Best Options for Sagging and Droopy Face?

Hi, I am a 25 year old female, 5'6" about 130lbs and am very upset with the draggy and saggy way my face has begun to droop. I have had a couple of procedures advised to me and I am now kind of confused as to what I'd like.

I would like to get fullness back in my cheeks and take care of my folds around my mouth also the asymmetry by my eyebrows. I have been given the options of fillers and buccal fat removal or a Mid facelift. What should be the better procedure?

Doctor Answers 19

Best option for sagging brows and cheeks.

A unilateral browlift on the sagging side will give you better symmetry. A cheek lift will improve true sagging, but not if the cheek is already tight as it probably is in your face since you are only 25 years old. A filler will lessen the creases you have without surgery. See an experienced facial surgeon in your area and let him advise you after evaluating your face.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Sagging face

The picture you posted shows a significant asymmetry of the brows. One needs to examine you and decide what the cause is? Is it hyperactive frontalis muscle, or naturally the left brow is higher. The height of the right brow seems to be in good position. Treatment can be as simple as Botoxor a full Brow lift.

The face is also asymmertic the left cheekis fuller, both sides have dropped causing the deep nasolabial folds and loss of volume in the cheek bone area.

Fillers is NOT an option.may be except fat injections,

In fact you may need at minimum a mini face lift with or without fat ijections to the cheeks.

Could not assess the jowles or the neck, need more views (pictures).

Samir Shureih, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 6 reviews

Sagging face in a 25-year old

Some patients whose cheek mass is primarily soft tissue, not natural cheekbones, tend to have early drooping of their cheeks.

It is possible to perform cheeklifts with an Endotine to elevate the cheek mass upwards and out.

It is also possible to augment the cheek area by several methods, each with their own pluses and minuses. Cheek implants, fat injection methods, or autologous nontraumatized fat-fascial grafts (LiveFill(R)) are all possible solutions.

Buccal fat pad removal is an excellent operation in the right patient, but not in patients who are too young or don't have a congenital "chipmunk face", so I would avoid that procedure.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 134 reviews

Correction of Facial Sagging

When your pants fall down, you will never get them up again by filling the pockets with more change (placing filler) or by removing change (taking the buccal fat pad). The only way the pants are coming up is to reach down and pull them up.

This is true in the case of the face as well. Either a Cheek Lift or a MACS Facelift will LIFT the sagging face and because it is mild and you have good skin the results would be spectacular.

NEVER allow anyone to remove your Cheek (Bichat's) Fat pad You will end up looking prematurely old with that oh-so-attractive- AIDS hollowed face look. The operation is only indicated for moon facies which could stand a partial removal NOT in people such as you.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

Facial Sagging in a 25 year old - what to do?

You are specific in your wishes _ you want fuller cheeks, less folds around your mouth and more eyebrow symmetry. Because you are in your 20's in particular it is probably not  loss of elasticity as your major problem. I would therefore start simple with fillers and Botox. If you are able to achieve the result you want without surgery then I would wait. I would not recommend buccal fat pad in your case as you don't have a round face appearance.

Re: fillers start with "HA" type fillers like Jeuvederm or Sculptra/Radiesse which are more long lasting  to see if you like the results. Do it in a step wise fashion over 2-3 treatments. If you do like the appearance when they start to disappear you can consider a more permanent solution like fat transfer, midface lift or other cheek augmentation procedure.

Dermal fillers versus a lower facelift

Patients today have many options for facial rejuvenation of the lower face. Dermal fillers are extremely popular impatience I want to correct the nasolabial folds and marionette lines (otherwise known as the smile lines). If this is your main concern, a dermal filler may do the trick.

If you're interested in changing the shape of the jaw or in redraping the skin on your neck, a lower facelift or in your case, a midface lift would be more appropriate. Your best bet is to work with a board-certified plastic surgeon who has great deal of experience in lower facelift & midface techniques, dermal fillers, and facial rejuvenation. They will be able to assess your concerns and recommend a course of treatment that will meet your personal goals.

Consider Orthognathic surgery

A lot of plastic surgeons will address the soft tissues of the face, however few go to the extent of performing bone reshaping of the face. In someone as young as you, I would prefer the latter after addressing the issues at hand. We often forget the proportion of the face and by evaluating the picture provided, it seems that you may have a very long mid face. The face can be divided into thirds in a vertical fashion and the length of your mid face makes your cheeks look descended. So the problem may not be the soft tissue rather the bone structure. You also have a long forehead and this too throws off the proportions some. I would be weary of addressing the soft tissue with any lifting or facelift techniques until the bone is addressed and worked up using imaging. I personally don't do these procedures however I would not operate on someone like you until I consulted with a orthognathic surgeon who may recommend a maxillary impaction, which would decrease the length of your mid face. The brow asymmetry could be treated with a simple botox treatment or a contralateral brow lift depending on physical exam findings and treatment of the other things mentioned first. Hope this helps. Unfortunately not an easy answer.

Sergio Alvarez, MD
Miami Beach Plastic Surgeon
4.7 out of 5 stars 185 reviews

Face Rejuvenation at Age 25

All in all, I think it is premature to discuss facelift at your age.  I personally would stick with non-surgical methods of facial rejuvenation.  Fat transfer may assist you with adding volume to your cheeks.  In addition, soft tissue filler such as Juvederm, Voluma or Restylane can assit with covering up the jowl area and nasolabial folds.

Best option for saggy face

If your skin sagging is so severe that cannot be fixed with non-surgical approaches, if you want to have an immediate result and you don’t want to wait for months to see the results; then you might be a good candidate for a face lifting operation. There are several techniques for face lifting operations the ones with minimal retractions and the ones that with a more aggressive approaches. You can decide the best technique that will work for you in the consultation with your doctor.

Midface lift

if you are looking to fill the hollowing of the tear trough by elevating the lid-cheek junction, the midface lift is the better option.  and more durable.

Ethan Philpott, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 16 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.