What treatments can I get as a 24 yr old woman to address flat midface and nasolabial folds? (Photos)

Question

I would prefer not to get threading or fillers after seeing that viral scan showing a womans face with filler migrated everywhere. My family also has the smile lines so it’s partly genetic. The other factor is ive had a very high stress life for someone my age and im tired of looking like it.

Yucel Sarialtin, MD · Answer

HiThank you for the photos and for explaining your concerns clearly.
First, a reality check that will actually help you: at 24, what most people call “smile lines” is usually a mix of genetics, facial shape, and normal movement, not premature aging. In your photos, the folds look mild and very common for your age &mdash; and treating them too aggressively can make a young face look unnatural.
Why fillers “migrating everywhere” is not the full story
Viral posts often show extreme examples or misunderstand the imaging. Filler problems can happen (especially with excessive volume, repeated sessions, poor product choice, or poor technique), but that doesn’t mean every patient ends up with migration. Still &mdash; you said you prefer not to do fillers, and that’s a valid preference.
If you don’t want threads or fillers, what are your real options?
You have two categories:
1) Skin-quality improvements (subtle but real)
These help the texture and how light reflects off the midface, which often makes folds look softer:
Medical-grade skincare: daily sunscreen + a retinoid at night (biggest long-term impact)
Microneedling / RF microneedling (for collagen stimulation, especially if pores/texture bother you)
Fractional laser (if pigmentation/texture is part of the “tired” look)
These won’t “build cheekbones,” but they can make the midface look fresher and reduce the shadowing.
2) Structural options (bigger effect, more commitment)
If the midface truly feels “flat” to you and you want a structural change without filler:
Fat grafting can be an option, but it’s still a “filler”&mdash;just your own tissue. It’s not always permanent and can be unpredictable, which is why many surgeons are conservative in young patients.
Cheek implants exist, but at 24 I would only consider them if there’s a strong skeletal deficiency and you understand the long-term trade-offs (implant edges, palpability, revision risk). It’s rarely the first choice for mild concerns.
Midface lift is generally not the right solution at 24 unless there is a specific, unusual anatomical problem. Lifting without volume replacement often doesn’t “soften” folds the way patients expect.
The most honest guidance
If your goal is to look less tired (and you’ve had a high-stress life), the highest-return plan is usually:
Skin + lifestyle basics (sleep, hydration, nutrition, stress control) &mdash; boring but powerful
A good skincare routine + one collagen-stimulating treatment series
Reassess in 3–6 months with standardized photos
If you ever change your mind about injectables, the safest approach is micro-doses in the correct planes, done by an experienced injector, avoiding overfilling &mdash; but you don’t have to go there now.
Warm regards,Op. Dr. Yücel Sarıaltın, MDPlastic, Reconstructive & Aesthetic Surgery &mdash; Istanbul

Franklin D. Richards, MD · Answer

From your photos, I agree with you. Your mid-face dips in with a very prominent nasojugular trough. Normally, a mid-face lift would correct all of this. At your young age, you could do a lift, but you could also consider fat grafting. Fat grafting works exceptionally well, especially in this malar cheek area and is a more permanent result compared to fillers.

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs. The underlying source of your concern appears to be a degree of underdevelopment of the upper jaw and the lower portion of the orbital rim. This results in reduced structural support to the anterior cheek and, particularly in someone who is slim, can make lower eyelid fullness, under-eye circles, and a relatively flat midface more noticeable.

Your dental occlusion appears to be good, and for this reason orthognathic surgery would not usually be considered necessary. Fat transfer offers a way to enhance volume in the midface and can soften the overall appearance, reduce the prominence of the tear trough, and improve contour on oblique views as well.

Gary M. Horndeski, MD · Answer

One thing for you to consider would be a lip lift. I recommend an eccentric lip lift. This 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.

Albert Yang, MD · Answer

Hey, you are still very young. I would start with the most conservative things such as hydrating , eating healthy and microneedling/laser/chemical peel to improve skin tone. That will "tighten" up the skin.
In terms of surgical options. I think a lower bleph + fat transfer would help the tear trough region. Hard to tell but a chin implant could help

Darryl J. Blinski, MD · Answer

At your age, best option would be to use fat grafting, nano, and micro type fat grafting. There is an injection of fat that is recently FDA approved called ALLOCLAE and the newer product not approved yet derma Clay. Best to do virtual consultation, but expect fees to range from $2000-$5000 per session again best of virtual consult with for better explanation.

Vikram Mookerjee, MD · Answer

There are a number of treatment options available to improve a flat midface and prominent nasolabial folds. Improving lifestyle factors such as stress reduction may help, since excessive stress can accelerate facial aging. In terms of surgical treatments, I would recommend facial fat transfer. This is a procedure where fat is harvested from a different part of the body (typically the abdomen or the inner thighs), processed, and then injected into the nasolabial folds and midface. This can improve volume loss that you may have experienced, and the results tend to be quite durable over time. I would recommend consulting with a plastic surgeon in person for a full assessment and any additional recommendations.

What treatments can I get as a 24 yr old woman to address flat midface and nasolabial folds? (Photos)

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