Q: 35. Began to notice slight jowls under corners of mouth a year ago. Droopiness around the mouth area has worsened, front lower cheeks feel flat & hollow. Nasolabial folds look deep. I appear to be frowning when I let the muscles in my jaw relax. Is this normal aging? Been chronically ill for years, if that factors in. What can I do to help combat the sag? I know facelifts aren’t recommended at my age, but I feel like I look 20 years older than I am. Confidence has taken such a hit.
A: Thanks for sharing your photos.
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.
Heredity will add to the laxity of skin and repositioning of volume losing soft tissues. Your photos appear to show these concerns.
I believe non-invasive and minimally invasive options would be best for you to add volume in your upper cheeks and stimulate tightening and lifting of the jowl region and beginning folds. I suggest you:
- Consult with a talented, Board Certified Plastic Surgeon and his team regarding non-surgical and minimally invasive options. Continue the anti-aging process with:
- A Zein Obagi, MD, ZO Skin Health retinoid program and peels for external stimulation and skin tightening, exfoliation and sun-damage correction
- Well skilled filler or fat grafting of the cheeks and beginning folds
- Sculptra is a minimally invasive injection series of bio-stimulatory filler for face and neck skin tightening
- Minimally invasive jowl and cheek lifting options such as Silhouette FaceLift suspension sutures may be a consideration for your nasolabial / corners of mouth and jowl to chin laxity.
I hope this is helpful. Stay well.
All the best!
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