I feel bad about my mouth
March 17, 2021 7:42 AM   Subscribe

Younger me never could have imagined that I'd be asking this, but: I'm 45 years old, and considering plastic surgery to correct the noticeably dropping/puffing corners of my mouth. Is this a bad idea? Can you talk me out of it?

As stated above, I'm 45. I'm female but somewhat androgynous presenting. Over the last couple of years the corners of my mouth have started noticeably dropping when at rest. Not only that, there has been a distinct puffiness developing around them, probably from the downward migration of my face.

My face is otherwise fine, I have no age-related complaints. I also have very narrow/thin/sharp features otherwise, so the mouth thing stands out a LOT to me.

I've always thought I'd be fine with wrinkles (which I don't have many of), but the sagging thing is altogether different. I feel like the sagging changes the very shape of my face and makes me look like a different person.

It's worth mentioning that both of my parents have very pronounced sagging skin on the lower halves of their faces, so I may have won a genetic lottery here.

I've done a little reading on procedures to correct this, and I don't think I'd want to go the fillers route, maybe a lower facelift? I feel like now is the right time, thanks to the masks we're all wearing. It might be harder to manage a couple of years from now, assuming masks go away.

The other part of me is thinking, I can't believe I'm even considering this. There are so many things I'd rather spend those thousands of dollars on. I also can't be bothered to spend anywhere near that amount of money on hair, makeup, clothes, etc.

Can I be talked out of this? Should I be talked out of it? It basically goes against everything I've ever thought I stood for.

Could you point me to any pictures of older or elderly women who are appealing even with pronounced sagging faces? The older Audrey Hepburn is the opposite of what I'm thinking; her face was noticeably wrinkled as she aged, but there was no visible sagging.

Has anyone else been where I'm at and made a decision that you felt was right, or that you regretted?
posted by anonymous to Clothing, Beauty, & Fashion (28 answers total) 13 users marked this as a favorite
I have no idea what the procedure itself is like, but just here to say it's your face -- infinitely more important and personal than your clothes and makeup -- and feeling bad about how it looks to you is a bummer every single day. If the procedure is within range for you financially and your research suggests that it's likely to make you feel better about how your face looks, then go for it, 100%. Nobody's going to give you points for enduring embarrassment and discomfort with your appearance.
posted by fingersandtoes at 7:53 AM on March 17, 2021 [15 favorites]

Facial exercises can help a lot. There's a ton of stuff online (see "face yoga", "facerobics" and whatnot).
posted by Grunyon at 8:06 AM on March 17, 2021 [2 favorites]

Can I be talked out of this? Should I be talked out of it?

I don't really know that you should! To my way of thinking, this is the kind of thing that will give you a daily peace of mind that is worth so much.

Not to say that I don't understand the feeling that it goes against what you stand for, of course. This isn't quite as invasive as plastic surgery, but I have been fighting my skin for years. It's constantly acne-prone, sensitive, and I'm always self-conscious about it. I'm almost old enough to be looking at wrinkles and sagging, but I'm still worried about my goddamn zits. But it seemed "vain" and "frivolous" to do any real, expensive, medical interventions. Because it wasn't crippling, right, just unpleasant. Well yeah that meant every day of my life is unpleasant. Who needs that? I recently went all in on a derm-prescribed skin treatment and while it hasn't started yet I already feel better. I love the idea that one day I just won't even have to think about my skin, and wonder what I can do with all the time and energy I get back.
posted by We put our faith in Blast Hardcheese at 8:11 AM on March 17, 2021 [8 favorites]

I don't think you're wrong for wanting this at all! I do wonder if you really want to jump straight to surgery - if you do, first make sure that you know how the surgery is likely to age, you know? You are going to have this face for like 40 more years, you don't want to rush into anything with long-term consequences.

For an older woman with some droop lines you could take a look at Angela Lansbury. I linked to that instagram of screenshots from Murder She Wrote because when she's smiling cheerfully (as she is in basically all photos of her taken in the last 40 years) it's not noticeable. Oh you can also see the droop in photos of her from The Manchurian Candidate. Anyway I think Angela Lansbury is very appealing, although she's been playing "old" since she was like 35, and that may not be a look you want and that's OK!
posted by mskyle at 8:21 AM on March 17, 2021 [2 favorites]

If it were me writing this question, I would want to be told:

"No way! Go work on self-acceptance! And stop reading about those procedures!"
posted by aniola at 8:35 AM on March 17, 2021 [8 favorites]

I won't weigh in either way about the procedure itself. But I relate a lot to what you're talking about and I hear a lot of internal conflict in your question.

