin filler 3 months ago. Still not happy with lower face droop Apperance.

Pasha Mostofi, MD, DMD · Answer

Hi there. At 28, a true facelift is almost never the right first step, and based on what you’ve shared and your photo, your concern looks more like early volume imbalance and mild tissue descent rather than significant skin laxity. A facelift is designed for more advanced sagging and excess skin, which you simply don’t appear to have. In your case, adding more filler, especially in the lower face, can sometimes make the area look heavier rather than lifted, which may be part of why you’re not loving your results so far.
What tends to work better at your stage is a more strategic, subtle approach. That could mean either dissolving and reassessing the current filler if it feels overdone, or shifting focus to restoring support higher in the face (temples, upper cheeks) rather than chasing folds directly. Fillers aren’t always the best long-term solution, this is where fat grafting can be a really nice, natural alternative in the right patient, as it restores volume in a softer, more integrated way.
You might also benefit from non-surgical tightening treatments or small tweaks like neuromodulators (ie. Botox, Dysport, Xeomin, etc) around the lower face to improve the pull of certain muscles. The key is balance, not more volume.
If you were sitting in my office, I’d recommend stepping back, possibly dissolving what’s there, and rebuilding in a more conservative, structural way, rather than jumping to surgery. Hope this helps!

Javier Parada, MD · Answer

At 28, significant lower face aging is uncommon, and in many patients the concern is more related to early midface descent, facial structure, or volume distribution rather than severe skin laxity. If cheek and chin filler have not given you the improvement you were hoping for, additional filler may not be the best solution.Based on your description, you may be a candidate for an endoscopic midface lift, which can elevate the cheeks and improve the appearance of the nasolabial folds and early lower face heaviness in a very natural way. This approach is often better suited for younger patients with mild laxity who want structural repositioning rather than more volume.A evaluation with a plastic surgeon would help determine whether your concerns are truly related to tissue descent versus volume loss or facial balance.

Semih Yildiz, MD, FEPOBRAS · Answer

At 28, I would be cautious about jumping to a facelift for mild lower-face heaviness or nasolabial folds. Your photo gives only a limited view, so an exam is needed to separate true skin laxity from facial volume distribution, filler effect, bite or dental support, and normal anatomy. Cheek and chin filler can help some proportions, but it can also make the lower face feel heavier if the placement or amount does not fit your face.
A deep-plane or mini facelift is rarely the first step at your age unless there is clear early laxity on exam. I would start with an in-person evaluation by a facial plastic or plastic surgeon who can review your filler, consider whether any should be dissolved or adjusted, and discuss conservative options such as skin tightening, small-volume contouring, or simply waiting longer for the filler result to settle before choosing surgery.

Julia Spears, MD · Answer

Hello, and thank you for your question.

At 28, true facial “sagging” is usually quite minimal, even when patients are noticing early heaviness or deeper nasolabial folds. In many younger patients, facial structure, volume distribution, genetics, skin quality, and even filler placement can all influence how the lower face appears.

Cheek and chin filler can improve support and balance, but adding more filler is not always the answer, especially if the concern is heaviness or lower face fullness. In some cases, overfilling the midface can actually draw more attention to the lower face rather than improve it.

It’s also important to remember that filler can take time to fully settle, and 3 months is still relatively early when assessing the final balance of the face. Depending on your anatomy, options such as dissolving and refining filler placement, subtle skin tightening treatments, or conservative additional contouring may be more effective than simply adding more volume.

A detailed in-person consultation with a board-certified plastic surgeon is the best way to determine whether the issue is truly tissue descent, facial structure, volume imbalance, or filler-related contouring.

Raffy Karamanoukian, MD, FACS · Answer

Unlike other tightening treatments, Ultherapy only requires a single treatment every one to two years and has long-term effects in skin stimulation and collagen production. Ultherapy is ideal for men and women who are experiencing mild to moderate skin laxity and desire a noticeable and long-term skin tightening treatment without the complications and risks of more invasive surgical procedures. Ultherapy can be combined with dermal fillers, Botox treatments, chemical peels, skin tightening lasers, and skin facials. Our plastic surgery and cosmetic center in Santa Monica offers Ultherapy as a complement to other skin treatments and cosmetic rejuvenation procedures.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Zoran Potparic, MD · Answer

Unfortunately, it is impossible to give you a meaningful advice based on this photo. It is not likely that you need a surgery to achieve desired improvement. In person consultation with a board certified plastic surgeon with good reputation in facial rejuvenation would help. Good luck.

28, female, lower face drooping - Should i get a face lift?

Answers (6)

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