Severely Sagging Skin at 24. Eyebrow Lift/face Lift Needed? (photo) (photo)

Hello,


  Thank you for including photographs with your questions.  It makes meaningful discussion about potential therapies a little more attainable.

  You are still very young and have very healthy skin.  The lower 1/3 of your face looks age-appropriate around the jowls and you have retained youthful contours in your neck.  I agree with you that your midface has signs of aging. 

  Feeling like your appearance suggests an age greater than your actual date of birth is a common complaint.  For someone as young as you the first thing I would do is look at photographs of your parents when they were in their 20s.  Prematuring aging is largely dependent on sun exposure (which you are avoiding) and DNA. 

  The good news is that there are a number of available therapies to help improve the contours of your midface.  I would suggest a good place to start would be to restore volume in your cheeks and midface.  Nonsurgical fillers such as Sculptra, Radiess & Juvederm can be performed in the office.  A longer lasting solution would be fat grafting, which frequently requires a visit to the operating room.  I frequently recommend starting with facial fillers, but given your young age and loss of volume, fat grafting as an initial therapy is certainly a reasonable option.


Hope this helps.

I believe the primary issue is volume loss.  This would be more common at your age than looseness of the skin unless you lost a significant amount of weight.  I agree with the other physicians who recommend that you have a complete examination by your primary care doctor and rule out any medical issues which may account for the volume loss or weight loss.

I do not believe that a surgical procedure is necessary.  I don't see enough laxity to make a facelift necessary.  I do believe you have had a loss of facial volume in the form of loss of facial fat which could be augmented with the use of injectable fillers like Restylane or Juvederm or a volumizer like Sculptra.  These products can be administered in a minimally invasive way with little or no downtime and they will offer a relatively long lasting result.

Thank you for your question.

These are challenging cases, and it sounds like you may or may not in fact be an appropriate candidate for a surgical procedure, especially given how young you are.