I'm a 61 year old woman and want to know what procedures are needed to regain a more youthful appearance (Photo)

61 year old diabetic woman, needs to know the best procedures to attain a more youthful appearance. Also how long will the effects of a well done plastic surgery last??? Do I need eye work, neck lift, Smas lift? I'm also a diabetic with control of my A1C. Can I still have extensive work done on my face, or is it too much a risk?

Doctor Answers 20

Neck Lift

Thank you for your question. You are an ideal candidate for the laser-assisted weekend. There is only a small incision under the chin and a tiny incision behind each of the ears. To restore a more youthful look to the neck and jawline, liposuction is performed to remove any excess fit. Then, there is surgical lifting and gentle tightening of the underlying muscle tissues of the neck. The last step is the laser rejuvenation technology, which is one of the most cutting edge procedures available. Always consult with a board certified facial plastic surgeon.Best wishes,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 116 reviews

61 year old diabetic woman, needs to know the best procedures to attain a more youthful appearance.

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.  As you know, diabetes affects small vessels and therefore the vascular supply to the skin following a facelift.  For that reason, a minimally, invasive SMAS face lift would be the most aggressive type of facelift that I would consider in a diabetic and if you require insulin injections, I would not even do that much surgery because of the added risk of poor healing and skin loss.  I have included information on the minimally, invasive SMAS facelift below.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Skin quality, volume loss, excess sagging tissue-all need to be addressed

Hi  Thank you for sharing photos.  When considering ways to look more youthful, there are several areas to address.  1)Volume loss can be restored with fillers, fat grafting (good for your nasolabial folds, marionettes and cheek-lid junction).  2)The excess sagging skin in the upper & lower lids,face & neck are best corrected by eyelid lift (blepharoplasty) and face & neck lift, probably with liposuction of the neck and face to provide more definition.  3)The quality of your skin (texture, pigmentation, poresize, fine lines & wrinkles) can be addressed with botox, chemical peels/laser resurfacing, physician grade skin care products, etc.  Pick what you will do based upon your downtime restrictions, time frame, interest in having/avoiding surgery, etc. Know that all three are necessary to get maximum rejuvenation.  Be sure to consult with an ABPS certified PS-Best wishes!

Vaishali B. Doolabh, MD, FACS
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Neck Lift Is Only Permanent Remedy for Turkey Neck

Thank you for your photos. My recommendation would be for a full rhytidectomy (facelift) with neck lift and platysmaplasty, plus upper and lower blepharoplasty. This will give you a dramatically rejuvenated look that will last anywhere from 10 to 20 years. As long as you are healthy and your diabetes is under control, you should handle those procedures well.  You have a great deal of under-chin sagging and jowling. Only a necklift with platysmaplasty can resolve neck drooping and only a mini lift or facelift can remove the jowls. I hope this helps.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Options to attain more youthful appearance

Based on the photo, you appear to be a candidate for a segmental facelift with a neck lift. A lower blepharoplasty may be an option as well. Consult in person with an experienced and expert board certified plastic surgeon to understand your options. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 41 reviews


Hello and thank you for your question. Based on your photograph, you may benefit from a mini facelift with a neck lift.  If good technique is used, this can be done with minimal scarring and can result in a natural look, not over-done look, with rejuvenation of your face.  In regards to your diabetes, you will need to obtain medical clearance from your medical doctor to make sure you are safe for surgery.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 124 reviews

Lower face and neck lift

From this photo, it seem like you would get a great result with a upper lid blepharoplasty, lower face and neck lift. An in person exam would be needed to come up with the best treatment plan. Find a board certified plastic surgeon in your area with expertise in facial aesthetics. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck! 

Dean Vistnes. 
Vistnes Plastic Surgery

#realself #drdeanvistnes #lowerfaceandnecklift #blepharoplasty

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 47 reviews

I'm a 61 year old woman and want to know what procedures are needed to regain a more youthful appearance

Thank you for your question.  Surgery can certainly be performed if your diabetes is well controlled.  Based on your photos, a lower facelift / neck lift and upper and lower eyelid surgery would improve your youthfulness.  Also, this may be complemented with fillers for the lines around your mouth and botox for the crow's feet.  Once you're  fully healed after your surgery, microneedling can be performed to improve skin texture.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Face natural lift first

You have some of the natural changes of aging and there are many things that can be done and done well even for someone with diabetes.  I always prioritize and the most important is a MiniLift which can address the sagging jowls and neck.  Eyelift or blepharoplasty will rejuvenate your eyes.  A filler or fat transfer is best to provide reduction of the deep lines around your mouth.  These 3 options are your first choice, others can be provided depending on your best desires.  I like laser resurfacing to reduce wrinkling throughout the face as another option.

David Q. Santos, MD
Bellevue Facial Plastic Surgeon
4.3 out of 5 stars 23 reviews

Face lift surgery at 61?

Thank you for asking about your face lift.
  • You have lovely features and look excellent for your age.
  • Surgery can definitely be done for someone with controlled diabetes -
  • Your regular doctor will clear you for surgery.
  • At a glance, a face and neck lift seem like the best approach -
  • With upper lid surgery and fat grafts if you want them done at the same time.
Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 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.