My face is bothering me so much. What do I need to do? (Photo)

Question

Hello. I’m 26 female. And I’m at a loss at what to do. My face is bothering me so much and I see so many conflicting things online about what I can do and what I shouldn’t do. I don’t like the shape of my temples/head, I feel like the divets are deep making my head look weird. I feel like I need a face lift to lift my eyebrows and jowels and smile lines. And a lower bleph for my tear troughs and eye bags. Iv heard horrible things about filler so I don’t wanna go that route.

Semih Yildiz, MD, FEPOBRAS · Answer

In the photos, you have a young face with some natural temple hollowing and mild under-eye shadowing, but I do not see obvious jowls or major lower-face skin laxity that would usually make a facelift the first choice at age 26. Photo review has limits, but the concerns you circled look more related to facial proportions, volume distribution, brow/temple anatomy, and normal shadows than to true facial descent.

A facelift does not reshape the temples or skull, and it is not the usual way to treat tear troughs. A lower blepharoplasty is helpful when there is true eyelid fat bulging or excess skin, but if the issue is mainly hollowing, it can sometimes make a hollow look worse unless volume support is addressed. If you do not want filler, other options to discuss may include observation, skin care, neuromodulator for subtle brow position if appropriate, carefully planned fat grafting, or no procedure if the exam shows normal anatomy.

The best next step is an in-person consultation with a board-certified plastic surgeon or facial plastic surgeon who can examine you without relying on internet trends. Bring your photos and list your top one or two concerns, not every possible procedure. If these thoughts are becoming overwhelming or you find yourself constantly checking your face, it can also be very helpful to speak with a mental health professional alongside the surgical consultation, so any decision is made from a calmer and more confident place.

Lexie Wang, MD · Answer

You need volume. All the areas you circled could benefit from volume and additionally it will give you a more lifted/tightened effect by adding volume. Volume augmentation will help lift the brows, help with the divots, smile lines, jowls, tear trough, etc. If you don't want to do traditional filler, you could consider doing surgical fat grafting, although that will require that you have fat to spare on your body. If you don't, then your only option is to consider something artificial like hyaluronic acid filler or a biostimulator (sculptra/dilute radiesse) to build your own collagen. For your face and your concerns, you are very hollow, so I would anticipate needing 5-6 syringes worth at least.

Gary M. Horndeski, MD · Answer

I recommend a frontal browlift. This will lower your hairline, decrease the vertical length of your forehead and pull up the eyebrows medially. At the same time, I 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. After this, you can consider a lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

My face is bothering me so much. What do I need to do? (Photo)

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