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Plastic Surgeon Dr. Dean Kane Answers Question Regarding Facial Drooping

Q: I’m in my late 20s and feel my midface is drooping a lot the last few years. The pics don’t so it justice but it drags my face down making my eyes hollow, my smile frowny and slight jowls. My skin is also very lax and lacks tightness. Early Jowls also run in my family. I want to avoid filler since it’s too expensive in the long run and also my facial skin is very thick especially in my cheeks so I don’t know where to put it without adding too much volume to my face. What are my options?

A: Thanks for sharing your photos. They are useful but not complete.

The beginnings of facial skin laxity start at 30 years old when collagen skin repair diminishes and passive skin aging relaxes downward. The web of fibrous compartments under the skin loses fat, stretches, separates and elongates forming 5 growing “waves” of skin at points of attachment, developing:

  • hooding along the eyes,
  • lower eyelid / cheek junction or tear trough / nasojugal fold
  • nasolabial fold,
  • lateral mouth commissure and marionette folds,
  • jowls and neck.
If you have gone through a weight gain and loss cycle, you may have reduced the volume of the face and similarly create these folds. If weight loss did occur, this may included lower protein consumption and collagen loss may have accelerated.
As you enter your 30’s, consider the reversal of natural collagen reduction and skin tightening, volume filling and non-surgical face lifting options. You do not appear to require any surgical, ie., incisional face lifting. 
I would recommend that you:
  1. with a talented, Board Certified Plastic Surgeon and his team regarding non-surgical and minimally invasive options. Consider:
  2. A Zein Obagi, MD, ZO Skin Health retinoid program and peels for external stimulation and skin tightening and acne / oily skin improvement.
  3. Sculptra is a minimally invasive injection series of bio-stimulatory filler for face and neck skin tightening
  4. In patients like yourself, I have found micro-lipocontouring of the submalar cheeks, jowls and neck with fat grafting of the cheeks and beginning folds to be extremely satisfying. You may combine this with
  5. Minimally invasive tightening options such as ThermiTIGHT or FaceTite, and
  6. Minimally invasive jowl and cheek lifting options such as Silhouette FaceLift suspension sutures 
I hope this is helpful. All the best!

Read more about similar topics:

Making the Decision to Get a Facelift

Skin ZO Obagi Facials and Peels


Silhouette Instalift

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at (410) 602-3322 or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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