Solutions for Extremely Loose Facial Skin?

It’s unusual to have severe skin
laxity in someone who’s only 21 years old.  There are several possible explanations for this
phenomenon.   Possible
explanations include loss of subcutaneous tissue following weight loss,
inadequate support of the underlying bones and genetic connective disorders
such as Ehlers Danlos syndrome.

It’s virtually impossible to make
any type of recommendation without pictures or a physical examination.  In addition, it’s important to
investigate the cause of this premature skin sag before a treatment plan can be
formulated.

Depending on the cause of the skin
sag, a variety of treatment options may be possible.  These may include procedures to augment the underlying boney
skeleton or increase the volume of the subcutaneous tissue.  In other cases excess skin can be
removed and tightened with standard facelift techniques.  If genetic conditions are identified, surgery may not be an option.

Under these circumstances
consultation with a board certified plastic surgeon is appropriate.  This surgeon should be able to help
formulate an appropriate treatment plan.

One would have to really see and examine a person if they feel that their facial skin structure is loose as the plastic surgeon needs to confirm how much fat you have or have not lost in your facial fat compartments. Especially if you’re younger you may need deep layer fat compartment augmentation restoration only and if you indeed have facial skin laxity we need a combination fat augmentation and a Lift and Fill facelift. This would require an evaluation to fully evaluate what type of specific facial rejuvenation procedure would optimally fit your needs to provide you with a natural looking, youthful face.

Hello,
It is rare to have significant loose skin at your age. However, I have performed "re-do" face lifts in women in their 30's!!
Take a look at my web site and you will see a re-do Facelift in a woman in her 30's. I do many re-do face lifts because of the value of the laser vertical lift.
It all depends on your your expectations and how you look now.

Because of your age, it's unlikely that a facelift is what you need without looking at your pictures. You may have a skin disorder, such as cutis laxa or Ehlers Danlos syndrome. Check with your dermatologist to see if a skin biopsy is indicated. However, if all is well with your skin structure then you may want to consider a facelift.

Severely sagging facial skin at 30 that began when you were 21 has me concerned that you may have an underlying collagen disorder.  I would seek the opinion of a qualified rheumatologist to rule-out any medical conditions before seeking the advise of a plastic surgeon. 

There are multiple factors than can cause very loose facial skin at a young age: lack of development of the underlying bony framework, extensive sun exposure, excessive exercising producing low body fat, smoking, or a genetic basis for a connective tissue disorder like Ehllers Danlos Syndrome.The options to improve the cosmetic appearance include surgical procedures, non-surgical treatments, or a combination of both. The optimal approach would depend on your anatomy, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure.I would suggest that you have consultation with a plastic surgeon certifiedby the American Board of Plastic Surgery and ideally a member of the American Societyfor Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns and options with that surgeon in person.Robert Singer, MD FACSLa Jolla, California

Ani,

I agree that having extremely loose skin at age 21 is unusual and you may have an underlying connective tissue disorder.  However, it's hard to tell without examining you or seeing a photo. The best thing to do would be to see a Plastic surgeon in consultation to assess your individual anatomy and give you realistic expectations of what surgery can fix. If there is any question that you have an underlying CT disorder, you may need to have this worked up prior to proceeding with any surgery.  Regardless, your surgeon can discuss your options and help you have a better understanding of any procedures.

Dr. Cat Begovic M.D.

What you describe give your age makes me concerned that you may have a congenital collagen disorder known as Ehlers Danlos.  My question to you would be do you have "stetchy" skin elsewhere?   Before you consider any elective cosmetic surgery, please seek the evaluation of a dermatologist or plastic surgeon to evaluate your skin.  After this assessment, you may be a candidate for treatments to add volume to areas that look hollow (fat injections or fillers) or skin tightening procedures.

Extremely loose facial skin in youthful patients can be from genetic predisposition, significant sun-exposure, less than optimal facial bone prominence, and low body fat.  I am in Scottsdale Arizona and have a large facial plastic surgical practice, and it is not uncommon for me to see early facial aging in patients mostly due to sun exposure and the fact that patients like to stay quite thin.  I would say you are a bit young to be seeing this, but I have seen patients like you on occasion.  First, the lax skin needs to be addressed, and in some fashion the underlying supporting structures such as the skeleton of fat needs to be augmented.  Most commonly I will achieve this by performing a facelift with some deeper tissue manipulation (the SMAS) to build up facial fat along the cheekbones to provide youthful contours and projection.  This will provide support to the skin and remove any excess.  Further fullness in the cheeks and cheekbone areas (which will make you look more youthful and help slow the development skin excess) can be provided with actual cheek implants or by fat injections should you have fat to harvest.  These procedures can be performed at the time of your facelift surgery or at a later date.  Finally, further skin tightening can be achieved with laser skin resurfacing which will enhance collagen production and improve the quality of your skin.  I would perform this after your facelift surgery.  All of these suggested procedures can be performed alone, or in combination and it is best to get the opinion of a Board Certified Plastic Surgeon to decide what your particular options are.

Best of luck.

Extremely loose skin at age 30 could be related to collagen disorders such as Ehlers Danlos. You should be evaluated by a dermatologist to determine whether this is the case, before pursuing cosmetic surgery. Extremely loose skin can be tightened up with a tuck facelift. The facial muscles themselves are not loose at all and are attached to the bone; they are not what you are feeling. The excess loose skin is unrelated to the muscles.