Ponytail facelift at 20?

Question

I am 20 years old, but i already have prominent eyebags and nasolabial folds. I'm looking for a permanent solution, so I am NOT interested in getting fillers or facials. I know there are less intense options such as the mini facelift, but I really like the look of a ponytail facelift, I feel like it changes the entire face in a way other procedures can't. Am I eligble for a ponytail facelift at my age? Are there any side effects getting it at 20 other than potentially worse scarring?

Semih Yildiz, MD, FEPOBRAS · Answer

At age 20, true facial laxity that needs a facelift is uncommon. Prominent eye bags and nasolabial folds at your age are more often related to genetics, lower eyelid fat, tear trough anatomy, cheek structure, facial volume distribution, skin quality, or bone support rather than loose skin. A physical exam is needed to know which of those is actually present.

A “ponytail facelift” is also not one single standardized operation. It is a marketing term used differently by different surgeons. In general, these procedures lift the temple, lateral brow, upper cheek, or midface to some degree. They usually do not directly correct lower eyelid bags, and they may only modestly affect nasolabial folds. If the main problem is under-eye fat or a tear trough, a lower blepharoplasty or fat repositioning may be more relevant than a facelift. If the folds are related to facial structure or cheek support, a lift may not give the change you imagine.

The risks at 20 are not just worse scarring. Other concerns include an over-pulled or unnatural look, hairline or sideburn distortion, temple widening, visible scars, hair loss around incisions, numbness, asymmetry, nerve injury, prolonged swelling, and the possibility that you may need revision surgery as your face continues to age. A lift done too early can also make future facelift planning more complicated.

Wanting a permanent solution is understandable, but permanent surgery is only helpful when it matches the anatomy. I would not choose this operation because you like the “ponytail” look online. I would start with an in-person consultation with a board-certified plastic surgeon or facial plastic surgeon who can evaluate the lower eyelids, cheek position, skin laxity, facial proportions, and whether any surgical option is appropriate at all. In many 20-year-old patients, the safest recommendation is no facelift, or a much more targeted procedure only if there is a clear anatomic reason.

Safa Manav, MD, FEBOPRAS · Answer

At 20 years old, undergoing a ponytail facelift for prominent eye bags and nasolabial folds might not be advisable due to the ongoing natural aging process and potential for overcorrection. Younger skin typically has good elasticity, and non-surgical treatments like laser therapy or microneedling might effectively address your concerns without the risks of surgery and scarring. Consulting with a board-certified plastic surgeon can help determine the best approach for your specific needs.

John Michael Thomassen, MD · Answer

A more targeted facelift that lifts the cheeks with incisions only in your hairline is a good option when a younger patient has deep nasolabial folds.  A face to face or video consultation can be done to determine if you are a good candidate.

Thomas Trevisani, MD · Answer

Without the benefit of physical exam or at least seeing the photos- it's difficult to comment accurately. It is best to set up consultation with experienced Board Certified PS to review your options

Alan Gonzalez, MD, FACS · Answer

Hello @Leila1122, thank you for your question. At 20 years old, you are likely too young to consider a Facelift. Before considering such an invasive procedure, it's important to explore the non-surgical options available to you. Non-surgical treatments such as Morpheus 8 or Ultherapy use Ulthrasound or radiofrequency energy which helps stimulate collagen production in the skin and ultimately provides improvement of structural features like sagging jowls or marionette lines. These procedures also don’t typically involve any fat loss. Be sure to talk openly with your doctor about all treatment options available so that together you can decide what will work best and make a non surgical protocol according to your goals and needs! Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Michael S. Kluska, DO · Answer

20 yrs old is extremely young for any type of face lift surgery. Without seeing your pictures it’s hard to address your options but you may want to look into facial balancing with injectable fillers and or fat grafting. Keep in mind nothing is permanent and whatever you start this young will require multiple procedures about every 7-10 yrs to maintain.

Metin Temel, MD · Answer

With the incision made in the temporal region, the eyebrow, eye corner and cheek tissue can be suspended upwards and can be applied at the age of 20, but it may not be appropriate for me to comment further without seeing the photo. Evaluation on the photo will enable me to interpret it more accurately.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are based on facial skeletal structure.
It’s unlikely you have a soft tissue abnormality.
This is one of the reasons a facelift is most likely inappropriate at your age.
The ability to make accurate assessments for facial aesthetics is inherently complex and for some individual treatment options are limited.
From what you describe a face/brow lift does not sound like a wise choice.
To make an assessment, we at minimum need to see proper pictures.
If you schedule consultations with plastic surgeons, expect at least some of them to offer you surgical solutions. That doesn’t mean having surgery is a wise choice.
Successful plastic surgery is usually based on first having a clear understanding of what the problem is.
The treatment should be aimed squarely at treating the primary underlying cause.
Best,
Mats Hagstrom MD

Berat Cigdem, MD - Account Suspended · Answer

Since you are 20, the issue isn’t aging but more likely related to your facial skeleton. Based on your description, you may have a “negative vector” in the midface, meaning your cheekbones are set back compared to your pupils. This can lead to under-eye bags and nasolabial folds.
As you prefer a permanent solution instead of fillers, a cheekbone implant would address the root cause. You could then combine it with a ponytail lift (or temporal lift) to enhance the upper and midface for a refreshed look.

Ponytail facelift at 20?

Answers (9)

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