Could a lower facelift be done on someone in their 20s? Why not?

Question

I do not need a lower facelift for reasons of ageing. I know this. But I have a very full lower face. It is caused by excess fat & saggy skin. Buccal removal, submental lipo, massatar Botox has not helped. My lower facial tissue & fat literally needs physically pulling back toward my ears. It is excessive & sagging forward, & has my whole life. A video I could demonstrate this but you will have to trust me. Could a lower facelift actually be done on someone in their 20s? Please explain.

Jonathan Kulbersh, MD · Answer

Thank you for your question. Lower facelifts aren’t generally performed at this age due to the lack of lines, wrinkles, and fallen tissue. Dermal fillers are a better option for restoring definition and youthful fullness along the chin and jawline. If submental fat is a concern, you could also consider Kybella injections. This treatment uses deoxycholic acid to dissolve fat cells under the chin to create a more contoured jawline. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to review your concerns and determine the best treatment option to help you achieve your aesthetic goals.

Jason Emer, MD · Answer

In our practice, we perform a non-surgical face lift / skin resurfacing treatment using Renuvion Helium Plasma Radiofrequency. ​To get the most improvement with skin tightening, we combine Renuvion (formerly J-Plasma) with lasers (Fraxel, Clear + Brilliant, CO2), microneedling/PRP, Ultherapy and InMode FaceTite. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​

Kevin Sadati, DO · Answer

Based on your photo, you're not a good candidate for facelift. For someone your age, I would recommend non-surgical options like Vivace or Profoud combined with PRP and skin resurfacing.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures. Age is not a factor for this kind of surgery. A Facelift is suitable for all patients that have lax facial skin, jowls, loss of definition to the jawline and developing deep lines and wrinkles. The effects of aging to the face frequent give the appearance of looking tired who ever much sleep you may have had. Unfortunately you do not present these signs so a facelift would be a lot of money for you for a minimal improve. I would suggest a non surgical approach such as threads or dermal filler. These are temporary solutions with no scarring. All The Best

Michael I. Echavez, MD · Answer

Most people in their 20's and early 30's are not reasonable candidates for a lower facelift.  Based on your picture, you do not appear to be a good candidate for a lower facelift, but it is difficult to fully assess you with just the single photo.  People in their 20's and early 30's do not normally have enough excess skin in order to perform a facelift.  Examining you in person would provide more information in order to give you the best advice.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants and lip implants), liposuction and/or facelifts for over 30 years...including SMAS and minimally, invasive SMAS type facelifts.  
 The photo shows mid cheeks grooves (indicate cheek fat has sagged off the underlying cheek bone that lacks adequate supporting volume), the cheeks are quite flat in the front, there is excess fat in the mid face however and the back portion of the jaw line is weak however there is no evidence of "jowls" in the lower face.  While it's not impossible for a 27 year old female to have jowls (who would therefore be considered a facelift candidate), this photo does not reveal jowls in the lower face which means you would not be considered a suitable candidate for any type of facelift procedure (described below).  All of the above mentioned contribute to create a thin, elongated, oval to rectangularly-shaped face.   Following my beauty principles, 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.  When the cheeks are flat or concave in the front, cheek augmentation with a dermal filler or using silastic cheek implants (permanent enhancement) can create full, round cheeks that will feminize the entire face.  Liposuction to reduce excess fat can be used to further shape the cheeks and face.
 There are many faces that have excess fat over the cheek area which hides the "true" shape of the cheeks below.  In addition to obstructing the cheek shape, this excess fat will sag prematurely as it is pulled by gravity at an accelerated rate versus a face without excess fat in the mid face.  Removal of the excess fat, with liposuction, is key when properly shaping the cheeks with cheek implants.  I have used this in combination with cheek implant surgery for 30 years.  In my experience these procedures when combined in a face with excess fat in the mid face are extremely safe, effective and reliable in the aesthetic results they produce.
 The back portion of your jaw line is a bit weak and can be augmented, without making your face appear masculine, using precise placement of a dermal filler (I prefer using Restylane Lyft).  
 Finally, the information on the minimally invasive SMAS facelift is indicated as a possible explanation of why your re being turned down for a requested facelift procedure.  
  If you have "jowls” these are sagging facial tissues and the main 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 SMAS facelift is the minimally invasive, short incision SMAS 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 and no incisions extend or are placed within the hair.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 anesthesiaproper SMAS Imbrication techniqueno incisions within the hair = no hair lossexcess fat can be removed from the face and neckexcess skin removed from the face and neckcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost 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.

Could a lower facelift be done on someone in their 20s? Why not?

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