Ali Riza Öreroglu, MD

After reviewing your photos, it’s clear that the tissue damage and loss of elasticity in your face can no longer be effectively addressed with minimal or non-surgical treatments. Therefore, I recommend a deep plane facelift surgery. This technique allows me to reposition the deeper tissues and effectively lift the midface sagging, providing you with a natural and long-lasting result. During the procedure, I also perform fat grafting to restore lost volume, creating a balanced and more youthful appearance. In your case, laser treatments and other non-invasive options would be insufficient. Based on my experience, this combined surgical approach is the most appropriate and effective solution for you. Of course, after a thorough physical examination, I tailor the treatment plan specifically to your individual needs.

Based on the concerns you've shared, a lower facelift or a more limited mini facelift may be appropriate to address laxity and improve definition in the lower face and jawline. Submental liposuction can help reduce fullness under the chin and enhance your neck profile. For facial asymmetry and volume loss, fat grafting offers a natural and long-lasting solution. In cases where deeper nasolabial folds are present, a deep plane facelift may be beneficial, as it repositions the deeper facial structures for a more balanced and lasting rejuvenation. That said, a physical examination is essential to properly assess your facial anatomy, skin quality, and tissue support. Without an in-person evaluation, it’s not possible to create an accurate and personalized treatment plan. I strongly recommend an in-office consultation to determine the best approach for your needs.

Based on your photos and the information you've shared, there appears to be noticeable soft tissue laxity and asymmetry in your face, which can sometimes occur after Sculptra due to uneven collagen stimulation or suboptimal injection technique. To correct this in a natural and long-lasting way, I recommend a deep plane facelift—a surgical approach that not only lifts the skin but also repositions the deeper facial muscles and connective tissues to restore youthful contours. In addition, instead of using filler to address volume loss, a more natural and durable option would be facial fat grafting, which can restore volume with your own tissue, offering softer and more harmonious results. Since your last Sculptra treatment was in January 2025, the safest window for surgery would begin around January 2026. However, if your tissues are soft and without significant nodules or inflammation upon examination, it may be possible to consider surgery as early as November–December 2025. A thorough in-person assessment and possibly imaging would help determine the optimal timing.

Although you’ve had a chin implant, if the sagging in the lower face and the downward pull at the corners of your mouth persist, I would recommend a combination of lower facelift and anterior neck lift to address these concerns effectively. A lower facelift helps to redefine the jawline and lift the jowl area, restoring structure and youthfulness to the lower third of the face. The anterior neck lift, on the other hand, specifically targets the front of the neck by tightening loose skin and muscles, creating a smoother, more defined transition between the face and neck. In addition, to restore lost volume and soften any hollow or deflated areas — particularly around the chin and cheeks — I often recommend fat grafting. Using your own purified fat, this technique replenishes volume in a natural way and can significantly improve overall facial harmony and skin quality. Of course, in order to determine the best and safest treatment plan for your unique facial anatomy and expectations, a physical examination is absolutely essential. This allows me to assess the structure and movement of your tissues and guide you toward the most appropriate approach.

Lines around the mouth can be quite distressing, especially at a younger age, and fillers don’t always provide sufficient improvement in this area. In your case, considering the overall sagging and volume loss in the face, a total facelift can be a more effective and long-lasting solution. This procedure repositions the tissues in both the mid and lower face, removes excess skin, and rejuvenates the facial contour.Fat grafting (fat transfer) can be performed under local or general anesthesia after the surgical recovery period; it helps restore volume to areas such as around the mouth, the nasolabial folds, and under the cheeks, resulting in a more natural and softer appearance.Since the patient’s own fat is used, the results tend to be long-lasting and well integrated with the tissues. That said, every face is unique, so a physical examination is absolutely necessary to create the best individualized treatment plan for you.