Facelift or fillers at 37? (Photo)

Im very concerned about my jowls and smile lines. I'm 37 and otherwise have no fine lines around my eyes just this early jowling and the deep smile lines and scowl lines on my forehead. I am at least 3 hours drive from any doctor to give a reputable response and would love to get your opinions.

Doctor Answers 33

Facelift or Volume?

Great question. Your main issue appears to be a loss of volume. Combined with that, your pictures indicate that you have a mild amount of jowling. It is difficult to assess the neck. There are two approaches that you can take. If you want to be more conservative, you could start with volume replenishment. Dermal fillers such as Juvaderm could be injected to provide more contour to the cheeks. The enhanced volume would provide you with a more refreshed look. Another option for volume replenishment is fat transfer. While fat is not as predictable as dermal fillers, there is the very realistic possibility that you would get a much longer result and can transfer a much greater volume. The downside is that it can be difficult to predict how much will survive.

If you want to be as aggressive as possible, consider a facelift as well as volume replenishment. Again, it is difficult to determine how much value you would get from a facelift from the pictures that you have provided. I would consult with an experienced facial plastic surgeon who can do a comprehensive analysis and present you with options.

Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Facelift at 37 ? Absolutely!

There is no standard timeline by which our genes, anatomy, environmental influences, and lifestyles coordinate their attack on our body inducing the negative changes we associate with "aging".
Some young folk have ragged tired looking eyes before they've hit thirty. Some blessed women don't benefit from much more than sunblock until they celebrate sixty!
On which latitude you live, how many times you've been exposed to pregnancy's hormones, how much weight fluctuation you've experienced, smoking, stressors, how well you process collagen, and how much elastin your parents gave you- are some of the factors which will define when your body, in this case face, changes.
Why is something to consider- so as to determine if things can be done differently henceforth to keep the aging clock moving more slowly.
When however - age 28, 37, 50 - is not really a difficult question. The answer is Now.
We should always be doing something to maintain our bodies- from exercise to hydrating, to sleeping face-up.
However, when we see loss of midface volume, relaxation lines in the nasolabial and mesolabial axes, scowl line etching, early jowling and softening of the jawline -- well, its time to act.
Restoring some volume can be done in the office with temporary off the shelf fillers, and relaxing some pesky wrinkle-causing muscles can too, with a neuromodulator like Botox. But I might recommend you consider using a little bit of your own fat positioned in your face strategically at the time of a conservative and gentle facelifting. I believe that combination will help you smile more- like in your first photo.
Do not be concerned with "whether it is appropriate at your age".
Find a board-certified plastic surgeon whose philosophy and offered approach resonates with you, and enjoy the benefits of modern aesthetic medicine and surgery.
Be well.

Andrea Basile, MD
Naples Plastic Surgeon
5.0 out of 5 stars 9 reviews

Should I have a face lift or fillers

Thank you so much for your question about having a face lift or fillers for your facial changes.

  • Consider Botox for the scowl lines on your forehead,
  • If long term investment in yourself is possible, have a face lift with fat injections.
  • Maintain the result with fillers.
  • If surgery is too much for you at this point, postpone surgery with fillers and save for a face lift.
You have a lovely face - you are smart to want to maintain it.

Be sure to see a Board Certified Plastic Surgeon.
Here’s hoping you find this helpful. Have a great day!

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

Facelift vs Fillers

Dear Marie,
Both facelift and fillers can greatly enhance your look.  Facial fillers rejuvenate the face by adding volume to the lines and deep creases and can soften facial appearance.  Facelift can do the same by getting rid of the skin laxity.  Using fillers for facial rejuvenation is relatively cheep, easy and hardly requires setting aside any time for recovery.   Facelift could be costly, it is more invasive, and requires taking some time off work of for healing.  At the same time, facelift would produce far better and much longer lasting rejuvenation than fillers.  

So, how would you decide which one is best for you? It is actually pretty simple. There is an easy test you can do at home in front of the mirror. Place your fingers on the side of your face and gently pull the skin upwards. If the lines disappear and your face looks years younger - your best treatment is facelift.  If, after pulling, the lines persist and your face does not look quite as good as on the picture with a good lighting - you should use fillers.

There might be some exceptions to this rule, of course, since all our faces are quite different in their structure and aesthetics, but for the most part it holds true.

Best wishes!
Dr. Konstantin

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews


Thanks for sending images.

While it is impossible to make an accurate diagnosis without an exam,
it does appear you would be a great candidate for injections.

