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My face looks like it grew downwards or sagged. Do you have any suggestions?

Dr. Dean Kane Q & A. shutterstock_77837938 Q. I looked a lot better in my 20s. The thing is I have lost fat and muscle in my face and my face grew downwards, so when I’ve lost the facial fat and muscle due to aging I look a lot older. I’m only 38. My self esteem is really low, because I was a somewhat attractive young man and this happening so fast was a shock. A.  So sorry for your troubles! Your photos show significant changes but many options can help. Thanks for sharing your pictures with us. ​Aging may be active due to more rapid decline in hormone levels or other concerns which should be explored with your primary care physician. Weight loss will accentuate the aging process in the face. Mostly, it is a passive descent after our physiologic and physical peak near our 30’s. ​ ​Your mustache and beard maybe camouflaging the soft-tissue laxity and descent of the skin along your nasolabial and marionette fold with loss of volume in your cheeks as they descend to the jowl and jawline. Hair loss too may be a cause of your concern. ​ ​Skin firming with improved texture changes can be achieved with:
  1. ​Retinoids such as Retin-A and retinol and the ZO (Obagi) Skin Health Therapeutic Systems.
  2. ​Sculptra to firm and “shrink” skin
Volume redistribution and fold filling will help:
  1. ​Voluma, Juvederm Ultra Plus or Perlane in the cheeks
  2. ​Juvederm or Perlane / Restylane for the nasolabial folds, corners of the mouth and marionette folds.
Address hair issues with an appropriate specialist or consider remaining hairless as many men do. ​ Consider a mini-facelift:
  1. ​To suspend the falling soft tissues of the cheek and jowl back up to the high cheek area, and
  2. ​Re-drape the skin of the jowl, neck and jawline upwardly.
In all the above options, proceed to a well experienced, Board Certified Plastic Surgeon or ENT facial surgeon who performs all of the alternatives for your best unbiased approach to rejuvenation. ​ ​I hope this helps. All the best!
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