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

I am devastated.... For the last 2 years my face has been quickly going south which has put me in a deep depression. My once beautiful face is falling apart and I need help and answers. I am petrified of plastic surgery but I will do what it takes. I am really hoping I can fix it with fillers for now to hold me off for a few years. I lost about 10 pounds 2 years ago and was in awesome shape but I have let myself go the last 2 years and it seems like the weight is going straight to my jowls!

Doctor Answers 21

Facelift Not Fillers Best Option For Jawline And Neck Sagging

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Thank you for sending your question and photographs.

Fillers will not improve sagging of the jawline and neck in my experience.

A properly done face and neck lift, performed by an experienced board certified plastic surgeon should give you a beautiful result. Please read the link below.

Be certain to consult a plastic surgeon who is certified by the American Board of Plastic Surgery and has experience in facelift surgery, and an excellent reputation in your local community.

Facelift at 39?

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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.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 63 reviews

Facelift at 39 Years Old

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Based on your photos, you are an excellent candidate for a facelift. You appear to have excess tissue in the jowl area. Your face appears to be sagging. Discuss your options with a Board Certified Plastic Surgeon. Based on your photos, fillers will not help you achieve your goal. Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Facelift at 39?

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I can see your concerns. You could certainly try non-surgical solutions but I think at the end of the day surgery will be the best choice for you. You have a rather weak lower jaw / chin which is contributing to your problem. My guess is that you would have great success with a neck lift (or lower facelift) and a chin implant. Your neck muscles could be improved with tightening, which is generally included in necklift procedures. Good luck.

Facelift/ neck lift and chin implant

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The chin implant placement would help significantly by augmenting the lower chin area and giving better facial balance and structure. There are fatty deposits in the neck above and below the platysma muscle but will need to be addressed by either a neck lift alone or a face neck lift, depending upon the amount of excess skin present. The amount of loose skin/ jowls in the neck will determine what procedure will need to be performed this is best determined at the time of the physical examination and consultation. For many examples please see link below to our neck lift/ chin implant photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

39 year old female with loose neck. What's best option?

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I think that a necklift with chin augmentation would provide a good improvement of your neck and chin, without having to go through a facelift.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

Facelift at 39?

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From the limited views on your pictures, I would say that filler will not be the answer to rejuvenation for you. Your aesthetic issues deal more with skin laxity, than they do volume loss, therefore fillers or laser treatments will not provide you with the answer. I would first suggest a "Mini Facelift". This procedure would help to address the laxity of the skin in your neck area, and also correct the jowls along your jawline. This procedure would provide you with a much tighter neck and jawline. I would also suggest a chin implant. This would help to strengthen your profile and also give the appearance of a more sculpted neckline. I understand your concerns with surgery, but these procedures are safe when performed in the hand of a board certified facial plastic surgeon. I suggest you schedule an consultation where a more accurate examination of your face can be performed, and an individualized plan for reaching your aesthetic goals can be addressed. Good Luck!

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Your expectations determine the best procedure: Surgical vs. Non-Surgical facial Rejuvenation

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How dramatic your results are from your intervention will be determined by your choice of procedures. In general, non-surgical treatments give the best results with minimal downtime, while surgical procedures give the best results but do have some associated downtime and recovery (which varies by patient, procedure, etc)

If you really want to avoid surgery, then you certainly do have some non surgical options. Fillers and volumizers like Restylane, Juvederm, Voluma and Sculptra can give you a "liquid lift" with minimal downtime. These treatments synergize with a non-surgical treatment like Ultherapy to get some lifting and tightening along the neck and jawline.

If you won't be happy without a perfectly clean neckline than you need to consider a surgical necklift. This probably would include some facial liposuction to remove the extra fat. I would also recommend you consider some form of chin augmentation since some extra chin projection would help add to your facial harmony.

You certainly owe it to yourself to seek out a board certified facial specialist (or more than one) in your area to your customized options. Your doctor should be able to show you some before and after photographs to give you an idea of what you can expect from both the surgical and non-surgical interventions. Hopefully this will help you make a decision you will feel good about. Best wishes!

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Facelift at 39??

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Hello and thank you for your question.

It wish I could give you definitive advice, but it is very difficult to provide with these limited photos. I can say that I see some joweling and some hanging neck skin that might actually require a face/neck lift to improve. There does appear to be some shadowing/hollows that might also be well addressed with fillers. I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.

Best of luck to you

Facelift vs Filler

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In reviewing your photos, it appears there is some fullness and laxity in the submental and lateral cheek area. I do not believe fillers will give you any improvement in these areas. Even though you may feel you are young to consider facial rejuvenation surgery, it will give you the desired effect. Patients often ask what is the best time. My answer is always " when you are ready to rid yourself of the problem that concerns you most". I would recommend a surgeon who can show you pictures of patients who have similar problems and then the post ops. This will confirm your desire to move forward.

J. Kevin Duplechain, MD, FACS
Lafayette Facial Plastic Surgeon
5.0 out of 5 stars 17 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.