I'm 44 years old and have sagging in my lower face and neck. Should I do a lower facelift or a deep plane facelift? (Photo)

I would not recommend a facelift but I do recommend a necklift or possible liposuction of the neck. You need to be examined to see how much fat you have there.

Best Wishes,

Gary Horndeski, M.D.

Hello, hope you are well. I think you would do best with a short scar neck lift, alongside FaceTite and NeckTite. It is not apparent from the photos that you submitted that incisions around the ears and hairline (per traditional facelift techniques) for skin removal are necessary. However, neck and lower face contouring and skin tightening can be achieved with the procedures mentioned above with minimal downtime, risk, and visible scarring.
Best,Dr. Tower

Thank you for your question and sharing your photographs.

Because your jawline contour is relatively good and it is predominantly the visibility of the marionette lines that disrupts the aesthetic balance, you could consider just a deep plane neck lift intervention as it produces improvement of the the jawline and to a more limited extent for the marionette lines.

If you are in favour of facelift intervention there is no particular reason against a deep plane facelift. It has a tendency to produce more consistent improvement for the marionette lines and jawline. The contouring effect however would make the contrast with the neck more significant and I would say that it is probably better to have either facelift and neck lift or just neck lift.

I think just facelift would not be the best outcome for your situation.

It is also fair to say that surgeons achieve good results for their patients with a variety of techniques both for the face and neck and a discussion in consultation and review of some of the past results is an important part of the decision process.