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Am I a good candidate for a facelift? I'm 46 and this was the recommendation I got from a local plastic surgeon. (photo)

I am most unhappy with the excess skin, fat, and jowling on my neck. I have no jaw/neck definition and my face sags down. I also don't like the way my eyes look, they make it seem like I'm tired but I'm not! A few years ago I looked young for my age now I look old and tired.

Doctor Answers 25

A physical examination is needed to see if you are a good candidate, but some self examination techniques can help you now

I wrote a book a few years ago called “The Fine Art of Looking Younger” and explained that facial aging is volume loss and descent or sagging. When I evaluate a patient like you who feels that their skin is sagging, I simply assess if I can move the skin and cheeks up and observe the jawline to know if the problem can justify the need for a facelift. Sometimes when people come from your age group, it’s more about volume loss and the skin doesn’t move very much. So a 3-dimensional physical exam is a critical part of this discussion.

When you move your chin way down and you see all these volume collecting, it’s very important to understand that a facelift procedure or necklift procedure is not going to eliminate all of that. As we get older, the skin quality gets thinner. So when we do a facelift, it’s about what a person looks like in a particular position. The photos that you need to take to evaluate the benefit of a facelift is a full-faced view, a side view and a three quarters view so that you can look at your jawline and cheek to see if it has come down. There are also tests to know if a facelift is beneficial for you. One is called the mirror lift. It is when you like the way your face looks when you lift the face up. Another good test is if your face looks better when you lie down and your face goes back and upward.

There are a few options for you and a facelift is a good option. The youngest person that we’ve ever done a facelift on has been a 37-year-old woman and there was clearly a genetic issue involved. However, it’s not the same facelift that I would do in a 67-year-old. In your case, it is a commitment and an important decision to make when considering what kind of facelift incision I would do. I would probably do it around the ear to elevate the tissue and deeper tissues called the superficial muscular aponeurotic system or SMAS.

I suggest that you discuss these important points with your surgeon. I also advise you to look at the different positions of your face. If you feel like your jawline improves by moving the cheeks up, then a facelift may be the right decision for you. So have a good communication with your doctor to make the right decision and to get more opinions. I hope that was helpful, I wish you the best of luck, and thank you for your question.

New York Oculoplastic Surgeon
4.5 out of 5 stars 40 reviews

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A relaxed straight-facing side profile picture is needed here. With the limited views provided, it appears that a mini-facelift+necklift+neck liposuction would be helpful. A chin augment may also be helpful but it is hard to tell without the relaxed side profile pic. Be sure to see a Board Certified Plastic Surgeon in your area.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 31 reviews

Am I a candidate for a facelift

Hello and thank you for your question.

It is difficult to give you any definitive answers judging solely by your photos. Your photos don't actually represent what a plastic surgeon needs to see to properly evaluate you (particularly your lateral views with your neck flexed). If you feel that you have excess sagging skin around your jowl area you may be a good candidate for a necklift. And if there is excess submental fat certainly liposuction can help. I recommend that you seek out a board certified plastic surgeon so that he/she may assess your concerns in consultation.

Best of luck to you.

David Cangello, MD
New York Plastic Surgeon
5.0 out of 5 stars 7 reviews


You photos show a loss of the right angle under you chin called the cervicofacial angle. You also have some jowls. The only question in my mind would be what type of lift, and that cannot be determined without an examination and full facial evaluation.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Good candidate for a facelift.

A facelift is one of the most effective facial rejuvenation procedures. It can visibly improve skin laxity, remove excessive fulness under the chin, and re-establish youthful face and neck contour. In your case, all these changes would result in significant rejuvenation making your face look youthful and refreshed. Best wishes!

Konstantin Vasyukevich, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Facelift options and alternatives for younger patient

Every case is different and in order to get specific advice you would need to be seen in person. However, there are more options for a woman in your age group than for someone a bit older. These would include nonsurgical procedures such as Ultherapy, minimally invasive procedures such as liposuction and fat transfer, short scar facelifts such as the MACS lift, or more traditional lift techniques. Just keep in mind that only a facelift gives facelift results, so you need to match expectations with the option you choose.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 30 reviews

Laserlift Precision TX

Based on your photos, I could not get a relaxed side view of your neck. Therefore, I will comment to the best of my ability. You are possibly a candidate for a short scar facelift or you might also qualify for a laser facelift using Precision TX. Precision TX is minimally invasive and the laser directly heats the undersurface of your facial and neck with the concept of shrink wrapping your skin back in place. It entails mild bruising, moderate swelling and minimal discomfort. Your lower eyelids would benefit from fat redraping performed from inside your lower lid.

Theodore Diktaban, MD, FACS
Manhattan Plastic Surgeon
4.5 out of 5 stars 13 reviews

Can you benefit from a facelift?

After reviewing your pictures, I think that you would benefit from a facelift and fat transfer. When done together, these two procedures work well to rejuvenate the face and neck. Good luck.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 43 reviews

Facelift Ready

I have reviewed your photos and it appears that you would benefit from a facelift to improve your jawline and neck. I also believe that fat grafting would enhance your results significantly as you have lost volume in your midface. I highly recommend you seek out a surgeon that performs these procedures on a regular basis and see several before and after photos that he/she has personally done. Best Wishes.

Manuel A. Lopez, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 29 reviews

Facelift at 46

In reviewing your pictures, I think you are an excellent candidate for a facelift and necklift. A well performed facelift/necklift should remove the excess tissue in the neck and tighten the muscles creating a corsett to pull against when lifting the tissues that support the face. For my patients, the deep plane facelift has provided the best results, but there are many ways to perform good facelift surgery. It is important to look at pictures of patients who are similar to you in age and who have the same issues that concern you before choosing a surgeon or specific procedure. If you like the results the surgeon shows you, chances are you will be happy with the procedure.

J. Kevin Duplechain, MD, FACS
Lafayette Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.