Droopy lower face. Options? (Photo)

Question

I’m not happy with the lower part of my face. It’s looks droopy on the sides with mouth corners downturned and marionette lines. I’d like to rejuvenate this area, get rid of jowls, lines and fat under the chin, lift the skin and have a more defined & youthful jawline as I used to (last pic). What procedures would you recommend to achieve the most natural result? Should I consider surgery at 36? I’ve had mid face fillers, dysport and Ultherapy a year ago but they didn’t seem to help much.

Muhsin Yilmaz, MD, FEBOPRAS · Answer

At 36, surgery can be appropriate if you have true lower-face and neck laxity, especially since fillers, Dysport and Ultherapy haven't given you the improvement you want.
Based on your concerns, I would consider a lower facelift with neck lift, with selective chin/neck liposuction if there is excess fat. This can address the jowls, downturned mouth area and jawline more effectively than adding more filler.
The goal should be repositioning the tissues rather than simply pulling the skin, which helps create a more natural result. An in-person assessment would determine exactly how much lifting and contouring you need.

Semih Yildiz, MD, FEBOPRAS · Answer

Thank you for including the photos. I can see mild early jowl and marionette shadowing with some fullness under the chin and jawline, but not severe skin excess. At 36, the best choice depends on whether the issue is mostly submental fat, skin/SMAS laxity, or chin and jaw support.

If the neck fullness is the main concern, submental or neck liposuction, sometimes with radiofrequency skin tightening, may help sharpen the jawline. If there is true lower-face laxity and downturned mouth corners, a conservative lower facelift/neck lift or SMAS/deep-plane approach can be more reliable and natural than repeated filler or energy treatments. Fillers and neuromodulators can soften marionette lines or support the chin/jawline in selected patients, but overfilling can make the lower face look heavier.

Since Ultherapy and fillers have not helped much, I would have an in-person consultation with a board-certified facial plastic surgeon or plastic surgeon who can assess your skin elasticity, platysma, bite/chin projection, and submental fat. Surgery is not automatically too early at 36, but the plan should be conservative and anatomy-based.

Ali Cetinkaya, MD · Answer

Sagging around the lower face, downturned mouth corners, marionette lines, and fullness under the chin can occur earlier than expected &mdash; 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 &mdash; 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 &mdash; especially if you're looking for a more defined, youthful, and natural lower face appearance.

Mark Beaty, MD · Answer

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.

Ali Riza Öreroglu, MD · Answer

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.

John Michael Thomassen, MD · Answer

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.

Jacob Tower, MD · Answer

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

Best,
Dr. Tower

Gary M. Horndeski, MD · Answer

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.

Best Wishes,

Gary Horndeski, M.D.

Lexie Wang, MD · Answer

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.

Robert M. Tornambe, MD · Answer

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.

Droopy lower face. Options? (Photo)

Answers (13)

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