Skin Laxity: Neck, Cheeks, Eyes. Bunches, Crevasses. Sunken Cheeks, Temples? (photo)

Skinny Male. Injections, Facelift, Blepharoplasty? 45, skinny. My skin's become very lax. Combined with effect of aging on fat deposits, leaves me with loose skin, hollow, sunken cheeks and temples. Jowl line undefined, flabby. Turning even slightly causes bunches of skin under neck &on cheeks. And smiling even slightly makes massive crevasses around eyes & cheeks. Botox helps, but the lax skin still causes non-dynamic wrinkles. I'd like to give my face a more vibrant look. I'm open to surgery. (I have thick hair). What do you recommend?

Doctor Answers 12

Loose face and neck skin is best corrected with facelift and neck lift

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Thank you for your question..  Based on the limited information available in your photographs it appears that you have most significant skin laxity in the neck and lower face.  At 45 years old your skin elasticity should be excellent and a facelift and neck lift should give you the tightened neck scan look that you show and one appear photos.  If the upper face and mid face look gaunt then fat injection or filler injection can restore volume to the mid face and cheek area and improve and rejuvenate her facial appearance.

Be sure to consult at least 2 plastic surgeons who are certified by the American Board of Plastic Surgery who are experienced and facelift surgery and cosmetic surgery.

Options for skin laxity

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From your photos it looks like surgery, like facelift procedures, would be your best bet. Having surgery earlier than later would be better. good luck.

Hello JP1968

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I would need better side, oblique and frontal photos of your entire face to really give you more specific advice on your face in particular. Yes, your lateral eyes 'crows feet' should be able to be helped signifcantly with Botox placed optimally. Smiling often bunches this skin up also but we want to keep that function. In general, facelift surgery is for sags and bags and can wonderfully improve "bunching up" skin in the neck and face. There are no in-office tightening devices on the market yet that can tighten the kind of issues you are having. Reasonable weight gain should also not be overlooked.

Good luck to you.

Mark Anton, MD, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 38 reviews

Facial rejuvenation options in thin males

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Thank you for the question and the photos.  Aging involves both loss of volume, laxity of deep connective tissue, and laxity of the skin.  Fat grafting and fillers are often helpful especially in males since the replenishment of volume provides a more masculine rejuvenation then skin tightening.  A face lift and neck lift can address the face and neck skin and soft tissue laxity.  You will want to consider this option carefully and make sure that you know what you would like to accomplish and what you would like to avoid.  Consult with a handful of board certified plastic surgeons prior to making any decisions.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Good candidate for facelift.

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The pictures provided do not tell the whole story but the excess skin can only be dealt with by surgical excision. Based on what I see I think you would be an excellent candidate for a well orchestrated facelift.

Face lift and eyes?

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Thank you for asking about blepharoplasty and face lift.

  1. Your photos suggest a face and neck lift, probably with blepharoplasty will help a lot. 
  2. Your skin has visible sun damage. Pre surgery skin care and a TCA peel are needed for your best result. .
  3. The deep lines reflect muscle-skin attachment - you will still need Botox afterwards. Best wishes.


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Traditional face lift which includes a neck lift will address your skin laxity, I would add some structural liposculpture or fat grafting to help volumize the mid face compartments that have lost volume to optimize your results

A comprehensive approach to aging face surgery

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Based on your limited pictures a few procedures you could discuss with your surgeon are:


-multi-level fat grafting

-conservative upper blepharoplasty

If you are not already, ask your doctor about a skin care regimen and treatments to improve your skin tone.  This alone will make you look and feel younger. 

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Face and neck wrinkles and laxity

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 Facial and neck laxity is best treated with a lower face/neck lift that will tighten the muscle layers underneath the skin as well as the skin itself. Cheek implants can be used for a  hollow malar area.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Skin laxity- skinny face.

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These recommendations are based on your limited pictures; adding volume combined with a face/neck lift would improve your features. A more formal exam would be helpful. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews

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.