Which facelift technique would best achieve this amount of lower-face lift at age 30? (Photos)

Question

What face/neck lifting method is best for a 30-year-old who lost 55 lb (25 kg) 2 years ago and wants to lift the midface, lower face, and neck—especially the lower face to the extent shown in my manual-lift photo? Since there are so many variations within each category, what specific type of mini/limited facelift, SMAS facelift, or DPFL would you recommend for me? Feel free to stop reading here; more context below if helpful. I’m confused by the conflicting advice. Some surgeons argue mini facelifts because of the limited dissection/inadequate release/repositioning of the deeper tissues can lead to a pulled/less natural look, increased tension on incisions, limited effect on mid/lower face & deformities like sweeping/pixie ear, and argue that a more complete release DPFL can look more natural even in younger patients. Others say a DPFL is too extensive at my age and recommend a mini or SMAS lift instead. I’ve also heard criticisms of SMAS lifts, including a less natural look, more tension on incision, greater skin-SMAS separation which can cause surface irregularities or a dull skin appearance. I’ve also considered hidden incision endoscopic full face/neck lifts using hairline and behind-ear incisions to address the midface, lower face, and neck. I’ve heard conflicting opinions on how well they lift the lower face and have noticed some results with cheek/temple widening, indentations, or visible pull lines creating that alien look.

Don W. Griffin, MD · Answer

Thank you for your questions. We are seeing patients present at younger ages with face and neck laxity due to weight loss. I will attempt to answer your questions and provide different options for you based on your photos. In general, the neck laxity does not improve much with short-scar of endoscopic facelift techniques. The specific technique-deep plane vs. SMAS lift is less important than the quality of the technique performed. There are pros and cons to each technique and no face/neck lift will last forever. Additionally, as I stated earlier, the main issue is to choose a technique that will address the areas that concern you and determine what you need done based on your specific anatomy. 
Looking at your photos, it seems your skin is more stretchy, than sagging, and that you have some volume deflation from your weight loss. Some of this can be addressed with fillers and/or fat grafting. Additionally, your submandibular gland on the side view seems enlarged. This can only be corrected with removal using a deep plane neck dissection. 
I would recommend that you have a consultation with a plastic surgeon to understand all of your options and develop a step wise treatment plan for improvement.

Kyle Kimura, MD · Answer

Thank you for your questions and photos! 
The fact that there are so many different opinions likely means there is no "clear best" option in your situation. It can also be quite confusing as the true definition for "mini lift" or "limited" lift are going to be different for each surgeon. I would agree, at least in my opinion, that a full deep plane facelift would be overkill in your situation. I feel your best option would be something like an endoscopic midface lift or minimal access midface lift. I think ultimately you should find a surgeon well versed in facial rejuvenation (ie facelifting) to discuss the nuances of all of these options and someone that you trust and feel comfortable with. 
I hope this helps and best of luck!Kyle Kimura, MD

Gary M. Horndeski, MD · Answer

Most plastic surgeons are very unlikely to perform a facelift on someone at the age of 30. You would benefit from an eccentric lip lift, not a bullhorn lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This takes 1 hour to perform under local anesthesia and costs $4,000. You would also benefit from a chin implant with possible liposuction of the neck.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Philip Wasicek, MD · Answer

Hello, 
Getting a facelift at 30 years of age requires serious consideration. It is uncommon for it to be the right answer. There are differences between changes for beautification and aging. What you are describing may be more for beautification than aging. Everything carries risk. There are risks with surgical interventions including what you mentioned. I would recommend an in-person consultation with a board certified plastic surgeon who specializes in facial rejuvenation. 
It may be reasonable to volumize your midface and cheekbones (with things such as HA filler, fat grafting, sculptra, among others). This may be a better starting point than a deep plane facelift. Hope this helps.

Which facelift technique would best achieve this amount of lower-face lift at age 30? (Photos)

Answers (4)

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