Does it seem like I would benefit from a facelift (please specify which) over fillers? (PHOTO)

Hi, I am 33 years old but feel like I have significant facial aging. The Dr. I went to seems to think I'm too young for a facelift and suggests fillers. Do you see the downward sag of my features? I used to have very full Mariah Carey / cherub like cheeks and now they are almost completely flat with fat migrated to around my mouth and jaw. I am thinking a mid face lift, or possibly a mid and lower facelift. I don't think fillers are going to correct the downward sag I'm seeing. Opinions?

Doctor Answers 19

Face concerns

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You are absolutely right that fillers will not correct the downward sagging appearence that concerns you. They will plump out depressions and hide variations in contour but they will not lift. You are a candidate for a pre-auricular ( in front of the ear ) type face lift. This will elevate your tissues nicely and get you the look you want back. As for your are on the very young side so you have to decide for yourself what you want to do. If you have a visible problem and there is a solution you simply have to weigh the pluses and minuses and decide the best answer for you. The scar does hide nicely and the procedure is simple and safe local anesthesia with a very quick recovery......However the scar is not totally invisible. The alternative is to do something like Voluma to fill up the cheeks and nasolabial folds. This is temporary and a second best answer if you do not want the surgery...My experience is that you will spend more for a "liquid " facelift, get less of a result, and be in need of more liquid in one or two years.

Does it seem like I would benefit from a facelift (please specify which) over fillers?

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Try "Liquid Facelift" 2 to 4 cc's of Juvederm Voluma to cheek area to lift the NL folds. You are slightly you for a FL/Cheek Lift///

Determining the Facial Procedures Best For You

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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. It is possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit to view a complete list of surgeries commonly performed. 

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives. It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

Early facial changes

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I can see the changes in your face.
Also the part of your lower lid visible in the photos suggests early descent of the cheek tissue.

You should not have a standard face lift.
Fillers will help - especially Voluma along the cheek bone.
But if this does not give you enough improvement,
 I have found that a true mini-lift, which can be done in the office, with elevation of the platysma and the SMAS and only enough skin to avoid pull lines can have remarkably good results in women your age.

Done correctly, it does not affect your ability to have a future face lift, does not cause distortion but does correct the early sagging. Discuss this with a Board Certified Plastic Surgeon if a trial of cheek fillers disappoints you. Best wishes.

Fillers are ideal for your stage of aging.

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I understand your concerns, but the opinion given at your consultation is probably right – the aging process at this time appears to be too minor to warrant a facelift. Fillers could make a big difference in the nasolabial folds, and also help restore some of the volume loss through the fuller part of your face, over your cheekbones. In general, my preference is to start with a conservative approach toward facial rejuvenation rather than rushing into surgery, as I feel this allows for more natural-looking results both immediately and in the long term.

Nirav Savalia, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 44 reviews

Try Fillers or Fat Grafting

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It is difficult to be completely definitive on recommendations for aging based on photos alone, but I would agree with the other opinions that the quality of your skin appears good in terms of elasticity, and your jawline appears firm. I have done midface lifts in unusual situations in people your age, but only after major weight loss that has resulted in deflation and loss of elasticity. I would recommend fillers as a first choice, and in general fat grafting will result in less undesirable changes and a more natural appearance than fillers done repeatedly over many years. I think that fat grafting could give you subtle enhancement in your cheeks and softening of the nasolabial folds, with consideration of selective use of fillers for areas that still appeared deficient (if any) after fat grafting. SCULPTRA Aesthetic, JUVEDERM VOLUMA XC, and RADIESSE are longer-lasting fillers, which for you would be better options. If the results do not give the rejuvenation you want, a future thoughtful discussion could include consideration of cheek implants and a midface lift with a thorough understanding of their risks and limitations. I would select a surgeon with experience with all options for a balanced discussion. Best wishes.

Fillers vs facelift

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People all age differently.You obviously have some early jowling and you might want to consider a Quicklift with some fat grafting as well.I am shifting more and more to using the patients own fatty tissue to augmenat areas on the face that would benefit from it.

Does it seem like I would benefit from a facelift

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Please discard the idea of a facelift, particularly a mid-facelift. In my humble opinion you do not need such an invasive procedure. You would do great by using a combination of fillers. I personally like Raddiesse and Voluma to build volume where needed. I will selectively use Juvederm and Belotero to fill wrinkles. Good luck and tread lightly. You are young. All the best

Facelift versus fillers in a young patient

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Looking at your photos, I think you may have lost some volume to your midface which makes you appear as if you might have some sagging. I would caution against a facelift and consider some volumizers to your midface. A new product called Voluma is very effective in restoring midface volume and giving you back a fuller face. The product can last up to 2-3 years and is very safe with no significant downtime except for mild bruising and swelling.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Fat and Fillers over Facelift for a Younger Person

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As your photos show flattening of your cheeks, I think that this deflation has probably resulted in the sagging of skin that leads to increased grooves near the corners of your mouth.  Considering your young age and skin appearance on the photos, I doubt that you actually have any significant inherent skin stretching due to loss of elasticity.  Therefore, I suggest injection of either your own fat or fillers into the cheek fat compartments.  This will create a more youthful facial shape and by re-inflating the skin will raise up the cheek skin that had sagged  downward, thus reducing the folds near your mouth.  Of course, you could always have some fat or fillers along these grooves to plump them out and lift the corners of your mouth is needed.  Interestingly, within the last decade plastic surgeons have appreciated that loss of volume in the mid face due to fat atrophy plays a significant part in facial aging.  Much more emphasis is now being placed on restoring the fullness of a youthful facial shape either by itself or in conjunction with a facelift.

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.