Need an opinion on facelift, blepharoplasty lower or upper brow lift concerns? (Photo)

I am 57 and in need of a face lift and neck lift. I just don't know the correct route to take. Some ps in consult said full face lift and one said mini. Also some say no lower lid or upper eye surgery yet. My lower are a bit hollow and upper just a small amount of skin. Eyes are deep set so this helps them not look so bad. No question on neck. endoscopic brow lift was suggested with no bhelps. I had too many consults and now confused. Want a natural result without being overdone.

Doctor Answers 32

Facial aging advice

It is really hard to advise you on the pic given.  I would recommend at least a frontal non smiling and a profile view.

From what you have provided an endobrow or upper bleph seem unnecessary.

Houston Facial Plastic Surgeon
4.7 out of 5 stars 81 reviews

Most faces age synchronously so a full facelift is almost always the best indication relative to the lesser procedure.

The photograph provided presents a somewhat incomplete picture of your situation. Endoscopic brow lifts were very common 10 years ago but Botox cut into this business. I don't see anything particularly wrong with the brow on the upper lids based on the limited information in the picture. Most patients in their 50s who are searching for facial aging solutions are candidates for a full facelift. Make certain you see lots of pre-and post op photographs by your surgeon. Certainly there will be some that will mimic your situation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews


Without examining you in person, it is really impossible to give you any kind of recommendation. It's sounds as if you've gotten a bunch of consultations so now, it's going to come down to choosing the surgeon who you feel does the best face work and who really listened to you. Schedule another appointment just to be certain. Keep in mind that there is no one size fits all facelift. As you've discovered, there are many different routes to delivering your younger looking face.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Need an opinion on facelift, blepharoplasty lower or upper brow lift concerns? (Photo)

To  have a "facelift" is not one operation for all comers but can be modified a great deal depending on what the problems are. Having not examined you and only seeing your frontal view I would guess that your previous consults were aimed at raising support structures in your face. This can be done with a short scar face/neck lift, and less invasive techniques such as structural fat grafts to treat eyelid hollows and tear trough formation. If skin excess is present a "pinch" blepharoplasty may suffice. Brow lift by lateral or endoscopic techniques are not universally necessary and your brows look to be fairly high. Neuromodulators can maintain a lifted brow along with fat grafting to the lateral brow. Hope this helps,


Dr K Dolynchuk

Ken Dolynchuk, MD
Manitoba Plastic Surgeon

Facelift techniques and different patients

Thank you for the question and the photo. You have a great smile. Facelift and eyelid surgery are not "one-size-fits-all" procedures. Some patients will need more work on the neck; others need repositioning of the cheek fat pads primarily. Some patients have a lot of lower eyelid fat; others have deep hollows. Without an in-person examination, it would be irresponsible for me to give you specific recommendations. Please visit with three or four surgeons to get different opinions. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 98 reviews

Timing for Surgery

Wow, great smile. You are beautiful. When one considers facial surgery, it can be very confusing. Interviewing different docotrs will allow you to see diffeent approaches. I prefer natural results, some prefer a dramatic surgical look. Look at their before and after pictures, ask to speak with a previous patient who has had the procedures. If the doctor does alot of faces they will offer computer imaging- a great educational tool.

 At the end of the day it is very important to feel comfortable with your surgeon. If you don't keep looking or it may not be time for surgery yet.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Confusion over facial rejuvenation recommendations

Hello.  Thank you for your question.  It can be very confusing for the average person when considering all of the many surgical and non-surgical options for facial rejuvenation.  In addition, recommendations from multiple surgeons may vary for the same individual, due to variations in experience between surgeons.  You appear to be a very attractive, youthful appearing woman in the picture that you provided.  However, unfortunately the picture does not provide much useful information for assessing your aging face concerns.  It would be more helpful to see additional views, including a frontal view without smile, and oblique and lateral views from each side that include the entire face and neck.  The choice between a "full facelift" and "mini-lift" is primarily determined by the degree of laxity in the neck that needs to be addressed.  A mini-lift will likely be inadequate for someone with significant neck laxity, but is a very good option for individuals with mild to moderate laxity in the jowls and mild laxity in the neck.  With regards to your eyes, if there is hollowing of the eyes, then fillers or fat transfer for volume restoration will likely be a better option than lower eyelid surgery.  It is difficult to asses your upper eyelids and brow in the picture, because you are smiling and your brow is elevated.  Anyway, it is certainly possible to get a natural appearing result from all of the procedures that have been recommended to you, in the hands of an experienced surgeon.  I would advise you to be certain that any surgeon that you choose is board-certified by the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery.  In addition, I would encourage you to assess the experience of your surgeon by viewing multiple before and after pictures to ensure that they achieve the natural results that you are seeking, and viewing patient reviews and testimonials to assure that their patients are happy and satisfied with their care and results.  Beyond these due diligence issues, you must choose a surgeon with whom you feel comfortable.  I wish you the best in achieving your aesthetic goals.

Michael Boggess, MD
Nashville Facial Plastic Surgeon
4.8 out of 5 stars 33 reviews

Zlift natural facelift with SMAS and limited lower bleparoplasty

you are a beautiful young lady. See a board certified ASAPS plastic surgeon in consultation the Vectra 3 dimensional imaging machine may help you visualize what you seek. Look at the results of the surgeon by checking there before and after photos. Knowing or meeting some one who has used the surgeon may help you relax about what the surgeon intends to do for you.  Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

I am 57 and in need of a face lift and neck lift. I just don't know the correct route to take.

 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.  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 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 and no incisions extend or are placed within the hair.
  • 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.  At 57 years of age, it could be a combination of low eyebrows and excess skin laxity of the upper eyelids.  This area is best assessed during consultation vis Skype or in person to decide if a Brow Lift, Eyelid Surgery (Blepharoplasty) or both would provide the best results. 

Hope this helps.

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

Confused from multiple opinions regarding procedures

Dear Mag1959,

Thank you for your question and the image.  It can be confusing hearing multiple opinions, especially as there is not always one right answer, just choices.  I always try to partner with patients to decide not only what procedures are going to give them the best outcome, but also what fits with their lifestyle, recovery, and budget.  Natural looking results are a key focus of my practice, having done thousands of these procedures, and is the number one concern of patients in my experience.  All the procedures you have been discussing in consultation can be done with a natural looking result...that is more a factor of the surgeon than the procedure itself.

As to the procedures you are considering, you have deep set eyes which tend to age well.  If your under eyes are more hollow than puffy, then fat transfer to correct the fat loss and hollowing may be a consideration.  It is difficult to assess your brow position from the picture, as the brows are elevated.  As to a face and neck lift versus mini lift, both address jowling.  The primary difference is the amount of work done in the neck which depends on the severity of aging changes and degree of plastysmal banding.  I cannot give you an opinion based just on that image, but hopefully that helps clarify which procedure may be best for you.  If another opinion will not confuse things further, I would be happy to meet you in person and give you my thoughts.

All my best!  Dr. Elizabeth

"This recommendation has been solicited without seeing this patient, and is not to be considered medical advice.  Please see a physician for medical advice specific to your situation."

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.