If I were in your exact position, I would first explore the hell out of these feelings. I might even find a therapist to talk through this with first. I would not want to go into an elective surgery without first doing some deep introspection about whether that surgery will address my concerns (for example, I'm the type of person who might be like, "Ok, face solved, now onto disliking my [other body part here]")

I'd also think about how my body will disintegrate when I die. And how I'd still be me if I had a permanent bodily change that the world might perceive as not conventionally attractive. How the risk of any surgery is significant, and does that balance out the potential reward?

But I'd also think about how I live in a society and want to feel good with how I feel that society perceives me and eff-it I can do whatever I want with my body. And how neat that I have the resources to adjust my body to my desires.

So yeah, in short, I would take my time in exploring this, not from an embarrassed or shameful or "I shouldn't be wanting this" place, but a place of curiosity, and kindness for yourself. And possibly loop an expert in (therapist) who can guide some of this introspection.
posted by Uncle Glendinning at 8:56 AM on March 17, 2021 [10 favorites]

I also think this is about accepting that death is a part of life. That's not something I've thought about too much yet, so I looked it up.

Here in this paragraph are some things the Dalai Lama says. That death is a part of life. Sooner or later it will come. What's important is why we're alive. Our daily life should be meaningful. Meaningful means if possible help others (or at least try not to harm others). Then you won't have regret.

Imagine your younger self, the one who would never be asking this question. Sit down and have an imaginary conversation with that person. Would your younger self prefer that you focus on de-puffing your mouth? Or on living a meaningful life?
posted by aniola at 9:05 AM on March 17, 2021 [4 favorites]

Do you want to be talked out of it or do you want permission? I think my personal “line” is if the procedure needs general anesthesia, I would hesitate a lot more. That feels more risky to me, and where I feel like talking to a therapist or something might help sort out how important it is to me. That’s not to say you shouldn’t do it in that case, but it feels bigger. If it’s local and it’s not financially a big deal, I say go for it and you’ll probably feel better. I had a small procedure years ago (I would have been fine without the surgery but since it was an option I went for it) and I have zero regrets, it was a great decision.
posted by jeweled accumulation at 9:08 AM on March 17, 2021 [1 favorite]

I think you should actually consult a plastic surgeon. They may say, "hey, here's a non-surgical option you can consider" or "hey, here's what it would look like if you did x procedure..." and you can assess how you feel based on that information. You're not obligated to do anything just because you talked to someone, but it doesn't sound like you have a full range of understanding what you could do, which I think is just as important as whether you should do it.

Personally, I have deep under eye hollows that can't be covered up or alleviated by makeup, more sleep, more water, facial exercises.... this is just my fucking face. I have always felt shitty about this part of my face and I have lately been wondering why I am waiting to pull the trigger on at least consulting with someone about fillers or other options. I think it's because I feel like I am supposed to love and accept my face the way it is, but that's not the way I feel and I'm tired of fighting it. This post has inspired me to actually do something about it. So I'm not sure if I've helped you at all, but you definitely helped me.
posted by sm1tten at 9:11 AM on March 17, 2021 [23 favorites]

When I visit Los Angeles, especially, I see a lot of people who have had cosmetic surgeries. Get a lot of recommendations, go to the most skilled practitioner. Sometimes people get talked into having more surgery, as long as they're having 1 procedure/ issue addressed. I'd be pretty wary of that, unless there's a procedure that will fix the thing you dislike in some comprehensive way. Some very beautiful women have lost what made them special by having way too much done.
posted by theora55 at 10:10 AM on March 17, 2021 [1 favorite]

You are not necessarily looking at surgery at all , and I absoloutely wouldn't go there as a first option. This is something routinely treated with fillers and/or botox. A cosmetic dermatologist would be a good first consult.
posted by DarlingBri at 10:19 AM on March 17, 2021 [15 favorites]

Plastic surgery in general is on the rise during the pandemic, so you’re not alone. That article has some interesting food for thought, or at least it did for me, as someone who has been staring at my own face in zoom for the past year.

If it were me (and some days, it is me!), I’d take masks and the pandemic out of the equation and just wait a year or so. In that time I’d try home treatments and routines like microcurrent, gua sha, and buccal massage to see if any of those helped either my appearance or self-acceptance. I’d also see if my desire for plastic surgery faded once we’re out of the pandemic and once I had other things to focus on (as someone who can be obsessive!), and whether that desire was a stand-in for some other feeling or wish.

