What surgical procedure(s) do you suggest for a refreshed look to my eyes/face/neck?

Thank you for your question and photos.Although you have some volume loss in the upper cheek most of your aging issues are visible in the lower face and neck. A SMAS facelift is the appropriate operation to correct this. This is a general term however which means different things in different offices. The SMAS is the investing layer of the muscles of the face and must be "lifted" for a long term result with the best opportunity for minimizing scarring. You will do very well with this operation. Volume addition to the face will also be important and this can be done surgically with fat grafting during your procedure. Your upper lids and brow position are good but the fat pads of the lower lids can be addressed during your facelift.Fine lines and wrinkles are best addressed by a laser resurfacing procedure which I do at a separate time.Your breast implants can be removed at the time of your facelift procedure. Staging the breast lift is an excellent idea.Seek out a board certified plastic surgeon with advanced training in facial aesthetic surgery.Good luck and I hope you found this helpful.

Best Procedures for Facial Rejuvenation. A SMAS face/neck lift and a Browlift using the Irregular Trichophytic incision which won’t leave a noticeable scar, and a lower  blepharoplasty are what you need to correct your aging issues. This should be done by a very experienced facelift surgeon who can show you dozens of natural results of his work on patients like you.

   In our practice, we perform a high-SMAS lower face and neck left.  The goal of a lower face and neck lift is to tighten loose facial and neck skin,  tighten loose  facial and neck muscles, lift the jowls, and remove any fatty deposits in the neck which also includes a platysma-plasty.    The hooded and extra skin on the upper lids can be addressed with an upper blepharoplasty, while the puffiness can be removed from the lower lids with lower lid blepharoplasty procedure.  Eyelid surgery and a facelift can be performed together under one anesthetic which allows one recovery period.  

I would suggest your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with who has all of the modalities of treatment available. You should discuss your concerns with that surgeon in person. Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California 

Which ever plastic surgeon you select should be able to work subtly with your natural features to enhance your appearance without an operated look.  Your features seem very favorable in the photos you provided.  SMAS facelift provides support for the sagging deeper tissues in the cheek area, and indirectly to the neck as well.  Anterior platysmaplasty suspends the lax muscle and fibrous tissues under the chin.  Placing a small amount of fat graft in the anterior cheek may be helpful.  Loose cheek and neck skin should be gently removed.  Lower blepharoplasty should remove the bags.  Upper blephroplasty should remove redundant skin.  Brow lift may be considered, but is not likely needed. I would guess that these procedures would be too involved to also do breast surgery at the same time.  These may sound like a number of procedures, but done well, should give a beautiful refreshed look.  The breast photos certainly show large and sagging breasts, which would often be quite uncomfortable.  Moderate sized, lifted breasts should benefit you greatly.  Staging the removal of the implants and the lift is a reasonable plan.  Your general health should be carefully evaluated by your surgeon, along with these and other questions in order to help you decide on the best plan of action.  Best Wishes.

Thank you for the questions and photos but you will get your most accurate answers after a full examination.   So go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results then look at photos of similar patients and become fully informed Dr Corbin