I am 36 years old. Do I need a facelift?

Dr. Dean Kane Q & A. shutterstock_78313426 Q. I am 36 years old. Do I need a facelift? My forehead and cheeks are sagging and it makes me look very depressed. I have to constantly hold a more uplifted expression on my face to combat the sagging. My eyes look very small because my forehead is almost sagging down onto the brow area. The area around my mouth is extremely droopy, in my opinion, and I have a serious frown if I don’t smile. Also, when I smile my eyebrows become very uneven. A. Thanks for sharing your photo. ​You have described yourself well and may consider surgical, non-surgical and minimally invasive options. ​It is not your age that is so important in which option is best for you, it is the combination of many factor including your heredity, weight loss / gain cycles, environmental exposure. Each, of course, has their advantages and disadvantages and so it is best for you to consult with a Board Certified, well experienced Plastic Surgeon or ENT Facial Surgeon to discuss what is best for you. ​ ​Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below. Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material. Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift. Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed. The most popular of the fillersRestylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin” Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!. Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well. Sculptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent. Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles! Dr. Obagi’s new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin. You may consider: a traditional face and neck lift, short scar face and / or neck lift. Other areas of skin laxity or fatty excess such as the eyebrows and eyelids should also be discussed with your surgeon in consultation for your best and longest lasting options. I hope this was helpful. All the best!
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