Do I Need a Lower Facelift at 36, More Fillers, or Chin Implant? (photo)

I just turned 36, One side of my lower face sags much worse than the other one. One side of my face is thinner. I recently got 1 siringe of Radiesse to fill my cheeks and 1 s. of juvederm to fill the sides of the nose. However the filling of the cheeks did not help at all lifting the lower face. Im worried adding more radiesse would make me look overly done. What are my options, is my chin possibly too small? do I need fillers, or a face lift. I want to do something before it gets way worse.

Doctor Answers 19

Facelift or filler for the lower face? Fillers don't pull or tighten.

Thanks so much for the photos. I'm sorry you didn't have more success with the Radiesse. Unfortunately fillers don't pull or tighten anything they just fill. Some patients whose main concern is the sagging along the jawline with early jowl formation could try having the depression in front of the sag filled to camouflage it - but proceed with caution if you decide to go this route since adding more volume to the jowl area can make the problem look worse and add unnecessary bulk to the jawline. I personally would not recommend this for you based on your photos.

The obvious question you raised is should you ideally have a facelift to tighten your jawline. The answer would be a definite yes if you were 50 but a cautious maybe at your age of 36. It would be the most effective option for improving the lower face sagging you describe, but with the highest risk and longest recovery time. A chin implant might improve your result - although more photos including a profile view would be helpful.

Don't rush into it and educate yourself as you are doing here. The video below explains the short incision approach to lower facelift - certainly not minimally invasive - but less invasive than a longer incision facelift that is used for patients who have significant neck sagging.

Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 108 reviews

Facial Sagging

The best advice is to have an in-person consultation with a specialist in the face.  There are a couple of different things going on which is contributing to your facial sagging.  You want to restore balance to your face to have an overall rejuvenated appearance.  Please consult with a board certified specialist who can guide you towards achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Chin and jawline issues

Itis difficult to assess your chin without a true lateral view. I do not think that you are a candidate for a lower facelift at this time. Fillers may help but an exam is essential.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Facelift and Chin Implant in California

Thank you for posting this great question and your photos. The decision for surgery has many factors, but in terms of your specific anatomic issues, it looks like a lower facelift with a chin implant (chin augmentation) would be a great treatment for your jawline and neck. Placing more fillers in the lower face can provide some camouflage, but the overall effect is, unfortunately, to make the lower face heavier -- NOT to provide a lift or improve the contour. A qualified aesthetic surgeon can help you with this decision process. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 113 reviews

Facial Structure Causing Premature Signs of Aging

Thank you for your question and photos.  Unfortunately your facial structure is causing premature sagging of the facial tissues around the lower face. Unfortunately more filler will not help this problem. A lower mini facelift would help.  Buccal fat pad removal would also help.  Unfortunately your photos are not a true lateral, but a small chin implant could also be helpfull to augment the structure of the lower face.  Having said that, you are on the younger end of the spectrum with respect to facial procedures. You may want to wait a bit longer.   You may need to have something done in the future and you don't want to look unnatural later. Best wishes.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Should I get a lower facelift at 36, More Fillers or a Chin Implant?

You do seem to have some relaxation of the jowl area and this benefits most from a lower facelift. Some patients with a lot of fat in the jowls can look better with liposuction of that area alone, but you do not seem to be in this category.

There is a step-off between the chin and the jowl, and a pre-jowl type of implant that augments this area as well as the chin in varying degrees could also give you a more pleasing jawline.

I agree that fillers of the cheeks will not help the lower face.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 49 reviews

Face lift at 36

You are beautiful but you do have signs of early aging.

  • Fillers such as Radiesse and Juvederm won't help much.
  • A lower face lift will help a lot.
  • The fullness by the mouth is probably fat and can be removed. 
  • The asymmetry may be thick muscle. Botox will help. 
  • See a Board Certified Plastic Surgeron about surgery and what can be done for the symmetry. In the photos, your chin seems fine but  your personal surgeon can best advise you about a chin implant.
  • Best wishes! 

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Facelift at 36?

   Facelift at 36 would improve the lower face.  However, the top fat component you have is buccal fat pad fat, and a portion of this can be removed as well.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Do I Need a Lower Facelift at 36, More Fillers, or Chin Implant?

 Aesthetically speaking, from the photos provided, the cheeks are flat and the chin is weak.  Chin Augmentation with a Chin Implant would augment the chin and balance the lower face.  I prefer using Perlane to augment the cheeks, which could be more full anteriorly but no fillers of Cheek Implants will lift sagging tissue from the jowls.  Only a Face Lift will do that.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Lower facelift and chin implant for facial sagging skin.

Lower facelift and chin implant for facial sagging skin would be best for your receded chin and sagging skin. I do not think a cheek lift is indicated for what you have which is well below the cheek.






Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.