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Sagging Jowls - Is a Mid-Face Lift Needed with Lower Lift?

asked 1 year ago by Zsa-Zsa in Cornersville, TN
Latest answer by Babak Azizzadeh, MD
Question viewed 1,171 times
Tags: age 45-54, jowls, sagging, combination

I am 54, but look slightly younger. I don't mind the normal aging around my eyes, etc. but my sagging jowls bother me. My Plastic Surgeon says he would not recommend having a lower face lift without at least also doing a mid-face lift, as well as a brow lift. Now he has agreed he would feel comfortable doing the lift without a brow lift, but says he would definitely recommend a mid-face lift with the lower face lift. Is it really necessary to also have a mid face lift with a lower face lift?

25 answers to Sagging Jowls - Is a Mid-Face Lift Needed with Lower Lift?

Lower facelift for saggy jowls

It really depends on what your ultimate goal of the procedure is. Jowls are typically treated with lower facelift. Midface lift typically repositions sagging cheek tissue. see video

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon

www.facialplastics.info

At 54 do a standart facelift.

Generally at 54, a standard facelift which takes care of cheek, midface, N-L folds, jowls, and neck makes better sense. It is not that much additional work and cost so why do it half way and then have to come back. The best avenue for you is a roitine lower 2/3 facelift. The brow is less important. Good luck.

George Commons, MD
Palo Alto Plastic Surgeon

Facelift Techniques: Harmonious Facial Rejuvenation

Approaching facial aging with surgery should be an individual decision that is directed by you the patient. There should not be any stipulations, however if your problem area is jowling within the lower face then an experienced facelift surgeon should be able to correct this with a lower facelift. A mid facelift is more for cheek and lower eyelid aging. I would agree that facial rejuvenation should be approached ideally with correction of the face, cheek, eyelids and brow, rather than... more

Andrew P. Trussler, MD
Dallas Plastic Surgeon

Facelift Surgery at 54

It's is difficult to assess you without seeing some photos and clinical background. As you clearly describe, I have no doubt that there are sagging jowls in your lower face. However, attending to your age (54) and to the presence of jowls, I believe that it's important to assess if there are more signs of aging in your face and neck (midfacial sagging, naso-labial folds, marionette lines, neck saggging... ). I believe that with all these symptoms together, the... more

Enrique Etxeberria, MD
Spain Plastic Surgeon

Is a midfacelift a necessary companion to lower facelift?

If you have a localized laxity of the jawline (jowls, neck bands) and your midfacial area is not deflated or descended, then a necklift alone is ok. If you do have some aging of the midface though, it is hard to complete a neck lift in a region that would benefit from lifting and tightening. The transition zone would better blend with the midface lift added - but only if you need it. Browlift may lead to a nice result, but does not impact the result of a necklift at all... more

Michele A. Shermak, MD
Baltimore Plastic Surgeon

www.drshermak.com

Facelift Options

For simplicity, I also divide the face into midface, lower and upper face when talking with patients. For jowls alone the lower facelift or standard facelift is the best. That being said, there are times where a midface lift is very helpful in obtaining good facelift results. This is especially true in a larger or rounder face. Your surgeon is the one evaluating your face, however. Consider their opinion and obtain a second opinion if that is what is needed for... more

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon

Mid Face Lift Usually Needed with a Lower Face Lift

Dear Zsa-Zsa- Generally for the most holistic and harmonious result, you should consider getting a mid and lower face lift together. In most patients, your face may look out of proportion with a nice result around your jawline and jowls, but continued saggy skin and lower cheek pads in the mid face area. You should do what you makes you the most comfortable and makes the most sense to you and your face. Most patients get a face lift and neck lift to get the... more

Roy Kim, MD
San Francisco Plastic Surgeon

Sagging jowls -- Mid-face lift or lower facelift?

Of course this is impossible to answer without having photos available for review. Nevertheless for sagging jowls, a lower facelift is the answer. Furthermore, I think it is crucial for you to be comfortable in what you are having done. And it is crucial for your surgeon to listen to your wants, needs, and concerns. If he/she does not, then maybe you should get another opinion so that you are satisfied that your needs are being addressed before having this... more

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon

Lower and mid Facelift

The terminology used by each physician may differ and does not necessarily correspond with textbook procedure so you need to break down the problem areas and your desires and what is truly needed to properly assess your best surgical protocol. In most patients at your age a mid facelift and lower facelift treating the jowls and neck area would be a good combination. A browlift is indicated in some patients however without preoperative photographs it is hard to determine your exact needs.... more

Michael Elam, MD
Orange County Facial Plastic Surgeon

Is a mid-face lift needed with a lower face lift?

The question is really what you are looking to correct. A standard facelift or lower facelift is ideal for the jowls and neck. If your surgeon is recommending an additional mid face lift it, then is likely that he or she is suggesting that you might not be happy with only correcting the jowls without the midface. If you undersand this point, but disagree, then you are right to insist on skipping the mid-face lift.

