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Lower Facelift Advice?

asked 3 years ago by cats in waterbury, CT
Latest answer by Larry S. Nichter, MD, MS
Question viewed 4,149 times
Tags: sagging, skin

I saw 3 board certified surgeons, two recommended lower face lift. One does lift in front of sideburn to avoid hair loss, and the other in the scalp for the same reason. I'm concerned about scarring in front of sideburn, but I don't want to have my sideburn pulled back either. I wear my hair off my face. Neck would improve with first, second suggested lift under the chin, a scar about an inch long. Second and third both recommended fat transfer to cheek/eyes area; two recommended lower Blepharoplasty. Third doctor ruled out other reasons. I'm now confused. Any advice?

20 answers to Lower Facelift Advice?

Lower facelift only

It is in my opinion the rare patient that would look their best with only a lower facelift, and the additional incisions between a neck-only facelift and a facelift are minimal. In many cases, there is more gathering and artifact (unnatural appearance) from a neck-only procedure. Why would there be a more pulled appearance from less surgery? When only a lower facelift is done, there is little restructuring of the deep tissues of the cheeks, and little chance to elevate and preserve the... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Facelift opinions differ

Depending on the training of your surgeons and the facelift technques they feel comfortable with in the treatment of your face, you will get a different opinion from every facelift doctor that you meet. The doctor who is right for you is the one who has a proven track record for giving you major improvements in the areas you want addressed. Many times different techniques achieve the same look. Be sure to view plenty of before and after photos, talk to former patients,... more

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon

Follow Your Inner Voice After Listening to Advice from Experienced Surgeons

You bring up important questions regarding facelift surgery: Incisions, scaring, cheek/ lower eyelid region and neck. Without actually seeing you, nobody can advice you for or against any of the surgeons recommendations. Just as a couple of philosphy points: 1. I do not like distortion and elevation of the hairline. Therefore, I virtually only use hairsparing incisions around the sideburns. 2. For a good neck improvement, an incision under the chin is mendatory in most patients. 3. About 80%... more

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

Facelift Incision choices

Great question you posed and a common one that comes up. In short here are the major pros and cons in my eyes: Traditional incision site is in the temple hair bearing area - Pros- hidden Cons: if you end up with a widened scar and hair loss, plus in all cases the sideburn is pulled vertically and ends up being higher than before - sometimes to the top of your ear. This is the most common method used Incision at the hair line - in this case it is... more

Larry S. Nichter, MD, MS
Orange County Plastic Surgeon

Facelift, Fat Grafts, Blepharoplasty

One of the great things about seeing multiple consulting physicians is to gain insight on all the possibilities. Sounds like you heard about all that is out there for you. The male facelift incision approach is a very big deal....I agree with you that making the incision in the area just behind the sideburn is important here. I have my patients grow out a light beard just before surgery to plan this out. There are some surgeons that advocate a post tragal incision, but... more

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon

Lower Facelift Advice and Confusion

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... more

Braden Stridde, MD
Federal Way Plastic Surgeon

psplasticsurgery.com

Lower facelift confusion

With such a variety of recommendations, it is difficult to decide. Facelift scars are usually quite inconspicuous and almost universally acceptable. Without photos or an examination it is difficult to tell you what is best. You might see additional surgeons to see if one approach is recommended more often. Additionally, view before and after photos of each surgeon's patients and see if you can find an example of someone like you. Finally, ask to speak to... more

Randy J. Buckspan, MD
Austin Plastic Surgeon

Facelift procedures

Welcome to the world of plastic surgery! Everyone does it a bit differently. I try to maintain the hair line so peopl do not get the "wind swept" look from removal of good hair. As for the additional procedures like with the face veryonen does it a bit differently.

Steven Wallach, MD
Manhattan Plastic Surgeon

Fat Transfer, Facelift, Blepharoplasty - I am confused as well!

What are your problems or concerns? Write all your concerns down on a piece of paper. Then put them in order from most to least important. Then write down all the doctors names and the suggestions that they made. Then cross check their advice with your concerns. Then go to your favorite of the group and go over each suggestion slowly. This is not rocket science, if it makes sense, then it probably is true.

