25yrs old and my face is sagging loads. Do I need a facelift or fillers/ fat removal etc? (Photo)

Its really getting me down how I look I dont know what to do, im slim all over apart from my face. Any advice will be much appreciated thanks!

Doctor Answers 24

Too Young For Facelift

I think your face is sagging because your cheek bones are relatively flat. A small or flat cheek bone is undesirable because it allows the skin and fat of the face to shift downward. Consider a filler treatment both in the cheek and under the eye to improve the overall shape of your face. Fillers such as Voluma act to lift the cheek naturally and thereby diminish the appearance of the jowl. The result could be made even better if combined with conservative measures to diminish fat in the lower face such as liposuction or minimally invasive radiofrequency (ThermiTight).

Best wishes

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Too young for a facelift?

Too young for a facelift?40 to 50% of my patients come from out of town or abroad and therefore the corresponding number of consultations are done via photographs and telephone only. Though very useful, this consultation cannot supersede an in-person consultation where the physician can assess the quality of your skin/elasticity and get a three-dimensional view of yourself.  Keeping this in mind, judging by your photographs, your skeletal structure of your midface (the area between your lower eyelid and corner of your mouth) is rather flat and therefore the overlying soft tissue is prematurely drooping, This is evident in your  prominent nasolabial fold and palpebralmalar groove (The inferior extension of your "tear trough"). You have have four options:

1. Do nothing

2.  Utilize fillers (temporary such as  hyaluronic acids/Voluma ® , etc.) and permanent ones (Bellafill ®, Fat transfer, etc.)

3.  Alloplastic malar augmentation with a cheek implant 

4. An endoscopic mid facelift. This takes one and a half hours and elevates the saggy soft tissue back onto the cheekbone. You'll not only get facial rejuvenation but also glamorous cheeks that you've never had before-all with your own natural tissue. As with a cheek implant, recovery is involved with not in significant swelling, especially in the first 2 to 3 weeks after surgery. 

I hope this helps any reader of this question.

Randal Haworth, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 48 reviews

25yrs old and my face is sagging loads. Do I need a facelift or fillers/ fat removal etc?

Based on your photo you have loss of volume in the cheek and early tear trough formation. A facelift will not correct this.

A dermal filler such as Voluma will give you a nice result. Do the filler first to see if you like the effect before considering fat injection which is more permanent.

Facial appearance

Hard to see from the photos since they are so close. In general you should not have much sagging at your age. If you have had a big weight loss it could contribute to your appearance. Ulthera is a non invasive treatment that may get you the lift you desire without surgery. Fillers can also help as can your own fat. In general liposuction is contraindicated because you will be losing volume in the face as you age. You are too young for a lift.

Good Luck

Dr. J

A. Dean Jabs M.D., Ph.D.
Board Certified Plastic Surgeon
Bethesda MD/McLean VA

Start with Fillers and consider fat

You could try one of the dermal fillers and consider fat transplantation later to the cheeks and under the eyes in the grooves.  You might even benefit from a small amount of liposuction under your chin.  I would not recommend a facelift.

D'Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.6 out of 5 stars 20 reviews

25 with sagging face

Your sagging skin is likely due to loss of volume of the cheek. Interestingly, the skinnier you get, the more your skin will sag due to further fat loss. Gaining weight is the cheapest form of filler but since that is generally not what most people want or need in America, you can potentially benefit from revolumization. You should see a plastic surgeon for an evaluation as you have many options ranging from fillers to some of the new minimally invasive methods to lift and tighten the skin without having a facelift. Which option you choose depends upon your own personal aesthetic and preferences.

Aric K. Park, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Facelift, Fillers or Fat reduction of the face?

Dear Lucybee:
Thanks for sharing your photos. These comments are based on the limited information from your pictures. Please seek a well experienced Board Certified Plastic Surgeon to evaluate you and offer you your best options. 

Based on these photos, you appear to have excellent elasticity and collagen resiliance in your skin. The folds I see are due to mild descent of the skin folds like a wave at the ocean. 

I think that fillers in the cheeks will fill the wave and pull back the nasolabial fold. You may need a touch of filler there too. 

There are many options including the newest 2 year rated filler, Voluma. 

I hope this has been helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 69 reviews

Facial rejuvenation in the 25 year old crowd...

I have looked at your pictures that you have posted on RealSelf.

1.  You do not need a face lift.
2.  You have a little bit of a line at the melolabial area (smile lines)
3.  Your neck is taught.

Based on these findings, I do not feel that you need a face lift.  I would recommend filler agents into the melolabial folds.  Your options are a Hyaluronic acid.  In this category, I would recommend either Juvederm, or Juvederm XC.  Another option would be semi-permanent millers such as Radiesse.


Raghu Athre, MD
Houston Facial Plastic Surgeon
4.7 out of 5 stars 80 reviews

Facelift not indicated in 23-year-old.

From the photograph I would not suggest fillers or facelift. You look young and should enjoy it while you can.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Unhappy with facial changes at 25

Thank you for your question about your face lift.

YOur photo suggests that fillers will be your best treatment.
You still have the facial fullness of youth in many areas so I wouldn't use fat injections at this time.

Always see a Board Certified Plastic Surgeon.
Hope this information helps. Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.