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Based on your photos and your goals, you appear to be an appropriate candidate for a facelift procedure. I would recommend including a necklift as well, which typically involves tightening the neck muscles through a small incision under the chin. A combined face and necklift will most reliably treat the jowls and neck cords. A conservative amount of facial fat transfer can also help restore some of the volume loss in the cheek, as well as soften the hollowness of the nasolabial folds and marionette lines around your nose and lips. 
Regarding skin wrinkles, although a face and necklift will usually improve them, you may want to consider including a laser or chemical peel for skin resurfacing. The facelift improves laxity in the face, while a laser or a chemical peel improves the texture and tone. These can be safely combined in the same procedure by an experienced plastic surgeon.
An in-person consultation with a plastic surgeon will help formulate a complete treatment plan, which may include some or all of the procedures that I have mentioned. Best of luck!

I'm in my early 60's and would like to get a facelift (and maybe lower bleph) to take care of the wrinkles, jowls, and neck cords. Please advise.

Would a facelift help with wrinkles, jowls and neck cords? (Photos)

There are a number of treatment options available to improve a flat midface and prominent nasolabial folds. Improving lifestyle factors such as stress reduction may help, since excessive stress can accelerate facial aging. In terms of surgical treatments, I would recommend facial fat transfer. This is a procedure where fat is harvested from a different part of the body (typically the abdomen or the inner thighs), processed, and then injected into the nasolabial folds and midface. This can improve volume loss that you may have experienced, and the results tend to be quite durable over time. I would recommend consulting with a plastic surgeon in person for a full assessment and any additional recommendations.

I would prefer not to get threading or fillers after seeing that viral scan showing a womans face with filler migrated everywhere. My family also has the smile lines so it’s partly genetic. The other factor is ive had a very high stress life for someone my age and im tired of looking like it.

What treatments can I get as a 24 yr old woman to address flat midface and nasolabial folds? (Photos)

Deciding between a Mini Facelift versus a Deep Plane Face Lift is a common situation for many patients, especially those with mild to moderate (but not significant) signs of facial aging. 
The term "Mini Facelift" can refer to many different techniques, ranging from skin-only facelifts, to minimal-access deep plane facelifts. It is important that you speak with the surgeons that you have consulted with, to understand exactly what they mean when they use the term "Mini Facelift". Ask about the incisions, and whether it will be a skin-only procedure, or will the deeper layers be addressed. In general, however, these procedures entail more limited surgical dissection, less manipulation of the soft tissues, with less powerful results that do not tend to last as long. 
In contrast, a full Deep Plane Face Lift is a more invasive operation with a longer recovery, but in skilled hands, it provides much more powerful results and tends to last longer. An experienced surgeon will be able to perform this procedure and create results that look very natural. If you are willing to undergo the more extensive recovery, this procedure is more likely to fully address your facial aging concerns, since the surgeon will have a greater ability to manipulate the soft tissues. Your biological age is not a major determinant of which procedure is indicated. I have seen an increasing amount of younger patients requesting deep plane facelifts, including many patients in their 40's. 
Perhaps most important to note is that results can vary significantly from surgeon to surgeon. You should ask each surgeon that you have consulted with for before & after photos that demonstrate the results of the procedures that they have recommended. You should study these photos, and think about which results most closely align with your goals.

I’m 42 and have been unhappy with how my lower face has been aging over the past few years. I’m noticing increased heaviness, loss of jawline definition, and early jostling and sagging. I’m 5’8”, 135 lbs, and my weight has been stable for years. I’ve consulted with several surgeons so far ,two have recommended a mini facelift, while two others have advised a deep plane facelift with a neck lift. I’m hoping to get additional input from experienced surgeons here on which approach may be most appropriate at this stage. I’m open to the possibility of future procedures, but I’d like to make the best decision for where I am now and achieve results that allow me to feel confident and refreshed while still looking natural.

42, lower face - increased heaviness, loss of jawline definition, jostling and sagging. Mini or Deep Plane Face Lift? (Photos)

Wrinkles ("rhytids") under the eyes can be caused by a number of factors including crepey and loose skin, uneven skin texture, volume loss, and the action of the surrounding musculature.
When determining the cause of the rhytids, it can be helpful to distinguish between "static" and "dynamic" rhytids. If the rhytids are purely dynamic and present only when animating the face, they are mostly due to muscle activation and be softened with neuromodulators such as Botox.
Over time, rhytids that were once only present during animation become deeper and remain permanently visible, even when the face is still. These static rhytids can be addressed with skin resurfacing such as laser or chemical peels, volume replacement of the midface with fat grafting, and possible removal of excess crepey skin as might be performed in a lower eyelid "pinch" blepharoplasty. These treatments can also commonly be combined.
Without an in-person evaluation, it is difficult to determine which treatments would help you most. However, if you have noticed that lasers, biostimulators, and neuromodulators are no longer effective, it may be time to consider other treatments such as lower eyelid blepharoplasty with or without fat grafting. An in-person consultation with your local plastic surgeon will be helpful for a more detailed evaluation and specific recommendations. Best of luck!

Hi..50 year old female been doing tox, biostimulatores and laaer for years now..but in the past year my unfer eyea are so wrinkly when i smile (yes i expect some for natural movement) but this is aging me...what would help this area?

50 years old - What would help my wrinkly under eye area? (Photos)

There are multiple anatomic factors that can contribute to eye bags and a hollow midface. These include the orbital vector (projection of the eyeball relative to the facial bones), the presence and size of lower eyelid fat bags, weakening of the lower eyelid septum that can cause fat bags to appear more prominent, and a lack of bony prominence of the midface facial bones. 
A treatment plan may involve a combination of procedures to address each of these factors. The projection of the eyeball cannot be changed, but lower eyelid fat bags can be reduced or repositioned, and the projection of the midface facial bones can be augmented to reduce hollowness. Augmentation of this area can be performed with fillers, fat grafts, or implants. 
You should consult with your local plastic surgeon to understand what option may be best for you. In addition, your rhinoplasty surgeon can counsel you on how soon after your rhinoplasty surgery would be safe to undergo any procedures to the lower eyelid and midface. Best of luck and I hope you find this information to be helpful.

I’m 27 years old and have always struggled with genetically bagggy/hollow undereyes. I’ve gotten dermal fillers since the age of 18 and recently got them dissolved a few days ago. I am looking for advice on procedures to address this area, and given my age, if I should stick with fillers again or move to surgery. I am getting a functional rhinoplasty soon and am also wondering how soon after the rhinoplasty I can address this area. Thank you

How to address genetically bagggy/hollow undereyes/mid face area? (Photos)

Vikram Mookerjee, MD

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