Sagging skin - what options could reduce this? (Photo)

Question

Hi, I am 23 and I have all these lines on my face (under eyes, nose, and lips). Is there anything that could be done to stretch skin back and reduce the appearance of this lack of smoothness on my face? I especially don’t care for the way my cheek folds over the corners of my lips, making my lips smaller.

Arturo Valdez, MD · Answer

Thank you for your question.
From your second photo, the way you have pulled back your skin leads me to believe that this is the look you would like to achieve through a cosmetic procedure . 
It's my opinion that,  in order to achieve this look,  you would benefit from, an Endowbrow lift, and eliminate the excess skin of your upper eyelids and small traction on the lateral corners of your eyes we can address all of this loose skin and do some fat grafting  under your eyes, and in the nasolabial folds. These combined procedures would give you the look you are creating, where in the  second photo, you are pulling the skin back. I  feel that,  if you were to have  an endoscopic brow lift (endowbrow), upper blepharoplasty, facial fat grafting, and a Foxy Eyes lifts with a canthopexy, it would address your concerns and provide you with your desired look. I hope this helps.
Wishing you the best!

Cem Berkay Sinaci, MD · Answer

Hello, as you are very young and do not have too much skin excess, my recommendation would be a temporal facelift through a 3cm incision inside the hair in the temple and some fat injection specially on the upper cheeks and lower eyelids. This mimics the second photo you uploaded. You are also a good candidate for upper blepharoplasty at the same time. Regards

Jacob Tower, MD · Answer

Good morning, hope you are well. I would tread lightly and start with non-surgical treatments that could help move you in the direction you desire. Radiofrequency microneedling is a powerful treatment to help tighten the skin by stimulating collagen and elastin production; it can also improve skin texture and complexion. It can be applied selectively, or to the entire face and neck. Precise application of dermal fillers can be considered around the upper cheek, but discuss longevity of treatment and specific goals with you provider. For the lips specifically, you could weigh the benefits of a lip lift and/or augmentation (I prefer to make a concrete recommendation for this only on in-person consultation). 
Best Regards,Dr. Tower

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photos you provided I highly recommend you an endoscopic mid-face lift combined with brow lifting to achieve the result you want. This combination would give you a better looking, fresh and more elegant look.Best regards!

Ronald J. Edelson, MD · Answer

There is absolutely no way you need a facelift. You gave looks pretty and perfectly appropriate for a 23 year old. Of course you will always be able to find some one to a face lift for you but that surgeon would not be me

Michael S. Kluska, DO · Answer

As we age, the bones in the face shrink and the fat tends to atrophy over time. There are multiple options out there for facial volume loss and restoration. Injectable fillers and Fat Grafting are the best options available for volume restoration in the face for your age bracket.

Connie Hiers, MD, FACS · Answer

You could have noninvasive micro-needling with radiofrequency to tighten what limited lose skin you have and encourage collagen formation in your skin.  You can also boost yearly or as needed as you age to help maintain.

Jonathan Michel, DDS · Answer

Hi, I would consider starting with simple treatments first before you jump to invasive ones. Some of the problems you describe in your photographs show signs of lack of volume in your cheeks. The easiest way to replace that volume would be with fillers. If you like the result of filler you can always keep up with that or consider more permanent, surgery based options. But I would think about filler first.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photographs.  You are very young and I would only consider nonsurgical treatments to solve your issues.

Filling your mid cheek region with dermal fillers will plump your cheeks and the area underneath your eyes and refresh the entire face including the nasolabial fold area.  I typically use 1 cc of a dermal filler like Restylane lift or Voluma into each midface region.

For generalized improvement in skin quality and mild tightening of facial skin I use radiofrequency micro-needling or RF micro-needling.

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