It’s your body and you can absolutely do what you want! I had plastic surgery before, and I might again, but it was never the ‘fix’ I’d hoped for. YMMV!
posted by stellaluna at 10:28 AM on March 17, 2021 [5 favorites]

I totally get feeling this way. It's very hard for women to deal with societal attitudes toward aging, no matter how much we know that we should be valued for more than our looks. I'm maintaining my gray hair as a political act, but sometimes it's hard.

I think it's unfortunate that women compare themselves to movie stars, whose livelihoods literally depend on looking good. I'd suggest looking for pictures of older women who weren't in showbiz and didn't get plastic surgery: Georgia O'Keeffe, Elizabeth Cady Stanton, Golda Meir, Jane Addams, Dorothy Day, Eleanor Roosevelt, Angela Davis. Not sure if these women are "attractive" enough or jowly enough for what you're looking for, but they give you, I think, a more realistic sense of what it looks like to be an aging woman.

Also, maybe don't read this paragraph if you feel that you really want surgery, but every time I wonder if I should get plastic surgery (and I'm sure it would make me look way better if it went well), I think of Olivia Goldsmith, author of The First Wives Club, who died at the age of 54 from a heart attack following what was considered minor plastic surgery (a chin tuck). And then I work on trying to accept my jowls.
posted by FencingGal at 11:22 AM on March 17, 2021 [9 favorites]

I also think you should consult with a qualified, experienced cosmetic dermatologist. You eat, talk, and smile with your mouth, and you're 45, so I think it's worth trying non-surgical procedures initially. If the results aren't what you hoped, they'll be covered by your mask as they wear off. Restylane, which you mentioned, can take 8-18 months to break down. The drooping and puffiness you describe can be caused by a very strong depressor anguli oris (DAO) pulling on the corners of the mouth; Botox injections to weaken/re-train the muscle last 3 to 6 months. This is what the latter procedure looks like, per the first Botox + DAO return on YouTube. (The RealSelf site has before-and-after photos for in-office stuff, too.)
posted by Iris Gambol at 11:52 AM on March 17, 2021 [3 favorites]

Heads up, if they suggest botox, it may cause or reaffirm what's already happening, over time (I have a friend with this experience, now.)

In the end, it's your body and your mouth.

You can wear a guard for teeth at night which may reshape structure. The lips are the most sensitive area of the face.

Maybe you could exhaust options before making a cut?

Don't feel bad about whatever you choose, just please research and be very confident if you choose a surgeon.
posted by firstdaffodils at 11:57 AM on March 17, 2021 [1 favorite]

It sounds like you want to be talked out of this? In which case I'd say that this stuff is often a spiritual issue in disguise (i.e., you're actually dealing with the reality of death). If you have no spiritual affiliations, this might be a good time to gently explore that world. And like, you don't have to believe in God or anything. Zen Buddhism helps a lot of people. If you're coming from a Jewish or Christian background, humanistic Judaism or the U.U. (respectively) might appeal. Alternately, you could be helped by therapy. I'd also suggest looking for truly meaningful charity work. No matter what it is, the point is to engage in an activity that isn't focused on appearance, and that connects you to your life story as a changing thing, as a growing legacy.

In terms of plastic surgery itself, I'd also point out that even celebrities get botch jobs, odd-looking fillers, etc. This is mostly not because they cheaped out or chose bad doctors; it's because cosmetic procedures are unpredictable. Also, at a certain point, people can lose perspective--as patients but potentially also as surgeons--as to what looks "normal." Not that this is a likely outcome for a single facial procedure, but if you're the kind of person who may not be satisfied with one go...

On the other hand, if you aren't trying to be talked out of this: there's little to lose from doing consults. Like, I think it's unhelpful to frame this stuff as a betrayal of your past self. It's not THAT big a deal. But then, I do come from a place where plastic surgery is pretty common. And, relatedly, you should know that pretty much all celebrities (and many many politicians, businesspeople, etc) get work done. If you think, "Wow, X is aging well," 99.5% of the time, it's actually that X has a skilled and judicious cosmetic doctor. It's not that they are superhuman and it's certainly not that they reflect realistic aging. This is why it's a bit hard to provide pictures of pleasantly sagging faces; famous women that one could google generally lack notable sagging. Or they have sag-related outcomes that are different to how most people age.

