Is facelift too radical? Non surgical options. (photo)

Question

I have extreme signs of aging in my lower face that I wish to treat. I’ve always had very full fatty lower cheeks and flat upper ones, smile lines and dimples and a weak chin. Aging is creating extreme sag, especially around the mouth and below the lip, plus loss of my jaw shape. I am only in my early thirties, so a facelift seems extreme. Possibly a minor one? I had upper cheek fillers that I felt helped, but worry about maintaining them. I also had rhino at 18 and felt it left this area expose

Ali Riza Öreroglu, MD · Answer

Visible sagging in the lower face and jawline can only be temporarily masked with fillers or device-based treatments. However, these approaches are often insufficient to lift and reposition descended tissues.
For a long-lasting and natural result, I recommend a lower facelift. This procedure lifts and tightens the lax tissues of the lower face, redefines the jawline, and restores a youthful appearance.
When combined with fat grafting, we can restore lost volume in key areas, creating a more balanced and natural-looking result. To determine the most appropriate treatment plan, a thorough in-person consultation and physical exam is essential.

Guray Yesiladali, MD, FEBOPRAS · Answer

Thank you for sharing your concerns in such detail. Based on your description, one of the key structural factors contributing to the changes in your lower face is likely low cheekbone (malar) projection. This often leads to a heavier appearance in the lower face, especially as early volume shifts begin with age.
If you’re not considering a facelift at this stage, targeted fat grafting to the midface combined with skin rejuvenation treatments could offer a noticeable improvement&mdash;similar to the benefits you experienced with upper cheek fillers, but with longer-lasting results and more natural integration.
If surgical intervention becomes a consideration, a focused, endoscopic midface lift would likely be the most appropriate method. This approach directly addresses midface descent without the extent or recovery of a full facelift.
A proper evaluation of your facial structure, including cheek projection and soft tissue behavior, would help determine which path offers the best outcome for your goals.
Warm regards,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon

Jake Thayer, MD · Answer

Hello and thanks for your question. You have a beautiful face and early signs of facial aging that you are noticing. Nonsurgical options do exist but given your description my recommendation would be a mini facelift to address the subtle laxity and descent in the lower face and prejowl area and combine this with conservative fat transfer to restore some natural volume to the cheekbone, temple and nasolabial areas. This fat helps soften the features, provides a youthful face shape and helps the appearance of the skin (fat transfer contains stem cells that help rejuvenate the skin). Thanks!

Stefan Mark Szczerba, MD · Answer

Definitely go with Morpheus treatments!!   If you feel like it's not aggressive enough then try Ellacor.  These are "go to" treatments though and perfect for your age.  Best Wishes!!

Ajaya Kashyap, MD · Answer

Thank you for your query. A lower facelift with some autologous fat injections or fillers can be very helpful for your face. Fillers alone can help as well.  Please find an experienced Board Certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Gary M. Horndeski, MD · Answer

I recommend a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michael P. Morrissette, DDS, FACS · Answer

More photos would be helpful, especially some profile photos. In the last photo, it appears that your chin is recessive and there is a facial asymmetry of the angles of the mandible, In addition, there is some cheek flatness below your eyes. Facial shaping can sometimes best be accomplished with facial implants. Specifically, cheek and chin implants as swell as mandibular angle implants. These are reversible yet provide permanent changes and do not require constant maintenance.

Michelle Zweifler, MD · Answer

Options for improving lower face include adding cheek volume which fat grafting is a longer option than filler to restore fullness.  Nonsurgical skin tightening devices like Sofwave help treat wrinkles and lift neck/chin/eyebrows and more.  A lower facelift helps to reposition lax cheek tissue with improving the cheeks, jawline and perioral regions.

Zeshaan Maan, MD · Answer

Hi - early 30’s is definitely on the earlier end for a facelift, though a mini facelift could be an effective option. Your best bet is to see a plastic surgeon in person for a consultation and be formally assessed. Depending on your exam findings, an alternative option would be to use dermal fillers for some tasteful touches to your jawline in the shorter term to give you a few years before surgery.

Connie Hiers, MD, FACS · Answer

You are not having any extreme aging, but mild at this point. i would suggest treatment with radiofrequency and micro-needling like Secret to help tighten your face and neck and improve collagen in your tissue.

Is facelift too radical? Non surgical options. (photo)

Answers (10)

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