Droopy lower face. Options? (Photo)

Sagging around the lower face, downturned mouth corners, marionette lines, and fullness under the chin can occur earlier than expected — not just from aging but due to genetic factors or structural facial anatomy. In your case, since you've already tried non-surgical options like fillers, Dysport, and Ultherapy without much improvement, the issue may lie deeper, at the structural support level (like the SMAS), which non-invasive treatments often can’t reach.
At 36, surgery is not too early — age is less relevant than facial condition and expectations. It's not about being a certain number, but about how your face is aging.
Here are some common approaches for your concerns:
Lower facelift or mini facelift: This targets jowls, marionette lines, and redefines the jawline by repositioning sagging tissues. It typically provides the most natural and long-lasting result when non-surgical methods fall short.
Submental liposuction: If there’s excess fat under the chin, this can help refine the neck and jawline.
Chin/jawline enhancement (with filler or implants): If the lower face is recessed, these can restore proportion and structure.
Targeted filler in marionette lines: May help if there’s still adequate skin tone, but without addressing sagging, the result is usually subtle.
You’ve already taken the right first steps by trying less invasive options. Now might be the time to explore more structural and foundational solutions — especially if you're looking for a more defined, youthful, and natural lower face appearance.

There are both surgical and non-surgical options available to address the concerns you described, depending on your preferred approach. Here are a few options:

Non-surgical:
• Lower face filler (strategic placement to lift corners and smooth lines)
• Jawline contouring with filler
• Skin tightening (such as Morpheus8, RF microneedling, or the newer Ultherapy)
• CoolSculpting for under-chin fat

Surgical:
• Mini facelift or lower facelift – directly addresses sagging skin, jowls, and deeper lines • Neck liposuction or neck lift – targets under-chin fat and loose skin
• Corner lip lift (sometimes considered for persistent downturn)

At 36, surgery can be an option if non-surgical treatments haven't been effective, and you seek long-lasting, more dramatic results. A consultation with a facial plastic surgeon is ideal for determining what’s right for your anatomy and goals.

Based on the photos, you appear to be a suitable candidate for a **facelift** surgery. The sagging in your lower face, marionette lines, andskint under the chin (if any) can be significantly improved with a **SMAS facelift**, providing a more youthful and defined appearance. This procedure tightens the facial muscles and deeper tissues, offering a more permanent solution. I would recommend an under chin liposuction if the volume under your chin is fat, rather than skin. This can only be decided after physical examinaytion While other non-surgical treatments, like Ultherapy or fillers, provide temporary results, a surgical approach would give you a more lasting and natural outcome.

A temporal cheek lift will lift your cheeks and jowl area with a small incision in the hairline. This can be very effective and can be done in the office under local anesthesia.

Hello, hope you are well. Great photos, thank you for submitting. FaceTite/NeckTite (bipolar radiofrequency) would be a great non-surgical option for you. This procedure reduces subcutaneous fat and causes soft tissue contraction with no scars or general anesthesia. It is a favored option for patients in their 30s who have relatively mild skin laxity and lower facial/jawline fullness. You will not achieve a tapered jawline by adding filler--a reductive approach is required. Good luck!

Best,
Dr. Tower

You are young and I do not recommend a face lift. What I would recommend is a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $3,000.

Best Wishes,

Gary Horndeski, M.D.

You said you've had dysport- have you had it specifically to the DAO and platysma muscles? I think those are extra strong on your face, causing the face and lips to be pulled down.

I appreciate your concerns, however I don’t think a facelift is needed at this stage. It appears from your photos that micro liposuction of your neck and jawline would do wonders for your profile and define and contour your neck and jawline it most attractive way. Come see me or another board-certified plastic surgeon in our area to explore the best options for you. Best of luck.

Hello,
While less invasive options may sound appealing, they come with limitations. Surgery remains the gold standard for achieving a lasting, natural, and transformative result. By investing in a skilled surgeon and a comprehensive procedure, you ensure that your face receives the care and support it needs—not just for today, but for years to come.
The debate between less invasive procedures and surgical lifting (reshaping, in early years) often comes down to long-term outcomes versus short-term convenience. Here’s what you need to know as a patient considering your options:
Less Invasive Does Not Equal More Natural! The idea that “less invasive” automatically translates to a more natural result is a misconception. Less pulling or minimal intervention means less structural support for your face. While this may result in a quicker recovery, it often sacrifices the longevity and effectiveness of the outcome.
Surgery provides the foundational support needed to achieve lasting and natural results that truly restore youthful contours.
Patients who opt for less invasive options, such as threads, lasers or injectables, may see immediate improvement. However, these changes are often temporary and can lead to irregularities or complications over time.
A proper surgical reshaping via lifting may take months to reveal its full results, but the payoff is a durable and harmonious transformation. Ask yourself if your goal is a faster recovery or a lasting, meaningful improvement.
Non-surgical options are often used to delay surgery, but they can complicate future procedures. Injectables placed beneath the skin can create irregularities or cysts that interfere with surgical lifts. Injecting into the SMAS (Superficial Muscular Aponeurotic System) layer, which contains critical nerves, can cause unintended damage if done improperly.
Surgeons frequently see cases where poorly performed non-surgical procedures make subsequent surgeries more challenging, requiring corrections that could have been avoided.
Choosing less invasive options or “less expensive” might seem appealing initially, but it often results in higher costs over time.
Revisions, corrections, and future surgeries add up quickly. Selecting a skilled and experienced surgeon from the beginning can save you time, money, and frustration.
There are limits to what injectables, lasers, and other non-surgical modalities can do. They have their place, but they cannot replicate the transformative effects of a surgical lift. These treatments are ideal for maintenance or minor improvements but are not a substitute for structural lifting when significant sagging or aging changes occur.
Think of it like dental care: brushing and flossing maintain your teeth, but they cannot straighten or repair them. Similarly, non-surgical options can only “buy time” until surgery becomes necessary.
A successful lifting procedure requires precise skill and anatomical knowledge. A good surgeon doesn’t just perform the surgery; they are also equipped to handle complications, revisions, and any future needs. Avoid practitioners who are newly trained or lack the depth of experience necessary to navigate the complexities of facial anatomy, particularly in areas like the SMAS layer or deeper tissue planes.

My recommended is Mini facelift or Lower facelift might be a good option for more noticeable, natural, and long-lasting results. However, if you’re not ready for surgery, thread lifts could be interim solutions while you prepare for surgical options in the future.