Is a facelift appropriate for a young 24 year old patient if they lost an extreme amount of weight (150lbs)? (Photo)

Question

Patient went from 340lbs to 200lbs in 1.5 years after extreme dieting at age 19. Patient than regain50lbs after a year. One year after this, the patient lost 70lbs. The patient is mostly concerned with the premature aging that has resulted in his face. - under eye circles -pronounced nasolabial folds -upper, mid, and lower cheek sagging -droopy lips - Patient has tried dermal fillers and but has not been satisfied with the results. Would a facelift be appropriate?

Warren Schutte, MD · Answer

From your photos, it does not looks like a facelift at this time would benefit you. An in-person consultation with assessment of your skin laxity would be necessary to know for sure. 
Consider doing skin resurfacing and collagen boosting technologies to keep skin thicker and more youthful. CO2 laser, RF microneedling, etc.

Thomas A. Mustoe, MD, FACS · Answer

Yes.  I have previously done a facelift on a patient after weight loss in her 20s and she was very happy, and a number of patients in their 30s . I do think technique and experience are important. For a natural long lasting result I feel strongly that the best  outcome Woukd be with a deep plane facelift.

Mark McRae, MD · Answer

Congratulations on achieving such significant weight loss 
Losing weight does result in less volume within the facial fat compartments, and can contribute to signs of aging.
That said, based on the concerns listed, facelift surgery would only be able to help address some of them.
The facelift typically targets the lower face, jawline, and nasolabial folds. 
The forehead is addressed in browlift surgeries as well as non surgical modalities.
The area around the eyes (peri orbital) is typically treated with blepharoplasty surgery. If the bags under the eyes are noticeable this can be a very effective surgery.

Particularly in men the mid face over time faces more fat atrophy than in women at the same stage of life. Fillers or fat transfer can be considered in these cases as additional procedures to help address soft tissue or fat pad deficiencies if they exist. This can be as a complement to a facelift, or on its own.

I would not be able to make a recommendation for facelift surgery in your case based on the photos provided here at this stage. However an in person consultation with a board certified plastic surgeon would be worthwhile to help explore your options.

In terms of droopy lips- an upper lip lift can be considered as the distance between the nose and the upper lip increases with time. I don't think he yet meets criteria for this intervention.  He still has a relatively youthful distance based on the photo provided so I would advise him to wait for that.

Congratulations on this inspiring health journey.

Gary M. Horndeski, MD · Answer

I would not recommend a facelift at this age. I would recommend a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey H. Spiegel, MD · Answer

Yes - a facelift can redrape the skin. But, it may be that there are other options as well for this person.  A video or in person consultation will be the best, but, it is possible that there are other options. Some other techniques can tighten the skin as well.

Ronald J. Edelson, MD · Answer

Although there may be a little looseness in your skin a facelift probably would not change the appearance  much.  That’s because you are young with good elasticity

Stephen Prendiville, MD · Answer

I would not perform a facelift based on the photos I am seeing and your current age. Be careful what you ask for, because you might get it from some Surgeon.

Andrew M. Ress, MD · Answer

Despite the way loss you really have very little excess skin.  You have experienced volume loss for the most part. The best way to correct I'm losses to replace volume loss is by using fillers such as wrestling or your own fat and if necessary to  remove a small amount of skin such as with a mini facelift.

Connie Hiers, MD, FACS · Answer

Congratulations on your weight loss!  No, a facelift is not the best option at your age. However, you can get good results with a treatment called Secret which is micro-needling with radiofrequency to thicken collagen, improve your skin's texture and tighten your face and neck with no downtime. It is 3 treatments done monthly.

Scott C. Lindsay, DO · Answer

Thank you for your question! At this age and with the minimal skin laxity you have, no, I don't think it would be wise. There are great lasers, radiofrequency technologies, etc that will help with moderate skin tightening, and I do think that could be a good option/compromise. Good luck!