Robert M. Freund, MD
New York Plastic Surgeon

Facelift are confusing - it comes down to what you can accept with incisions

Hello, There are different approaches to rejuvenating the lower face and I don't blame you for being confused. It is difficult to understand the different approaches, especially when different surgeons are recommending different options. I am sure they all have your best interest in mind. The reason there are so many approaches to incisions and placement is because not one of them is better for all patients. There are pros and cons to incisions in front and below the hairline,... more

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon

In the right candidate, Lower facelift is great for the jowls and neck

Not everyone is a good candidate for facelift surgery. It is important to consult an experienced surgeon to understand the limitations of the facelift in certain body types. The lower facelift is an excellent technique to improve jowling and sharpening the cervicomental angle (where the underchin and neck meet). Additionally, It is critical to choose a surgeon that suspends the deeper tissues, and does not place the tension on the skin in order to achieve a natural... more

Stephen P. Smith, Jr., MD
Columbus Facial Plastic Surgeon

Many different face lift options.

You've done the right thing by collecting a variety of opinions. As you have learned, there are many options available in facial rejuvenation. Today's modern facelift not only addresses the loose skin but the loss of volume that always occurs in the aging process. In our practice, we almost always combine fat injection to fill the area that has been emptied by this lost fat. Once the inner structure of the faces that established, we can then use the skin to gently... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

Facelift advice

Best advice is to post photos so we can see exactly what you are referring to. If 3 docs give 3 differing opinions, I first think you are requesting results and options they can not agree with or understand exactly what you want. It is like the patient who wants a face lift without scars! Post photos PLEASE. FROM MIAMI Dr. B

Darryl J. Blinski, MD
Miami Plastic Surgeon

Facelift Choice

The one issue I will address is incision placement in Facelift surgery. There are passionate advocates for Facelift incisions placed into the temporal hairline and those that support the incision along the temporal tuft (just in front of the hairline). I am an advocate the the latter approach for the following reasons: a) stabilization of the temporal hairline: there are few appearances that are more stigmatic of a Facelift than a raised temporal hairline (a frequent result of an... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

Multiple opinions will usually just confuse

Most patients today seek many opinions before choosing a surgeon. Assuming all are appropriately trained and certified and perform their surgery in a safe environment, how can a patient make an educated choice? The internet is equally confusing- patients are literally drowned with too much information. I recommend 2 rules to every prospective patient. 1. Choose your doctor by a happy patient referral or at least a doctor referral, not an ad 2. Look carefully at before and after pics... more

David Shuter, MD
Jupiter Plastic Surgeon

Lower Facelift and Facial Rejuvenation

Surgical treatment of facial aging changes must be carefully individualized to match each patient's aesthetic needs and desires. No two 'facelifts', by necessity, are the same. In helping a patient to make decisions about plastic surgery for facial rejuvenation, I always examine and assess how each aesthetic area or 'unit' of the face contributes to an individual's overall appearance: the brows and eyelids, the cheeks or 'midface', the lower face and chin, and... more

Michael Law, MD
Raleigh-Durham Plastic Surgeon

michaellawmd.com

Decide which is more important for Facelift

The incision in front of the sideburn can avoid moving the sideburn back. This would be the only way to avoid moving the sideburn up. So the decision is up to you what is more important, moving the sideburn up or a scar in fron of your sideburn. Now for males, their beard hair can be adjusted with shaving to grow a new sideburn. But for females, when you move the sideburn up you will not have the sideburns back to completely normal after the facelift. Fat injections under the eyes and cheek... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

Ask to speak with former patients

Hello Cats, Dr. Rand has very clearly and efficiently answered your question. I would only add two more pieces of advice: 1. Ask to speak with former patients who have similar anatomy to yours and underwent similar procedures being proposed. This in no way "guarantees" an outcome for you but it does give you a very good sense of what the procedures can accomplish and how they may apply to your anatomy. Also photos are helpful too and ask to see ones of patients that are... more

Kamran Jafri, MD
New York Facial Plastic Surgeon

There is no one single answer

What you are seeing is that plastic surgery of the face is more of an art form than a science. Each doctor has different talent levels, different training and experience, and a different eye for what is attractive. Look at the photos of each doctor's work and look for patients that resemble what you have and what you want and go with that doctor.