I have wrinkles and sagging from corners of mouth to chin, making me look OLD. How can I fix this? (Photos)

Thank your for the question. It's best to see standardized full face pictures from all angles (front and profile). Facelift addresses the jowls and sagging skin in the lower face/neck area and improves the jaw line and neck contour. It's also common to do fat grafting for malar augmentation as part of the procedure to get the youthful cheek back. Facelift is not a replacement for skin care and it does not address acne scars or other fine lines.  You are too young for a face lift. I would start with a good skin care and non-invasive facial rejuvenation methods, including fillers for malar augmentation  and improving the nasolabial and marionette lines. I would consult with a plastic surgeon and discuss your specific concerns. Best of luck!
Pej Aflaki, M.D.
Johns Hopkins-trained Plastic Surgeon

Thank you for your question.  In order to tighten and smoothen the skin you would likely need both procedures.  The facelift would get rid of the sagging skin and and will take care of the wrinkles around the mouth.  However, it would have minimal effect on the appearance of the acne scars.  Skin resurfacing (laser or dermabrasion) would be the best procedure to improve the surface of the skin.  It will make the skin appear smoother and would greatly complement the rejuvenating effect of the facelift.Best wishes!Dr. Konstantin

Many women your age notice a significant degree of sagging and wrinkling that is best remedied with a full rhytidectomy (facelift). Though your photos are not complete, they seem to show some volume loss in the mid face, which can be improved with fat grafting done during the facelift. I’d also recommend a neck lift with platysmaplasty to fix your sagging chin and neck, plus a chemical peel to improve the wrinkling and stimulate the production of new collagen. Microneedling could help improve the scars.
Moisturizer isn’t enough at your age; you need a serious skin-care program that includes retinol and hyaluronic acid. Also, because you live in Nevada you have to be sure to wear sunscreen outdoors, while indoors near windows and while in the car. Don’t go outside without a hat; sun will damage your skin sooner than anything. I hope this helps.

Your best option would be a facelift or mini facelift.  The issue is excess skin gathering around the corners of your mouth.  The lines formed can sometimes be filled with HA fillers or fat grafting but eventually it is the excess skin that needs to be addressed.  

A facelift is a good option when the face looks better with pulling the skin tighter.  There's no way to do that will fillers, lasers, Ultherapy, Thermage, etc.  If significant skin tightening is needed then a facelift is the way to go.  There are different ways to do facelifts and though I don't like the term "mini-facelfit", because that tends to get overused as a marketing tool, someone with just a little early aging in the lower face/jowl area does well with that minimal incision approach.  That can often be done in the office under local anesthesia too.  Seek out the opinion of a board-certified plastic surgeon.  Best of luck.

The loose skin and changes in jawline and neck contour would be best improved with a facelift.  The acne scarring and skin irregularities will respond best to skin resurfacing and possibly some laser treatment as well.  I would expect an excellent result in the hands of an experienced surgeon.

Thanks for sharing.  You would be a candidate for a mini lift to tighten and lift the area of concern.  Another non surgical alternative would be the Profound RF Microneedling device to help tighten the area as well.  Again both options target the area of sagging that you are concerned with.  Seek an experience facial plastic / plastic surgeon for recommendations.

Silhouette Instalift is the Best way to lift the lower Face, smooth out the skin and replace volume, especially when the neck and cheeks are not showing excessive laxity.  The Silhouette Instalift are absorbable threads with attached mini-cones that lift the lax skin and stimulate your own collagen formation.  This improves the contour of the skin and lifts mild to moderate laxity of the facial tissues into position. The threads are placed using local anesthesia in the office setting.  The  lifting of lax tissue and volume replacement last up to 2 years. 

For the pictures you send, a lower face with SMAS work can help enormously, but working with a dermatologist also be essential to obtain optimal results.

There are 2 issues here.  Your acne scarring could best be addressed with careful filling with a filler, which is easy, minimally invasive and easily reversible should you not like it.  The skin smoothing could best be achieved with a mini-facelift, which tightens and smoothes the skin with minimal scarring and a short recovery time.  See a board certified plastic surgeon for a consultation.

Hello and thank you for your question.  I do feel that 42 yo can be a bit early for a facelift.  However, if the concerns you have are located in the oral commissure and jowl areas, then a mini facelift or type of facelift with more limited incisions will certainly help and resolve the problem. This would then give you years of improvement. Other modalities that are less invasive may be useful as well and an in person consultation would be best with a qualified facial plastic surgeon.  Our facelift consultations are complimentary and we can cover all of your available options to come up with the best plan possible for your individual considerations.  Best of luck to you.