Boris M. Ackerman, MD

You fall into a category of a "revision facelift". A different anatomical consideration needs to be considered. A short answer - you need an "curated" extended deep plane facelift. Seek out a very experienced facelift expert for an in person consultation.

There are some facial changes that start occurring in some patients in their 40’s. I routinely perform facelifts on properly selected younger patients. If a patient knows that they will have a facelift at some point in their lives, then my advice is - “the younger the better”. This advise has held up in over 25 years of my practice specializing in facelifts. When expertly performed, using the best techniques, the patients look quite young and yet very natural. There are a few causes for somewhat premature aging - significant weight loss is one, environmental factors is another, genetics factors also can play a role. Seek out an experienced and talented facelift surgeon for an in person evaluation. Ask to see ‘before/after” photos of other patients in similar age group and with similar signs aging. This way you will get a realistic idea of your possible result.

Facelift is a general term that can describe a few different techniques. There are many "named" facelifts that are mostly marketing terms. The most common facelift technique in the U.S. is the so called "SMAS" facelift, which can correct aging of the cheek, jawline and the neck. An experienced surgeon will choose the technique that he/she is most comfortable performing, and that creates most benefits for the patients. In my facelift practice, I carefully assess each individual patient's anatomy, and then design the ideal technique. Most often that involves the "Deep Plane Facelift" in combination with the "Anterior Platysmaplasty", plus some other adjunct procedures. The goal is to create significant rejuvenation and yet have the patient look very natural.

Rhinoplasty can change the nasal appearance in many respects. One of the more common requests is to make the nose smaller, but that is only one aspect of creating a more balanced and more attractive nose. Based on your photos, it appears that your nose could be made smaller and more refined. The limiting factor in making the nose smaller is the ability of your nasal skin to shrink to accommodate the new smaller underlying framework. Only in person evaluation can determine that. Most likely, your nostril will need to be made smaller, but any resulting incisions should leave nearly imperceptible scars. Seek out a Rhinoplasty expert that has lots of experience operating on patients with your type of nasal anatomy.

Your request is quite reasonable. Based on the photos, your nose can definitely be made more refined and elegant. Your nasal anatomy has some very specific features that require certain surgical techniques. Seek out a Rhinoplasty expert for an in person evaluation. Ask your surgeon to show you some examples of "before/after" photos of other patients with your unique nasal anatomy.

You are a candidate for a younger lower neck and facelift, its best to go to a surgeon who specializes in this procedure and can create a beautiful and natural looking facelift for you. Find a surgeon who will design a facelift plan depending on your unique anatomy; for some patients it is a vertical lift, for some a deep plane or a SMAS lift.

Revision rhinoplasty requires a deep understanding about what is disharmonious with the nose. For a more natural rhinoplasty I would suggest addressing the bridge and tip. This will give a softer more feminine look that is very pleasing. Revision rhinoplasty is a very difficult procedure so be sure to see a surgeon who specializes in this type of surgery.

Face lift would not be the best option for your facial aging. After carefully reviewing your pictures the best options for you would be a Lip Lift w/ Fat Graft, and Co2 laser resurfacing. These procedures will give you a much more youthful, refreshed, well balanced look. Be sure to find the right doctor who specializes in the Lip lift technique!

Premature facial aging can happen at any age and is actually determined by the facial anatomy.This is a great question and very common question as well.After carefully reviewing your pictures you are a candidate for a very specific procedure called the Deep Plane Facelift. Your jawline will look defined and your saggy jowls will disappear giving you a much more refreshed youthful look. I don't think a chin implant will be necessary with the Deep Plane Face Lift as this correction alone will be sufficient to balance your face.

Ideally the fat graft should be done at the same time as a facelift. Most importantly, you should find a facelift expert to carefully assess your face, so that the proper facelift is performed. It's possible to do a facelift first, and then after a few months to do Structural Fat Graft.