Best Options for Sagging and Droopy Face?

Sagging of the facial skin and underlying tissue over ligaments attaching the skin to the bones can cause a droopy face even in the mid 20s and 30s. They can never be corrected by just filling the face with fillers. There are various types of facelift procedures that can be helpful to different age groups. A mini-facelift working on SMAS and minimal scar can help a young patient with lower face sagging (early jowls) however an older patient with sagging of the brows, midface and neck would require a full face and necklift. A proper facelift procedure involving pulling the SMAS should be performed for best results. I personally in many among other techniques use the composite facelift technique where a SMAS flap is elevated with minimal skin dissection, a very quick recovery and very long lasting result. This can be narrowed to a mini-facelift with even less skin dissection and shorter operating time (ideal for younger patients). Some parts can also be filled with fat grafting (Lift & Fill) to enhance to overall result and make you look even younger. Reduction of your buccal fat also through the same approach will help you get a nice and tight "nefertiti" result.
There is no age limit for facelift surgery. What is important is deformity the patient has and his/her expectations. It is usually easier and safer to perform surgery on a younger patient. In general I advice my young patients to undergo preventative care procedures. These include regular botox injections, fat grafting if a depletion in volume is starting to occur and superficial skin tightening procedures that DO NOT damage the underlying tissue (such as needle RF). While these procedures usually make the younger patient looking for facial rejuvenation happy, not all will be satisfied if the deformities are severe (regardless of age). As a rule of thumb, if there is sagging of tissues and excess skin, a facelift operation is inevitable!
Hope this helps,
Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

I am generally against the idea of disguising volume loss by removing more volume (such as a buccal fat pad removal). Buccal fat removal is appropriate for some patients, but based on the photo provided, adding volume to the upper cheek area would probably be most helpful. This can be done with injectable fillers, fat transfer, and even cheek implants. I do not think any type of facelifting procedure is indicated.Be sure to see an expert who can review all of the surgical and non-surgical options with you in detail.All the best,

Hi,
You are a great candidate for in-office fat grafting or filler. I would not advise a mid-face lift or buccal fat pad excision to address the concerns you mentioned. I encourage you to seek out a surgeon who is highly trained specifically in aesthetic plastic surgery, and someone who you feel comfortable taking care of you throughout the pre and post procedure period. Thank you very much for your question. 
Mark G. Albert, M.D.
NYC Aesthetic Plastic Surgeon