I'm 44 and my face looks gaunt and neck is sagging. What minimally invasive procedures would help? (photos)

I'm planning to get a rhino revision & lip reduction and while taking pics today I realized how old I look! I'm wondering what I could do to improve my loose jawline & cheek hollows. I'd prefer non surgical or very minimally invasive. Thank you

Doctor Answers 7

Minimal invasive procedures for laws of facial volume etc.?

your loss of volume can be improved using Voluma injectable filler. It is reliable and lasts two years. Fat sounds to patients better since it is permanent but very often patients end up with lumps and asymmetries which are very difficult to correct. A mini lift will also  help to remove excess skin in your face and or neck. See several very experienced facelift surgeons who will discuss with you the most minimal procedures as well as procedures that have actual merits so you don't waste your money. 

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Revision rhinoplasty and cheek implants

To restore volume in the mid-face can be performed with fillers placed in that area in the office setting with to be minimally invasive, And temporary.  Cheek implants can offer a more permanent alternative. A revision rhinoplasty procedure can accomplish reduction of the significant hanging columella and alar retraction present. For more information and many examples of both procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Loose Jawline and Neck Laxity, Cheek Hollows - VASER/ThermiRF + Botox, Fat/Sculptra Injection, Thermage/Ultherapy, Fillers

In order to improve the jawline and cheek hollows, I use a combination of VASER liposuction and thermiRF at the same time for this.  Noninvasive options such as thermage, ultherapy, kybella, and fillers can also be used.  Please get a formal consultation as in addition to the above,  lasers, microneedling/PRP can be used for texture tone and intensif microneedling/RF for fine lines and some tightening. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

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44 and my face looks gaunt and neck is sagging. What minimally invasive procedures would help?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos your cheeks are flat anteriorly (in the front), jowls are present and the chin is weak.  These factors combine to create a rectangular shaped face.

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 "Jowls” are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Minimally invasive or non-surgical procedures to help with hollow cheeks and loose jawline

Your pictures do demonstrate some loss of volume in the cheeks.  The main non-surgical option to improve this issue would be injectable fillers.  Adding volume to your cheeks would most likely improve some of the looseness you see along your jaw as well.  Your neck does not appear saggy to me, but there are some non-surgical skin tightening treatments such as Ultherapy or radio frequency that could potentially help.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Thin face

What you can see mostly in these pictures is some volume loss in the face.  The neck looks pretty good.  Your best bet would be either fat transfer or fillers to the cheeks.  this will help to replace the lost volume and will help to tighten up your jawline. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

44 and face looks gaunt and neck is sagging. What minimally invasive procedures would help?

Based on your photos I would recommend fat transfer to cheeks, chin and jawline. ThermiTight to tighten the skin in the jowl and neck area. I would also question your desire for lip reduction especially after volume enhancement to the face.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

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.