Neal Goldberg, MD
Westchester Plastic Surgeon

Lower facelift

What really distinguishes a "lower facelift" from a standard facelift is how high into the cheek and temple the surgeon dissects. Some surgeons use the term lower facelift to imply a lesser degree of complexity or downtime to the surgery, which I do not always think is an accurate representation. Depending on how hollowed out the area of the cheekbones is, you may need some form of suspension of the mid-facial tissues beyond the lower face/necklift territory, which in turn may... more

Tim Abou-Sayed, MD
Palm Beach Plastic Surgeon

Midface Lift with Lower Facelift

At age 54, you likely have some element of midfacial descent/deflation in combination with jowls. The hallmark of a well performed procedure is a harmonious look; addressing the jowls without addressing the midfacial area leads to a look known a s the "lateral sweep". A complete Facelift will address the midfacial region in addition to the jowls, jawline, and neck. Whether or not a brow lift is indicated is more subjective and would be based on your anatomy... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

Combining surgeries may not be necessary if your goals are limited to jowling

If jowling is your conly concern, a mini facelift may be sufficient. Your surgeon will discuss what each procedure can add to your overall results. however if your goals are limited to the jowl area, you may be able to obtain the results you want with a more limited surgery. In my practice, I find the mini-facelift procedure able to meet many of my patient's goals for jowling and neck lift improvement if they don't desire more extensive procedures.... more

Marwan R. Khalifeh, MD
Chevy Chase Plastic Surgeon

Minifacelit

Zsa Zsa-there is no one size fits all when it comes to face lifting. If it does not make sense to you, you may need another opinion. Dr Siegel

Michel Siegel, MD
Houston Facial Plastic Surgeon

Mid face lift necessary with lower face lift?

Your question is a good one, and you should not proceed until you feel comfortable that you have arrived at a satisfactory plan. Every patient (and surgeon) has a different approach. Ask your surgeon to show you in the mirror what you will look like with the lower facelift alone, then with the lower facelift and the midface lift. If he wants to do the midface lift to correct and/or prevent a deformity that will result from doing the lower facelift alone, take a look at... more

Steve Laverson, MD
San Diego Plastic Surgeon

Lower face/neck lift can be done without mid-facelift

A comprehensive face/neck lift will lift the jowls, so a mid-facelift is unnecessary. If the cheeks are quite flat, lifting will help, although if more of a contour augmentation is preferred, then consideration for cheek implants inserted through an intraoral approach to augment the cheek area can be considered. A comprehensive lower face/neck lift will address jowls, any facial laxity, fat removal above and below the platysmal muscle, and tightening the neck muscles both the front and... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Facelift, Neck lift

It is really difficult to say what you would benefit most from without at least seeing photos of you. I individualize for all my patients and do what concerns them the most. Sometimes though, if one area is enhanced and not another, that area stands out. Watch my videos!

Edward J. Domanskis, MD
Orange County Plastic Surgeon

Lower facelift with or without midface lift

As long as you understand the expectations with each approach, you and your surgeon should make the decision together about which procedures to do. You should make sure that a lower facelift to fix your jowls would not expose or make more prominent another sign of aging. I think that it is unusual to have isolated jowls without other areas that sag, and so I try to address all of the problem areas with one surgery to provide the most natural results.

Jonathan Heistein, MD
Fort Worth Plastic Surgeon

Midface Lift, Lower Facelift and Correction of Jowls

In my practice, the best technique for correction of jowls is a lower facelift. The lower facelift addresses sagging tissue along the jawline and neck. The jawline will be refined and the neck will be tightened. It is true that a degree of midfacial aging is usually also present. Lesser degrees of midfacial aging need not be addressed by a midface lift. Instead, during a lower facelift special techniques can be used to elevate the cheek and rejuvenate the... more

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon

Neck and midface lfit

Remember that the face and neck should be addressed together. Patients who have youthful necks but aged faces can have a "chipmunk" type of appearance. Chances are that you need your midface addressed as well. Doing this also allows your board - certified plastic surgeon to remove excess skin from your neck via the facial incisions.

Samer W. Cabbabe, MD
Saint Louis Plastic Surgeon

Facelift options

Most patients that present to my office requesting treatment of their jowls will often need elevation of their cheeks as well. I prefer doing this at the same time, because the face will look out of proportion. I use a High SMAS technique.

Steven Wallach, MD
Manhattan Plastic Surgeon

A Midface Lift Can Significantly Improve Jowls

Depending upon the technique used, a midface lift can improve the "jowls" much more than a traditional lower facelift alone. What appears to be jowl fat may frequently be drooping buccal or cheek fat. In my technique of an endoscopic midface lift I reposition this drooping cheek fat higher in the cheek which improves the jowl and corner of the mouth much more than a standard facelift. In addition elevating the cheek also tends to elevate the jowl fat along the... more

James C. Marotta, MD
Long Island Facial Plastic Surgeon

Sagging Jowls and Facelifting

The definition and separation of "upper", "mid", and "lower" facelift may be somewhat vague and confusing. The jowls are at the bottom of the face and easily seen. However, jowls may be only a part of the problem of an aging face. Rather than worry about what procedure name you are having or not having, let your doctor correct the problem according to his experience. Some patients require more, and some require less. Your doctor has... more

Randy J. Buckspan, MD
Austin Plastic Surgeon

Lower and mid face lifts

Depending on how the lower facelift is performed such as a SMAS lift, you can get a nice midface lift without technically doing a separate midface lift. The names are not standardized so look at the doctor's photos of people like you to see if you like what is being suggested and if so, go for it.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Face lift

Once you have jowles, there is also some aging to the mid face. If you do the lower face, there would be a major contrast with the mid face. Therefore a face lift include the mid face the lower face and neck.

Samir Shureih, MD
Baltimore Plastic Surgeon

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