I'm 42 yrs old and face is drooping. What can I do without going under the knife?! (photos)

I have significant mid face laxity. I've noticed that one side of my mouth is drooping as well. I was also told that I'm missing buccal fat that would normally support the cheek. Looking at pictures of my mother she had this same issue. Surgery is NOT an option as I can't afford to take off work for that long. Can someone please tell me if there is anything that I can use over the counter or if it's even possible to replenish the fat or laxity I lost. This is so depressing!

Doctor Answers 12

PDO Threads (Novathreads) for NonSurgical Lifting

Thank you for posting your photos.  You are an excellent candidate for a Novathreads procedure to non-surgically lift the corners of your mouth.  Novathreads are dissolvable threads that are placed under the skin to produce a temporary lifting result (usually 9-12 months).  The procedure is easy, done in the office under local anesthesia and does not have any downtime.  This procedure is often combined with other treatments like neuromodulators (Botox/Dysport/Xeomin) and injectable fillers for optimal results.  


Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Non surgical solutions are a good start

Non surgical solutions are a good start since the downtime is minimal.  Over the counter sunscreens will help prevent future laxity of your skin.  Fat or hyaluronic acid fillers can replace the lost fat and and some lasers can help with lax skin.

What can I do without going under the knife?

Thank you for your question and series of photographs.  I would recommend a consultation with a board certified plastic surgeon to assist you in your planned facial rejuvenation.  With the initiation of a good skin care regimen, chemical peels, Botox, and dermal filler use, I think you would see natural, noticeable improvements with minimal downtime.  See the link below for articles of additional information

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

I'm 42 yrs old and face is drooping. What can I do without going under the knife?!

Thank you for your question and the photos.  From your appearance in the photos, I don't think you're ready for a surgical facelift.  Non-surgical treatments like Ultherapy, an FDA approved ultrasound technology, treatment, has been shown to help lift and tighten the brow and neck. In addition, many patients report improved skin tone after Ultherapy treatment.  In addition, some facial fillers like Voluma or Radiesse could be of benefit to you.  Adding volume to the cheeks typically results in a more youthful appearance.   You may also be a good candidate for SkinPen, a microneedling procedure that reduces fine lines and wrinkles and improves skin tone by stimulating collagen.  I would most definitely try a non-surgical approach at this stage. 
I hope this is helpful.  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 61 reviews

Volume and Tightening

From what is visible in the pictures, you do not yet require a surgical facelift to achieve the results you want. Expertly-placed injections of Voluma into your cheeks would help uplift your skin. Keep in mind that because one side is showing more drooping, it is especially important that you receive injections from a physician or aesthetician experienced with Voluma. Additionally, such injections can be combined with Ultherapy treatments which would boost your facial skin's natural collagen production, resulting in tightening of your skin. View the video to learn more about Ultherapy and combining it with other treatments. 

Jennifer Levine, MD
New York Facial Plastic Surgeon
4.3 out of 5 stars 24 reviews

Non Surgical Treatment of Mid Face Laxity

You appear to be an excellent candidate for mid facial fillers like Juvederm Voluma. This is a very specialized procedure and needs an expert injector with significant experience in this area. Even though surgery does not require a significant time off work, injections may be the best option. There is nothing over the counter that will help you.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Non-Surgical Face Lift

Thank you for your question in regards to a non-surgical face lift. A combination of facial fillers such as Voluma and Juvederm can help you achieve your desired goal by filling in volume loss. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 150 reviews

Ultherpay, Fillers and Botox

Dear patient,
A combination therapy using Botox to raise the eyebrows and fillers such as Voluma in the temple area to lift up the brows can result in significant and long term lifting of the forehead.
Fractional Co2 laser Mixto CO2 laser)  and Ultherapy are a little more invasive and more expensive but can also improve the texture of the skin and lift the forehead and neck area. Results can last 2-3 years.

Both these modalities are performed without cutting the skin or the use of general anesthesia.
I hope this was helpful. Yours,
Dr. David R.


A. David Rahimi, MD
Los Angeles Dermatologist
4.7 out of 5 stars 49 reviews

Nonsurgical facelift options

There are multiple nonsurgical facelift options available to you and include:
1) Viora (Radiofrequency) laser tightening
2) Laser resurfacing (I like the cool helium plasma)
3) Threadlift (I prefer the Sillhouette lift)
4) Fat grafting to cheeks, nasolabial fold, lips, and prejowls

Please see link below and contact our office for more details.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 44 reviews

I'm 42 yrs old and face is drooping. What can I do without going under the knife?!

Thank you for your question. Much of what causes facial aging and loose skin is loss of mid face volume in the form of fat. The use of new dermal soft tissue fillers such as Voluma can plump the cheeks, restore an apple cheek, and lift the cheek. For more information on dermal fillers please read the following link:

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.