I have gained 20 pounds since my facelift 2 years ago. When I lose this weight, will my face sag?

At age 73, losing 20 pounds probably will show up in your face, but how much is unknown. Depending on your skins elasticity and other factors such as sun damage, do you smoke? Losing the 20 pounds may be better for your health, and there are steps you can take if your face shows the weight loss such as fillers or a revision surgery. Good luck.

Every case is different.  You might want to wait and see how your face reacts as you lose weight.  If you start to see unwanted signs of laxity you may consider limiting further weight loss (as long as there is no absolute medical need for you to lose more weight).

Thank you for your question.  If you are planning to lose the 20 pounds there is a possibility this will affect the results, especially because at 73 unfortunately patients skin quality is not as elasticity.  All The Best 

One the of the key signs of facial aging is loss of volume.  You can clearly see this comparing infants to the elderly.  As such, any process that causes the face to deflate, ie time, weight loss, or gravity, can increase the appearance of facial aging.  That being the case, all of your weight loss will not come from your face and neck.  If the weight loss does cause some laxity, the facelift can be revised to restore your appearance.  Best of luck

Dependent factors:  How much weight loss?  What is the inherent elasticity of your skin?  Where do the 20# come off your particular body?  Smoke?  Sun?  Quality of the surgery?All the above factors will have some play.  Bottom line is the answer is yes, your skin will show some additional sagging with significant weight loss.  Some more than others.  But you have no choice in the matter.  If you lose the weight...see what happens and if the resultant sagging is unpleasant, I'll bet your surgeon (if he/she has some heart) will give you a super deal on a little touch up.  You'll look better and feel better with the weight loss regardless.  If my patients are going to lose significant weight, I have them at least get close to that weight prior to surgery.  

sfairbaugh,
A 20 pound weight loss is significant, and since aging is so variable and individually based it is hard to predict how much your face will reflect the weight loss.  In general the more you weigh the "fuller" your face will appear, and if the volume loss or sag is significant then there are procedures that you have for correction.  The options may include fillers, fat injections or even a revision surgery to remove excess skin.  Good luck with your weight loss goals!
Dr. Julie Edween

The answer to your question is, "I dont know!"  There is no way of predicting how much of your weight gain was deposited in the facial area and how much volume you will loose in the facial area.  Also, as we all age, we continuously loose volume.  After the weight loss, and after you reach steady-state weight there needs to be an assessment of how much volume loss there is and how much ptosis (or loss of structure) in tissues there.Ptosis is dealt with with some sort of suspension surgical or nonsurgical (exilis, etc)Volume loss is dealt with with fillers/fat/ALMI, etc

As we age we don't make as much collagen which is the building block of skin. As you lose weight your skin will not type significantly. In my experience performing over100 facelifts a year, I offered the patient's an honest evaluation of what to expect. Some patients want to be firmer and more youthful whereas others want a much more natural look. It's important to discuss your goals with your board-certified plastic surgeon

I’m sure your face seems fuller after gaining 20 pounds. Most people like the fuller appearance. It seems more youthful. Unfortunately a 20 pound lose will result in you losing some of that fullness. Fillers might be an option to replace the fat volume that you lose. Dr. Michael Sullivan Sullivan Centre

 Hi, it's unknown if the amount of fat in your face would be sufficient to cause sagging when you lose 20 pounds.  It might cause the cheeks to flatten instead of creating "jowls" which remain the primary indication for some form of facelift procedure as discussed below. I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  If after the weight loss you have you "jowls”, in the lower face, these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.