Do I need a facelift at 39 or will fillers help for now? (photo)

That is a tough one. While I generally would suggest that 39 is quite young for a facelift, your photos demonstrate facial aging that exceeds your chronological age. Part of what contributes to your advanced facial aging appearance is your small / retruded chin. I would suggest starting with a genioplasty (osteoplastic v alloplastic) depending on your surgeons comfort level. You may even consider seeing a craniofacial or maxillofacial surgeon to do a bsso. either way I would address your chin/jaw, do submental / jowl liposuction (cautiously - you have loose skin) and maybe a platysmaplasty with ant belly of digastric reduction/resection.at this age I think the effort should first be to normalize the lower 1/3 facial anatomy.see if that holds you over, if not then go for a facelift. you would benefit from a true facelift more that a mini lift. you need to make sure your malar tissues are really addressed well.

I wrote a book a few years ago called “The Fine
Art of Looking Younger” and explained that the elements of facial aging can be
broken down to two simple processes: volume loss and descent. When I look at
someone who is complaining about looking older, I assess which part of facial
aging is dominant or if it's a combination of the two aspects.



The youngest patient that I have ever done a
facelift on was 37-years-old. We can conclude that facial aging can have a
major genetic aspect and this something that we can’t control. However, we can
control physical health and wellbeing. I encourage my patients to manage their
health which includes avoiding toxins such as cigarette smoking, excess alcohol
use, lack of sleep and severe stress. All of those things can cause a person to
age significantly.



In order to make a proper recommendation, there
has to be a basic physical examination. The reason for this is that when I look
at a photo and I see a jowls in that area, I can’t tell if the skin is loose
and sagging and whether lifting the skin will reposition the jowls. If the skin
is relatively taut or tight, then there is no indication to reposition the
skin. In my practice as a facial cosmetic surgeon, I had done procedures
limited to liposculpture where I just put in a small cannula and suction to
define the jawline or I do a facelift with a limited amount of liposculpture if
appropriate.



It is
important that you start exploring your options but you do need a physical
examination first. Without it, you’re going to get a lot of suggestions that
are in the absence of the important aspects of understanding the tissue. I
recommend that you find a qualified cosmetic surgeon and learn about your
options. A lot of times in your age group, there can be a combination of a
limited surgical procedure with the use of volume enhancement fillers placed
strategically and a little bit of skin care. All of these things can get you
looking your best. I hope that was helpful, I wish you the best of luck, and
thank you for your question.

Hello in Middletown, I spent a few years at St Andrews School. I agree with the theme of a chin augmentation with implant or osteotomy and a face and neck lift. If you truly have had a really dramatic change in facial features you may benefit from medical evaluation to rule out rheumatoid type disorders as well as seeing an dentist for panorex xray to make sure your condyles are not resorbing contributing to this rapid change. Good Luck!