Dear Anon,
I am often asked this very question by my patients; giving the "right" answer is not that easy. In general terms my answer will relate to what the chief concern (or change) that the patient is expecting to correct. Essentially facial aging is best evaluated by isolating the the many components that contribute to an older looking appearance.
That is, looking at the skin quality, the bone structure, and the presence tissue laxity. In cases when I see that the patient has significant jowling, neck skin/muscle laxity, the loss of cheek area fullness, and overall facial skin laxity the treatment will likely involve a combination of a face/neck lift, and other complimentary treatments.
Some of these additional treatments may involve a combination of skin resurfacing (eg., laser treatment.) to tighten the skin, and the restoration of cheek, or other area, fullness with either a facial implant, or injecting a "Filler". Sometimes these additional steps can be performed at the same time, or may be done in a staged approach at a later time after the initial surgical healing.
Using a filler as an adjunct has been particularily beneficial to treating the deep naso-labial folds that the face-lift in itself often does not treat as well.
In the less advanced cases however, much can be accomplished with facial skin resurfacing, and the application of the wonderful longer-lasting fillers now available. Many times these less invasive procedures can really help to post-pone the need to get the classic surgical facelift.
Best wishes.
