My face is saggy from smoking and weight loss. Is 24 too young for a facelift? (Photos)

Question

I’m 24, with severe skin laxity from years of smoking and having an eating disorder which caused me to lose A LOT of weight really fast. My body is fine, but my face is so saggy I hate going out in public, it breaks my heart. I’m tapering off of smoking, but the damage is done. Is there anyway to save my face besides a face lift??? It makes me so depressed :(

Bryan Gawley, MD · Answer

At 24 years old, I would not recommend a facelift.
Looking at your photos, I actually don’t see the type of facial aging or tissue descent that would typically make someone a facelift candidate. What I do see is a young face that has likely been through significant physiologic stress from rapid weight loss, smoking, and perhaps some volume depletion. Those factors can absolutely affect skin quality, facial fullness, and how you perceive your appearance.
The good news is that a facelift is almost certainly not your only option&mdash;and in my opinion, it would not be the right first option.
The first step is lifestyle modification. If you’re still smoking, continuing your smoking cessation journey is one of the most powerful things you can do for your skin. Smoking accelerates collagen breakdown, impairs blood flow, and contributes to premature aging. The body and skin have a remarkable ability to recover once that ongoing damage is removed.
The second step is focusing on comprehensive skin health. At our practice, we call this SkinFitness&trade;&mdash;the idea that healthy, youthful skin doesn’t come from a single treatment, but from a personalized plan. That plan starts with a consistent daily skincare routine designed to improve skin quality, support the skin barrier, and stimulate collagen production over time.
Once that foundation is in place, you can build upon it with treatments that help strengthen the skin and support collagen and elastin remodeling. Depending on your anatomy and examination findings, those options might include:
Medical-grade skincareRetinoids and collagen-stimulating ingredientsMicroneedlingRadiofrequency microneedlingLaser treatmentsSkin resurfacing proceduresVolume restoration if weight loss has caused facial deflationAfter you’ve optimized your lifestyle and skin health, it may be worthwhile to meet with a board-certified plastic surgeon for an in-person evaluation. In select patients with early laxity, there are minimally invasive skin-tightening procedures such as Renuvion® or FaceTite® that can sometimes provide improvement without the downtime and commitment of a traditional facelift.
Most importantly, try not to be too hard on yourself. At 24, your skin still has tremendous regenerative potential. The photos you shared do not suggest someone who has “missed their window” or requires major surgery. I would focus first on restoring your health, maintaining a stable weight, quitting smoking completely, and developing a long-term SkinFitness plan before considering any surgical intervention.
You may be surprised how much improvement can occur over the next 12–24 months once those fundamentals are optimized.
&mdash; Dr. Gawley

Semih Yildiz, MD, FEPOBRAS · Answer

At 24, a facelift is uncommon and should not be the first assumption, but age alone is not the deciding factor; skin quality, weight stability, nicotine use, and facial volume loss matter more. In the photos, there appears to be some cheek and lower-face skin laxity when the skin is pulled, but the images are limited and do not show enough to decide that a facelift is necessary. A good evaluation would look at whether the main issue is loose skin, loss of facial fat/volume, skin texture from smoking, or body-weight and nutrition changes.
Before elective facial surgery, the safest step is to be fully nicotine-free for the period your surgeon requires and medically/nutritionally stable after the eating disorder and rapid weight loss. Some younger patients improve with time at a stable weight, skin care, lasers or energy treatments, or carefully planned volume restoration; a facelift or limited lift is usually reserved for clear structural laxity that cannot be corrected otherwise. Because this is causing significant distress, it is also worth involving your primary doctor or mental health support while you explore options, not because the concern is not real, but because the decision should be made from a stable and supported place.

John Diaz, MD · Answer

At 24, it is very uncommon to be a candidate for a traditional facelift, even with a history of smoking or weight loss. In younger patients, facial sagging is usually related to early tissue laxity, volume loss, or skin quality rather than true aging of the deeper structures. In these cases, I may consider a very limited or endoscopic-assisted facelift only in select situations, but more often I focus on targeted treatments that address skin health and volume while preserving natural facial movement.

Liann Casey, MD · Answer

Hi there! The face lift surgery is also known by its more medical name, "rhytidectomy." The name means "wrinkle removal." The goals of surgery are to remove signs of aging such as wrinkles, jowls, and visible sagging. I do not think you would benefit greatly from a face lift surgery as you do not exhibit these aging hallmarks. However, if skin quality is your concern, there are many non-surgical treatments to improve skin quality. After smoking cessation, the least invasive would be to start a daily skincare regimen with peptides and actives that stimulate collagen and elastin production. Wear sunscreen daily. Procedures that cause controlled injury to the skin can help stimulate regeneration and thickening, such as microneedling, Morpheus8, and laser treatments. I would stay away from fillers as you look like you have very nice volume. You are young and healthy and full of life- get out of the house and enjoy it! With sunscreen on!!!

Ajaya Kashyap, MD · Answer

Thank you for your query. You may benefit from non surgical procedures. I would recommend radio-frequency based skin tightening along with autologous fat grafting. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. I recommend starting with filler rather than jumping straight to a facelift, especially at 24. Significant weight loss and smoking can create a saggy or hollow look, but in someone your age, this is usually due to volume loss rather than true structural sagging that requires surgery. Strategic use of hyaluronic acid fillers—sometimes combined with skin-quality treatments—can restore support, improve facial contours, and create a more lifted appearance without the invasiveness, cost, or long-term commitment of a facelift. I hope this helps and best of luck!

Albert Yang, MD · Answer

Stop smoking is a really good decision! keep it up. If you have stretchy skin in other parts of the body and joints or heart condition. Consider getting worked up for ehlers danlos first as that will change the management a little. 
If the stretchy skin is to be improved. I would consider deep plane face/necklift . The smoking history would make other type of facelift more complication prone.

My face is saggy from smoking and weight loss. Is 24 too young for a facelift? (Photos)

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