Injections to the cheek area such as Juvederm Voluma could provide tightening by reinflating the face.
Your images show a pre-jowl sulcus that would do well with augmentation. This could help camouflage the early jowling that you are seeing. Lastly conservative treatment of the nasolabial folds and marionette lines after volumizing the cheeks would further help with rejuvenation. All of this could be combined with a nonsurgical tightening device such as Viora Reaction to provide further enhancement.

While a minifacelift is an option, I do recommend trying to hold off on this as you are only 37-

Best of luck!

Mark Hamilton, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 43 reviews

Facelift or Fillers

Thanks for your question. As you can imagine there is not a lot you can't have done these days. A facelift should address the concerns you have so can be varied to suit. If your skin is loose, sagging or creating the appearance of jowls you may be a good candidate for Concept™ Facelift Surgery. This type of Rhytidectomy is unique as the facelift is performed under local anaesthetic, and is less invasive than traditional methods, meaning the cosmetic surgery has a significantly faster recovery time. The cosmetic procedure is similar to a mini facelift as it is performed with a short scar that runs in front of the ear, down to the ear lobe and tucked behind the ear. There will be no dressings or drains afterwards. This is performed as a day case, walk in-walk out procedure with minimal bruising and downtime.
Please find a reputable and qualified surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve. All The Best

Facelift or fillers at 37

Thank you for your question.  Start with fillers and or fat transfer to restore volume to your face. Botox will also help rejuvenate.  Consult with a Board Certified Plastic Surgeon. Best Wishes.

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Your facial lines may be helped with a limited facelift for a relatively young age, and volume correction

Jowls are the loss of definition of the jawline because of descent of skin and some fat. However, in your case, I think the descent in this area is relatively minimal. To determine if there is a significant amount of laxity of your skin that would justify a facelift, you can pull your skin back a little. If you see a dramatic improvement, then you might want to consider this as an option. I’ve been doing facelifts for over 20 years and in my practice, the youngest patient I have ever done a facelift on was 37-year- old, and you have some similarity with her: both of you have a relatively thin face, and acknowledged that no matter how much filler that she was going to place on her face or to her mesolabial fold or the marionette line, she wasn’t getting the correction she wanted.

Rare as it is, a facelift in a 37-year-old is done very differently than someone who’s in their 50s or older. We’re not doing the same type of surgery because there isn't as much descent. The type of incision that you would have is usually limited. In my practice, I hide the facelift incision in the inside of the ear and try to follow the natural contours of the ears so it’s well camouflaged such that a woman can pull their hair back and not feel self-conscious, but you still have to be prepared for a physical scar. Fortunately, we use in our practice not only the surgical technique but also a material called extracellular matrix and platelet-rich plasma (PRP) to optimize the wound healing process and to make the incisions as invisible as possible.

I suggest that you meet with doctors to get opinions of what would be of any value. Get an understanding of how much descent and the desire to augment relative lack of volume. If your choice is to give yourself some fullness, then fillers such as Scupltra, hyaluronic acids, Radiesse and PRP can all be done various ways to get the results that you want. There are different areas of the face which these fillers can be appropriately applied. I hope that was helpful, I wish you the best of luck, and thank you for your question.

From my practice, your age would be the youngest that I’ve ever done a facelift for but it is something that is possible. In terms of what effect it would have on you, that requires a professional opinion based on a physical examination. I suggest that you do a limited amount of a pull. If you like the result, then take the next step and travel as far as you need to meet with a doctor that you are comfortable with. Move forward with the plan based on your understanding of the risks and benefits of doing lifting versus volume or combination of the two. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Delay a facelift with fillers at 37

Your pictures show that you have lost a considerable amount of volume, perhaps through weight loss, or as sometimes occurs naturally as we all age. At age 37, you can reverse these lines by using carefully placed fillers. Fillers will help smile lines and can conceal early signs of jowling. You may wish to consider Juvederm, a filler that is regularly used for cheek volumisation which has a positive effect on the smile lines and jowls. I've seen my best filler results with young patients who have not yet developed deep set lines and wrinkles. You should be able to postpone a facelift for several more years with properly injected fillers.

Yannis Alexandrides, MD
London Plastic Surgeon
4.5 out of 5 stars 16 reviews

Facelift or fillers at 37?

37 yo- is somewhat early for a facelift. However, I have had more long lasting results when the facelift is done early. The foundation for facial anti aging treatments is the tightening of the tissues. Once this is achieved - the non surgical treatments have a more beneficial result. So, in short i would do the far and neck now-- and pursue the non surgical treatments after 6-9 months.

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 63 reviews

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