What Procedure Accomplishes This Kind of Upward Diagonal Correction? (photo)

I have read extensively about the MFLs and FLs but doctors and I do not think I'd really benefit from the "standard" techniques. I'm 32 but have extra skin in the mouth area that form "pouches" or folds. There is no fat to remove. If I pinch my skin up by my sideburn, this alleviates the problem entirely. So I wonder if a skin-only lift could be done, with the scar in this region (see image). I don't think I need subperiosteal dissection - and doubt I'd benefit from standard MFL techniques.

Doctor Answers 14

Fat grafting versus MACS face lift


Thank you for the question.  Its rare that a 32 year old male without weight loss or other such issues would need a skin tightening procedure of the face.  Common questions that come to mind is if there is an inherent, congenital skin problem or if there has been volume loss in the face.  Fat grafting would be indicated if there is skin problems.  Skin only face lift may be indicated if there is excess skin.  The incision for such a procedure would located at the ear cheek junction and at the side burn.

All the best,

Dr. Remus Repta


Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Facelift at 32


you likely are a little young for a facelift. However, i must provide an alternative opinion to that of some of the other surgeons. facelift incisions that go into the hairline above the ear are noted for distorting/vanishing the sideburn. this can create a very unusual look in some patients. It is more of an issue in women then men but still an issue in men.  The lines you showed are reasonable in most patients (just inside the hairline is good too becuase hair often grows through the scar thus covering it) – the key is careful suturing of the skin to reduce scarring. Furthermore, one should not be overly concerned with scars in facelifts. When time is taken in closing the incisions, and when the appropriate sutures and techniques are used, scars are rarely noticeable. What is more of an issue is when the technique overall is not appropriate and the desired results are not achieved.


Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 57 reviews

Sagging cheek at age 32

Based on your photos it appears that you are a good candidate for facial fat grafting, if you have any excess body fat that could be used as a donor

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

What Procedure Accomplishes This Kind of Upward Diagonal Correction

I think a skin only cheek lift will accomplish what you desire, some call that a mini facelift.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Fold of skin around mouth in 32 year old male

Thank you for your question and the photos. It is doubtful that a facelift will adequately correct what you describe and show in your photos.

One thing to consider is a combination of small cannula liposuction directly to the area with some adjacent fat transfer/fat grafting next to it to blend  and camouflage the contour into a natural appearance.

To be sure, see at least two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Excess Peri-oral Skin in Young Man

Incisions that you have drawn will not improve the excess skin adjacent to your mouth and will result in an unfavorable scar in front of your sideburns. A limited facelift with muscle elevation would help, but I would need to have a serious talk with you before doing this in a young man.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews


I doubt that a skin only lift would help for any significant time, if at all. Trying to correct folds near the mouth by pulling the skin back near the ear doesn't do it. I think it's hard to give further advise without an examination to see how your skin and tissue really move. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Facial Fold Reduction by Modified Facelift?

While diagrams and arrows would suggest that this area could be improved by a pull from the ear area, I doubt that will be effective. It is a long distance from the point of pull and this facial fold area. In addition, it would likely only be effective (even if it will) by causing potential sideburn hairline displacement moving it back right up against the ear. One other option to ponder is reduction of fullness in the fold area by fat removal with small cannula liposuction. I might try that first as it is simpler and some modified facelift approach is always a backup alternative. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Fullness around the mouth and facelift

In general, the farther away a deformity is from the incision, the less effect any surgery will have on the problem.  Your specific issue is in an area rarely directly lifted or tightened by any kind of facelift.  The pull of the skin in any surgery progressively diminishes as the distance to the problem grows, despite what you see when you pinch your skin.  You will be disappointed with the results in an extended surgery, and there is a high possibility of injury to the nerves which move the lips.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon
4.0 out of 5 stars 8 reviews

What Procedure Accomplishes This Kind of Upward Diagonal Correction?

  At 32 years old, I wouldn't be so eager to jump into any type of Face Lift procedure.  Thread and suture lifts are ineffective, IMHO and you're a bit too young to have the scars associated with any type of skin removal.  Aesthetically, your cheeks are quite flat and shaping those with fillers like Perlane or Cheek Implants would create the proper aesthetic cheek shape.  The jaw line could be more flared by using Radiesse to shape and augment the mandibular angle.  Botox can be used to weaken the lower lip depressor, allowing the corner of the mouth to elevate.  This can be combined with a small amount of Perlane to fill out the Marrionette lines.   

 Even if you had a Face Lift, IMO, your face might look too pulled or tight without some facial shaping as discussed above.  Be sure that the surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 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.