33 y/o concerned about marionettes and mild sagging - is it too soon for a microlift? (photos)

Question

I am a 33 yo woman. I am suddenly experiencing mild sagging on my lower face and marionettes. I had an appointment with a reputable doctor who decided not to use filler on me saying only surgery could correct that. He also advised on some non surgical/minimal surgical skin tightening procedures (Morpheus/Facetite) but I'm so scared of them as I keep reading they can cause fat loss (I am very skinny). Is it too early for a microlift ? I don't know what to do but I'm really obsessing about it.

Ronald J. Edelson, MD · Answer

You are too young to really see much difference from a facelift. You would see virtually no improvement. I’m not a big fan of injectables because they can cost a lot over time. Reconsider the facelift in about 10 years

Alan Gonzalez, MD, FACS · Answer

Hello @Gingerkitty90, thank you for your question. At 33 years old, you are likely too young to consider a microlift. Before considering such an invasive procedure, it's important to explore the non-surgical options available to you. Non-surgical treatments such as Morpheus 8 or Facetite use radiofrequency energy which helps stimulate collagen production in the skin and ultimately provides improvement of structural features like sagging jowls or marionette lines. These procedures also don’t typically involve any fat loss. Be sure to talk openly with your doctor about all treatment options available so that together you can decide what will work best and make a non surgical protocol according to your goals and needs! Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Bora Ok, MD · Answer

Hello from Istanbul! The degree of sagging is a better determinant than age when deciding on a facelift operation. Many patients do need facelifts in younger ages, especially due to sagging caused by extreme weight fluctuations. As for you, you may be a good candidate for a mini facelift and mini neck lift. Since you are quite young, you should keep in mind that you may need additional procedures in time and that all surgeries come with certain risks. Best of luck!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You may benefit most from a combination of non-surgical treatment options to revitalize your appearance. Hyaluronic acid dermal fillers can be administered to reduce the appearance of marionette lines, while Kybella injections can submental fat below the chin to create a more contoured jawline. RF microneedling can also treat sagging skin without causing fat loss. This treatment uses a combination of microneedling and gentle radiofrequency heating to boost collagen production and refresh the skin from the inside out.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to answer any questions you have and determine the best treatment plan to help you achieve your aesthetic goals.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to answer any questions you have and determine the best treatment plan to help you achieve your aesthetic goals.

David Hansen, MD · Answer

You would do great with a little lipo under local and facetite with Morpheus to tighten up the jawline and neck and it is so easy to undergo with only 1 day downtime and immediate results for roughly only $4750.

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Jeffrey Lisiecki, MD · Answer

While I wouldn't say you're "too young" for a mini facelift necessarily, based on your photos you look like you could benefit from other treatments. One, your chin looks like it's a little behind its ideal position, so adding support there with either a chin implant, certain specific fillers, or fat grafting would help the marionettes and submental skin excess. Secondly, submental facetite/morpheus would likely be helpful--your concerns about fat loss are not unfounded, but they can be used in a way where that risk is minimized.

Kenneth D. Steinsapir, MD · Answer

Surgery, even the radio frequency skin tightening procedures will cause you some harm. It is very unlikely they will actually help you because you really don't need these procedures. Often is such a circumstance, it is much easier to have harm than benefit. I do recommend removing all the ancient filler service that may be in your face. The runny fillers you have had in the face do tend to drift down the face causing volume in places they should not be in. I suspect this accounts for some of the volume in the lower face.

Brian K. Machida, MD, FACS · Answer

Usually I do not recommend non surgical treatments such as Morpheus or Facetite, but in your case I would have you consider it. You have a positional area of looseness. Usually this positional problem cannot be corrected with facelift surgery because all lifts are judged in the facial rest position and not with your chin to your chest. If you tighten your neck with your chin down, it will be difficult to straighten up.
You have a localized collection of fat and slightly loose skin which could be treated with Morpheus Facetite and given your age, it would seem a reasonable treatment.

Cagil Meric Erenoglu, MD · Answer

Hi dear Gingerkitty90!
You are very suitable candidate for chin liposuction, smart cure rf skin thightening and fat injection to chin tip. Excess fats are removed under the chin, the skin is tightened and taken fats from you are injected to chin tip for achieving harmonious and elegant facial features in this procedure.
Smart Cure with its heads specific to the jowl area, ensures that the total energy is transmitted to all skin layers in a controlled manner and at the same time at the desired power, thus tightening under chin and neck skin. You can get rid of mild sagging on my lower face and marionettes. You can re-gained definining jawlines and shaped face as you desired. You can return to your daily life shortly after the procedure.

33 y/o concerned about marionettes and mild sagging - is it too soon for a microlift? (photos)

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