I am hypothyroidal. Will my sagging facial skin and jowls reform when my thyroid is treated? (photos)

"I suggest reaching out to an expert for a formal consultation. I like to recommend my patients start a combination of facial rejuvenation treatments.

1) Skincare with products and microneedling/PRP
2) PDT Light Therapy a few times per month with growth factors
3) Laser treatments like Clear + Brilliant regularly and others (Fraxel, Moxi, Viva, CO2, Erbium, Halo) a few times per year
4) Sculptra injections a few times per year for collagen production with fillers like Juvederm, Restylane, Belotero, Radiesse, and/or Bellafill
5) Thermage/Ultherapy for yearly skin tightening with or without PDO or cone-based Instalift threads for lifting
6) Botox every 2 to 3 months to stop movement lines and prevent lines at rest

Best, Dr. Emer."

Thank you for your question. As your thyroid hormone levels are normalized your skin quality may improve with time. Have you lost weight recently? Weight loss can affect fat distribution in the face and lead to the appearance of skin laxity. If with time you do not see improvement, there are so many helpful options to tighten your skin and regain your volume loss. Sculptra is a great option to re-volumize, this helps to encourage your own collagen to be produced and can help replace volume loss in cheeks and folds. Tightening procedures such as the Ulthera is a great way to tighten skin without any surgery. See a qualified dermatologist to guide you. Best, Dr. P. 

I am sorry to tell you that you will feel better, you may lose weight, and there will be subtle changes in your skin, but laxity or looseness does not usually improve to a degree that will be considered "back to normal."Of course, the primary goal will be to correct your hypothyroidism with appropriate thyroid therapy and follow-up visits and blood tests by your physician or endocrinologist. See what happens to your skin. If I'm wrong, then good for you. If not, then you have numerous options, which will have become necessary anyway as you continue to mature (nice way of saying grow older).If plastic surgery is on your roadmap, take the time to see one or more ABPS-certified plastic surgeons (ASAPS members) with experience in facelift/necklift surgery. At least then you can make an informed choice to proceed with looking like you want to and now feel like, or to accept the changes you see and take a vacation instead! Either way, it's better than feeling sad. Best wishes! Dr. Tholen

From the submitted photos it appears you have both a loss of facial volume and skin laxity. These are unlikely to completely resolve when your thyroid is balanced. There are options to consider for improvement such as FaceTite, fillers, Morpheus8, or a surgical facelift. Once your levels have stabilized see a provider near you to learn more.

Thyroid levels effect your metabolic rate and thus weight which affects the neck contour. When you are hypothyroid, you will likely carry more weight on your neck which will make it fuller and heavier; when you are hyperthyroid, you will carry less weight on you neck so your neck will look thinner but you will have more loos skin.