Sagging Skin After Weight-loss at 21. Is a Facelift my Only Option? (photo)

I’m 21 and I’ve been overweight most of my life. I’ve recently dropped 55 lbs over the course of a year. (180, now 125 at 5’2”) I’ve noticed sagging or loose skin and I’m definitely concerned about my face. The sagging became noticeable when my face started slimming about 5 months ago. Should I lose more and my face will firm? Should I look into a facelift or are there other non-surgical ways? Does my skin just need more time and/or a specific care regimen? Facial exercises? Glycolic Peels?

Doctor Answers 23

Facial aging in the young

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i dont think people in their twenties should be considering facelifts

but there are other procedures that make sense

young patients with premature aging can consider

blepharoplasties, browlifts, fat grafting, fraxil, fillers

Austin Plastic Surgeon
4.9 out of 5 stars 62 reviews

Non-Surgical Options May Be Best, Consult A Surgeon

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It’s not unusual for patients to develop facial skin sag following massive weight loss. In older patients who have poor skin tone, a facelift is usually necessary to correct the problem. In younger patients who typically have better skin tone, the skin tends to contract and tighten with the passage of time. In most cases skin contraction takes about a year to occur following weight stabilization.
For this reason, conservative management is usually appropriate when skin sag develops in younger patients. In some cases injectable fillers or fat transfers may be necessary.Rarely modified facelift procedures may be indicated as well.
Your pictures suggest relatively mild skin sag. This may improve with the passage of time.Fillers may be helpful in the short term.
If you’re considering surgical intervention, it’s important that you consult a board certified plastic surgeon.This surgeon should be able to perform an appropriate evaluation and formulate a treatment plan.

Wait until stable weight

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Congratulations on your weight loss!

I suggest you wait until you've reached a stable weight  before considering a facelift. Because you are still young, there is a good chance the skin on your face will firm up again as long as you lead a healthy lifestyle. For now you may want to consider nonsurgical skin tightening treatments such as laser skin tightening and fillers. These are less invasive and may be a better option considering your age. 

Give your skin time to adjust and Consider Facial Volumizers

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It is difficult to imagine that you would be a candidate for a facelift or other surgical methods at your age. Once you have reached your goal weight, allow your skin some time to adjust.  Start a medical grade skin care regimine in the meantime to help your skin snap back into shape.  Also, drink lots of water to stay hydrated.  Quite possibly you may want to consider Scupltra or another injectable filler to add volume to your cheeks to give you a more youthful, rested look.

Best of luck to you.

Dr. Clevens

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Sagging Skin After Weight-loss at 21. Is a Facelift my Only Option?

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Since fat loss during weight loss cannot be directed at one area or another, it is hard to predict what more weight loss will do to your facial appearance. At your age I would suggest getting to your desired weight and then letting things settle in for a few months prior to deciding what to do. At your age I think that non-surgical options like Sculptra should be considered first though, versus a surgical procedure

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

Facelift after Massive Weight Loss at 21

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  From the photo, I would not recommend a facelift.  However, fillers or fat grafting to restore some of the volume or help with the tear trough may be appropriate.  Find the plastic surgeon with ELITE credentials who performs thousands of procedures each year.  Kenneth Hughes, MD Los Angeles, CA

An In Office Evaluation is Required

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Patients really need to be evaluated in person or at least in pictures before deciding upon procedures.  Degree of droopiness and skin quality are very important determining factors.

Jason Pozner, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 46 reviews

Methods to try before resorting to a face lift

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A facelift is probably not necessary at the age of 21. You should get to your desired weight and then wait a few months to see how your skin adjusts. From there you should start with injectable fillers such as:

  • Sculptra
  • Juvederm
  • possibly injections of your own body fat.

A facelift would be a last resort for a 21-year-old and if necessary I would consider a mini-facelift such as the Lite Lift ™.

Facelift after weight loss

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At your age your skin will contract and tighten on its own to a significant degree.  You may notice loss of fullness in the mid cheek just under the lower eyelid.  This relative flattening may respond well to the use of injectable fillers like juvederm or Restylane or possible Sculptra to add volume very specifically to where it has been lost after weight loss. In addition, if you actually have some skin laxity that does not improve with time a minimally invasive skin tightening procedure like Thermage may be of benefit.

Thank you for your question.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews

Facelift following weight loss

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After extensive weight loss, it is important to wait over a year to allow the skin to naturally tighten before any decisions are made. Skin retraction is more likely in younger people and those with thicker skin. Once a stable state is reached, a decision can be made regarding appropriate treatment. In someone young, several alternatives to facelift may be available such as Ulthera, SmartLipo, and laser or chemical peel. In older patients, a facelift and neck lift is frequently necessary.

Nicholas Nikolov, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 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.