Ultimately, if a procedure will help you feel better in your daily life, rather than standing in for deeper psychological issues, and you can afford it...there's no need to moralize to yourself about that. Your body is your own. An unaltered body is not better or purer than a refashioned body. Like, I've had plastic surgery and I'm happy to report my soul is intact, despite the judgmental warnings of concern trolls. In my case, yeah, insurance called the surgery gender related and paid for most of it, but I don't think there is necessarily a sharp delineation between "understandable" gender surgeries vs. "chosen" cosmetic procedures. Aesthetics 100% played a role in my choice of doctor/procedure in a way that was not related to dysphoria but rather to vanity, and I feel 0% bad about that. Every day I look at the area that was operated on and think, "Damn, that looks good." And you know? That feels good.
posted by desert outpost at 11:58 AM on March 17, 2021 [7 favorites]

Just to give you an idea:

A little over a year ago, I went in for a simple facial (which is just massage and masques and stuff) - and the therapist gave me a treatment with hyaluronic acid. I was AMAZED at what it did to rejuvenate my face. I had had some jowls starting to happen as well. I felt like a teenager (or at least mid-20s) again. You might want to give that a try first.

On another note, I never knew how much my spine had been altered from a traumatic accident over a decade ago (without apparent fractures), and I thought I had just been "getting old"... when I finally allowed my chiropractor (I'd been regularly seeking massage, & had seen physiotherapists and acupuncturists to assist me initially, but had previously had a bad experience with chiropractic before the accident so hadn't sought one out) to adjust my cervical spine last Fall, and WOW.

It changed my entire face.

My neck was longer again. I could breathe in more deeply, and wasn't as tired any more. I've since had to continue to have it adjusted, but the benefits of feeling SO MUCH better after more than 10 years of pain (which we all accommodate to some degree) that I hadn't even thought was pain anymore by that time. (I didn't let him touch my neck for 1-1/2 years, until I knew he knew my body's reaction to treatments and I was in terrible pain that hadn't been so pronounced until then - that's how spooked I was of neck manipulation).

It has continued to be life-changing, as I realize how much of the brain fog that had been affecting me was again NOT AGING. It had been affected by trauma. My face had been sagging and looking old due to trauma. I can't say that I look quite as young as I once did, but the effects were dramatic, and I am still very pleased to be in a much happier, healthier place - and to see that reflected to me in the mirror as well!

Best wishes on whatever you choose.
posted by itsflyable at 1:41 PM on March 17, 2021 [3 favorites]

I briefly worked in a plastic surgeon's office, taking the before and after pictures. Such a weird job. Anyway, often the patients would get chatty with me (nerves I'm guessing). Most people did feel happy with their results, but most people were also pretty quick to go to "Ok doctor, what can I fix next?" One woman even turned to me and giggled "I think I might be addicted to botox!"

You shouldn't feel any shame for wanting to change your appearance - society doesn't make it easy for aging women. But before you spend however much money fixing this "problem," it might be worth interrogating whether the "problem" will really go away once your mouth looks different, or whether it will just pop up in some other form. You are, of course, the best person to figure out that answer to that.
posted by coffeecat at 2:41 PM on March 17, 2021 [3 favorites]

I’ve got some sagging only I can see and I’m almost 40- I’m not considering a face lift, but I’m going to do a thread lift... maybe try that and see if you like it! Then see if the benefit to how it makes you feel is worth going all the way? Or just keep getting thread lifts for a while.
posted by pairofshades at 2:48 PM on March 17, 2021

In almost every picture of Audrey Hepburn, she's smiling to a greater or lesser degree. Do you feel like working on a resting serenity face? Not so much that you're grinning like the village idiot, just a little secret kind of a smile. The secret might be "I look awesome and saved $5K!"
posted by kate4914 at 2:57 PM on March 17, 2021 [3 favorites]

Coincidentally, YouTube just recommended a video to me about correcting frowns. It’s called something like Reverse Your Frown by Dr Anthony Youn. He recommended filler and Botox injections as a first strategy, and a small surgery only If that didn’t work (less than a full lift). Anyways I recommend checking out the 0video, the dr is very pleasant and matter of fact.

I‘m not trying to encourage you to have plastic surgery or anything. Just that there may be less permanent options that are less expensive and eventually wear off if you don’t like the results.
posted by exquisite_deluxe at 4:42 PM on March 17, 2021 [1 favorite]

I've done a little reading on procedures to correct this, and I don't think I'd want to go the fillers route, maybe a lower facelift?

