Facial sagging and caving in at 37. What is the best route for me to take? (Photo)

I am 37 years old, a few years ago, I had 2 back teeth removed on left hand side and since then I have noticed a definite caving in on cheeks, also after going through a horrible divorce lost a lot of weight in a matter of weeks and it's really showing everywhere.. I have enlarged pores and I am wondering what the best route to take would be? Do I try fillers? Or a mini face lift? I find that when I pull my face outwards my pores look less obvious too

Doctor Answers 7

Options to alleviate facial sagging and concavity

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Removing teeth also removes a fair amount of facial structural support. The resultant bone shrinkage will cause a caved in appearance. Hopefully you can undergo dental implant or bridging which should provide some help. A cosmetic dentist can guide that process.

  • Volume loss may be addressed from regaining some of the weight you lost, but it won't correct everything
  • Sculptra can replace volume in many areas of the face by triggering your body to produce new collagen
  • A good skin care program will address breakouts and skin texture (peels, microdermabrasion and a good pore de-clogger - I like Cebatrol)
  • A facelift removes redundant skin and you aren't there yet. It won't solve the issue of support loss from removing teeth nor will it improve your skin quality
But don't despair - It's likely you aren't taking the best care of yourself in your current situation. Some tender loving self care goes a long way. Choose a healthy diet and spend time with caring friends and family. It's easy to magnify the negative when you're under stress. 

Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Facial sagging and caving in at 37. What is the best route for me to take

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I would start with fillers such as Sculptra to regain the shale and fullness first. At your age that might be all that you need

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Sagging, Texture/Tone and Volume

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You need a combination of lasers fillers and skin care. I suggest speaking to a cosmetic dermatologist who can give you a full facial rejuvenation consult to suggest best treatments.  Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

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Early sagging of facial skin with volume loss.

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The best treatment to begin with would be gaining back the weight that you have lost. Take care of any dental problems and then once you have regain the weight have a face lift of whatever sort to remove the excess skin of the cheek and/or neck. See a very experiencedfacelift surgeon for this.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
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Facial sagging with possible minilift

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No question that the dental support on your left is an issue. Is there a planned dental reconstruction? If so, once that is complete reevaluating the left cheek would be necessary. If not, fillers to the left cheek would be helpful. Once your weight and emotional stress settle a minilift might be possible to help resolve what appears to be early loss of support along the jowl area.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Facial volume loss

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I am sorry to hear you have been through so many recent problems and I hope your life is settling down a little.  Facial volume loss is one of the most common reasons for aging changes in the face and it seems that you have two underlying reasons for the loss and changes you see in your face--loss of dental support to help support the cheek internally and weight loss with subsequent thinning of the subcutaneous fat and loss of fat in the fat compartments which can lead to some of the skin sagging you see.  It would take an in-person evaluation of your skin and your facial structure to decide whether you would benefit most from filler or a lift or a combination of the two and also to evaluate your pores and what could improve them.  You may see some improvement in your face with re-gaining the weight you lost as this would be your own natural "filler."

Take control

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Congrats on taking control of your skin. Sun protection every day and retinol every night is important.  Looking at you I would advise volume replacement first.  I like radiesse and voluma for this.  After that we can do some fine tuning---add some icing to the cake.  

Sandra M. Johnson, MD
Fort Smith Dermatologist

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.