Mid face lift, eye lift? Which surgery can help? (Photo)

I am 46 years old. Marionette lines, drooping hollow eye lids and an overall tired look. What surgery can help these areas

Doctor Answers 29


With the aging process, the skin becomes less elastic allowing gravity to imprint changes on the face and the neck. Skin becomes looser causing folds around the mouth, fat shifts to flatten cheeks and muscles loosen creating neck bands.  A facelift pulls up on drooping skin and sagging muscles to reverse these changes. In most patients the benefits of a facelift are most pronounced in the lower cheek (jowls) and in the neck area with a revitalized chin and neck contour. I recommend meeting with an experienced, certified physician for an in-person consultation. Best of luck.

Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews


Hi there. Thanks for sharing your photo with us. For surgery options, I recommend a facelift to raise the droopiness of your skin. I also recommend some fat injection below your eyes to correct some hallowness. For non-invasive options, I recommend some fillers around the mouth, your nasolabial folds, and around the eye area. It is always best to have an in-person consultation for a more accurate evaluation. 

We wish you the best of luck!

Peter Newen, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 33 reviews

Most Effective Facelift Procedure on Jowls, Eyes, Neck

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.

It is also possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 102 reviews

Which surgery can help?

If you feel that your face does not reflect how young you feel on the inside, a facelift may be the solution to help you look and feel younger. During your consultation, your doctor will evaluate your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure. Based on this evaluation, he/she will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. Your doctor should make sure you have a full understanding of what results to expect.Always insist on a board certified surgeon!


At 46 years old, you are fairly young, and instead of a full facelift, you might want to consider using fillers in the mid-face, nasolabial folds, and around the mouth. Injecting fillers is a minimally invasive, outpatient procedure and it may be enough to help you reach your aesthetic goals, albeit temporarily. The fillers due wear off over time, but it may allow you more time to decide before proceeding with a more invasive procedure like a facelift. 

Salem Samra, MD
Middletown Plastic Surgeon
5.0 out of 5 stars 3 reviews


Thank you for your question. A facleift can resolve the creases below the eyelid and improve the marionette lines. It is also common to have facial implants, fat transfer and skin resurfacing procedures done at the same time as a facelift to address your concerns and desires. I suggest that you move forward and consult with a board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 110 reviews

Facial rejuvenation options

Honestly, it is hard to give any kind of accurate advice from a photo. Your best bet is going to be scheduling a consultation with a board certified plastic surgeon in your area to be assessed in person and discuss options. A blepharoplasty will remove excess skin and fat above & below the eye, but sometimes placing filler in the mid-face/cheek area will improve the look of the under eye area. Bottom line, you have options.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 31 reviews

Which facial surgery can help?

Facial rejuvenation surgery is a great way to achieve a more refreshed and less tired look.  An in-person examination by a board certified plastic surgeon will be the best way to determine which facial procedures will give you the most natural and refreshed results.  Eyelid lift (blepharoplasty) surgery can remove extra skin or bagging under the eyes to “wake up” the eyes and facelift (rhytidectomy) surgery can gently pull back and remove extra skin in the mid face, jawline and neck area for a more youthful result.  A personalized consultation will answer your questions and detail the best surgical plan for you!

Do I need a face lift?

Hi! It's tough to say with the picture you provided. I recommend setting up a consult with a board certified plastic surgeon. A face lift will help with the neck and jowl area but not so much the eye area. You may be a candidate for a blepharoplasty and fillers to help with marionette lines. Best of luck to you!

Scott C. Lindsay, DO
Reading Plastic Surgeon
5.0 out of 5 stars 3 reviews


from your photos, it is hard to tell if you need a facelift.  A standard facelift will tighten your neck and jowls, and you might benefit from an eyelid lift at the same time.  I am not a fan of the so called mid face lift.  I think it accomplishes very little for the additional cost involved.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 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.