I mean, if you're considering surgery fillers are a much less invasive thing to try. most (all?) hyaluronic acid fillers slowly fade away over time, and are nearly instantly reversible. A skilled practitioner can lift the corners of your mouth without changing hardly anything about your appearance.

Before you try that though, you could also give Tretinoin (Retin A) to help improve the tone of your skin. I know you said you aren't worried about wrinkles, but after using Curology for about 8 months I discovered that my sagging eyelids were much more lifted- even though I don't put tret directly on my eyelids. It just sort of generally gave a tightening effect all over. I've been made much more aware of this as I slacked off my routine during the pandemic for no good reason, and am noticing my jaw looking more soft and my skin a bit more crepe-y. Apostrophe and Rory also have prescription retinoin programs now (they often put them in terms of acne treatment, but tret treats sagging skin and lines too).

I used to a be strong believer in aging completely naturally, but that was before my appearance seemed to change overnight. It really bummed me out, and being bummed out over something that I thought I'd never be bummed out about- well, that was extra demoralizing. Doing something about it is worth it for me for my state of mind- I don't care about crows feet, or laugh lines, and I want my eyebrows to move. But I don't want under-eye puffs or hooded eyes or jowls- it turns out I find them really upsetting when I see photos of myself. I think there are some steps you can take before you decide you really need surgery, and if you do decide you want to talk to a surgeon, that's okay. We get to change our minds as new information comes to light, even if that new information is "I don't like my downturned mouth."
posted by oneirodynia at 4:51 PM on March 17, 2021

Can you talk me out of it?

Uncanny valley?
posted by clawsoon at 5:19 PM on March 17, 2021

Debora Spar, the former president of Barnard College, wrote a lovely essay about this dilemma a few years back.
posted by Viola Swamp at 5:48 PM on March 17, 2021

This is not a bad idea if you have a consultation with a qualified plastic surgeon who thoroughly discusses all of the options available to treat whatever your concerns are so that you can make an informed decision. There are laser treatment options, like Ultherapy or Thermage, and injectables, like dermal fillers and Botox/Dysport, that may be a better fit for your concerns than a face lift. Full disclosure, I'm early 40s F, and my skin has been through the ringer as a municipal lifeguard for six years combined with chloasma from hell when I was pregnant that never went away. I spent so much money on topical products trying to get my face to be less than 4 colors at a time and it was very demoralizing to never get the result I was hoping for. Last year I finally got tired of beating myself up about worrying about how much I was worrying about my skin and scheduled a consultation with a reputable provider. After a very long talk about all of the treatment options available, I booked a series of Fraxel treatments and am so very glad I did. I feel like I got my face back and look like myself again. Dollar for dollar, the Fraxel was more cost effective than all the OTC creams, serums, or masques I could ever buy and I do not regret making the choice. It has not turned me into a plastic surgery addict and I don't lay awake at night wishing I looked like a celebrity. I'm simply very happy to look more like myself.
posted by Lady Sugar Maple at 7:02 PM on March 17, 2021 [4 favorites]

Seconding the idea to consult with a board certified plastic surgeon. In my early 40’s I suddenly developed a large double chin even though not overweight. Thank genetics; older people on both sides of my family had the same look. I asked some of my local doctors for recommendations and got liposuction and a neck lift from a plastic surgeon. It has lasted for many years and I have never once regretted getting it done.
posted by serendipityrules at 8:22 PM on March 17, 2021 [1 favorite]

As someone upthread suggested, try facial exercises. I use Ageless if You Dare and I've noticed some subtle changes. Add a retinoid to your skin care routine, also as suggested. Basically try everything you can think of that's non-invasive before turning to surgery.
posted by Beethoven's Sith at 7:16 AM on March 18, 2021

Can you talk me out of it?

Sure. I am a 35 year old woman who has been going gray since I was a teenager. For the first time in my life I feel fairly secure with how I look even though I notice some tell-tale pre-aging signs, especially in my skin and some thinning areas of my hair. I no longer am trying to look like a 20-year old, but I need an accurate barometer for what a normal 40, 50, and 60 year old looks like. It is incredibly important to me as I transition into the gray zone between young woman and middle-age to see other women who are the future versions of the crone I aspire to be, who have normalized and embraced the act of visible aging.
posted by mostly vowels at 3:39 PM on March 18, 2021 [1 favorite]

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