Puyallup Lower Face Lift doctors

To some extent the answer depends on your goals. From what we can see on your single frontal photo, you appear to have some early jowling and laxity in your neck area. Along with your jowl, you are developing a perioral skin fold that extends from the commisure making your mouth look downturned. Your left side looks worse than the right, which is common.

It you want to correct the jowl and neck laxity then a facelift is really the only thing that can provide a good correction of both of these areas. On the other hand, some filler judiciously placed in the skinfold that extends from the commisure can provide a nice enhancement as long as it's not overdone. By filling the fold you will somewhat mask the appearance of the jowl and you can put off having a facelift for now.

TCA peel, IPL, and Fraxel are all skin surface treatments and you should not anticipate any significant improvement in the jowl/perioral area, as it results primarily from descent of facial soft tissues. Hopefully you were not encouraged to pursue any of these treatments with the goal of fixing the jowl and skin fold. On the other hand, your skin quality looks quite good, and this is the benefit of the treatments you have outlined.

In theory it would be possible to do both of these procedures at the same operative setting, however it depends on the complexity and time it takes to do each procedure.

Do you have a lot of loose skin, extra fat, or muscle bands under your chin? If so, then the correction will be more complex, will take more time, and your "lower facelift could eat up a good chunk of the day.

Having keloids that are so severe as to require radiation therapy for treatment is a little unusual. This would suggest that you have a very strong propensity to forming keloids and could mean that you have an increased for recurrence, and it may have implications for your facelft surgery as well. Also, if your breast have been irradiated, then you have a significantly higher risk of complications, skin and/or nipple compromise, with your breast sugery.

So it's sounding as if this might not be the best combination for you.

Aftrer reading your question, I am little confused as well. Part of this confusion arises from what one means when they say "lower facelift". For some people, they are refering to the neck and tissues below the chin. Other people tend to include the jowl area as well. And some might take it to mean anything below eye level. Really, whatever term you use it is not all that important. You, and your surgeon, need to define the problem areas that you wish to address and then you can formulate a plan to address those problems. It is important to remember that different surgeons may recommend different approaches and all can potentially achieve good results.

With regard to the incision in front of the sideburn vs up into the scalp, good results can be obtained with either. If your sideburn is not high, then extending the incision up into the scalp can keep it more hidden. There is a small risk of hair loss but generally very low and very localized. On the other hand, if you have a higher sideburn, continuing the incision up into the scalp will usually pull your sideburn higher. At a certain point this looks very unnatural, so placing the incusioin around and in front of the sideburn can be a better choice. The best answer depends on your anatomy and preferences.

When referring to "lower facelift" most people are indicating that the areas under the chin and into the neck are included. There are generally three components to the changes that occur in this area and need to be addressed. They are fat excess, separation or "banding" of the platysma muscle, and skin excess or laxity. If someone is concerned about this area, they generally have components of all three. The skin laxity component is usually addressed along with the rest of the facelift, as long as the incision is continued back behind the ear and into the scalp. The issue of fat excess can be addressed with liposuction, however it is usually more effectively corrected by direct removal through about a one inch incision under the chin. Using this approach also allows for repair of the separated platysma muscle. Having a clean and nicely sculpted chin/ neck area usually requires correction of all three components.

Whether one should also have fat transfer to the eye area and/or a lower blepharoplasty is way beyond the discussion of lower facelifts and incision placement. If these are problem areas for you, then it could be reasonable to address them at the same time as your facelift.