Sagging skin-face. Need facelift. Could it be minoxidil causing this sag or is this just my skin? (photos)

Question

I have had fillers. But I feel that my sagging skin is getting worse and I look 40 not 32. I've been told to wait for a facelift. But is this really the case. I feel every few months my skin looks even more saggy. Could it be minoxidil causing this sag or is this just my skin?

Ajaya Kashyap, MD · Answer

Thank you for your question.I do not think this is from Minoxidil. There are multiple options to correct the volume loss and "sagginess" that you feel. I would recommend making an appointment with an experienced Board Certified Plastic Surgeon who can evaluate you and offer different options. In my opinion Micro Fat Grafting is an excellent option as is the use of Fillers. All The Best.

Jeffrey M. Darrow, MD · Answer

I am not aware Minoxidil can cause the issues you noted.  Your photos show good facial contour and a sharp jawline.  If fillers have not help rejunvenate the areas of your face where you are beginning to lose some volume, you may wish to have a mini-face lift where some of the facial fat can be elevated to rebuild the width of the face and skin elevation to help lift the corners of the mouth.  This could be done with local anesthesia only.  See a board certified plastic surgeon for an in depth consultation about your best option.

Todd C. Case, MD · Answer

As we age, the facial fat volume decreases and the face seems to fall forward and down creating deepening nasolabial folds, marionette lines and jowls.  If you have lost weight, this may accentuate your facial volume loss making things look saggier or drawn looking.  At your age, fillers or perhaps fat transfer to restore volume should be considered over a face lift.

Mario J. Imola, MD, DDS · Answer

Tissue descent associated with facial aging begins to occur in the fourth decade of life, however, is not clinically relevant in most people until after the age of 40.  In some, however, visible changes can begin in their 30's.  If these people wish to improve sagging skin around the lower face and in the neck, it may be best to start with non-invasive techniques such as Ulthera.Minoxidil can either be given as an oral or topical medication.  Neither forms have reported side effects relating to skin laxity.  Oral minoxidil can cause water retention, skin redness and bloating.Mario J. Imola, MD, DDS, FRCSC, FACS.

Heather J. Furnas, MD · Answer

To my knowledge, Minoxidil doesn't have an appreciable effect on skin sagging, but age does have a gradual impact. A face can lose some of the youthful roundness in one's thirties. Some of the tightening treatments, such as Ultherapy and Venus, can help tighten tissues when patients are bothered by skin laxity, but aren't ready for a facelift. Filler (like Juvederm or Restylane) around the corners of the mouth can also help, and Voluma along the cheek bones can give a subtle lifting effect of the lower face.A facelift is a good option when the skin laxity is more pronounced, specifically when you notice jowls that disrupt the smooth line of the jaw or when the neck skin is loose.If you click on the link below, you can see how Juvederm smoothed out the contours around the mouth.All the best.

Aric K. Park, MD · Answer

First off, I can't say that minoxidil is causing or not causing your issues. There have been no reports to my knowledge of any complications from use of minoxidil like you are describing. What is very common is that at age 32, the fat volume of your face begins to change. This can lead to the sagging around your mouth and early signs of jowl formation. Your options are to have some sort of tightening procedure (laser, radiofrequency, surgery, etc) or revolumize your cheeks. At your age I wouldn't do surgery. I would either tighten the skin with a laser or minimally invasive technique (thermage, ulthera, etc) or revolumize depending on whether you like fuller cheeks. Hope that helps

Frank Filiberto, MD · Answer

You may want to consider a Platysmaplasty, which is a simple procedure which will slow the process of drooping jowl formation. If your present problem really bothers you you should combine it with a mini-lift which would restore your jaw line and remove the droopy jowls stopping the progression of marionette lines.Both procedures take about 45 minutes to perform.

Bryan Mendelson, MD, FRACS, FACS (retired) · Answer

Even though what you notice is the skin, it is not really
sagging skin, but normal aging of the facial tissues, that is of all the soft
tissues of the face,

It is significant that the photos you have posted, both this
time and in the previously, do not show significant sagging, which is  in contrast to
your assessment as posted.

While a facelift is the only way to definitively tighten
laxity of facial tissues, a good facelift still has sufficient laxity to allow
normal movement of the face.The
time to have a facelift is when early laxity is present, with the head tilted
and before the laxity is present with the head in the neutral position.

To have a facelift too early is folly as there is not only
the cost and  the recovery but also  the risk, and the major risk in your situation
is of disappointment with the result, even with the best facelift performed in
the world.

You are young and do not seem to have a realistic understanding  about what a
facelift can deliver. You should appreciate the judgement of the surgeon who
declined to operate on your face.

The reality is that while you can see changes with the
years, all of us have to accept that aging is part of living. While slowing
the aging appearance is possible, to stop it is impossible and in
trying hard you would end up with the dreaded artificial look.

Unfortunately, the photos did not show your cheekbone
structure sufficiently to know whether enhancement of the cheekbone structure
would be beneficial. In general people with well developed cheekbones, not only
look better, strong cheeks also slow the rate of facial aging.

Darryl J. Hodgkinson, MD, FACS, FRCSC (retired) · Answer

It is possible that Minoxidil has contributed to the aging of your face but I doubt that stopping the drug could revberse the situation you have.
You appear to have jowls and a flattened midface so a surgical lift adressing those problems is your only option if non surgical proceedures have been unsuccessful.

Sagging skin-face. Need facelift. Could it be minoxidil causing this sag or is this just my skin? (photos)

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