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 35

Facelift on 57 year old

You are a youthful looking 57. You look happy and attractive. In the right hands, you could have an excellent result. Many more photos would be needed to provide accurate assessment.  But you want to find a plastic surgeon with examples of many, many natural looking results. The last thing you want is something that will distort your appearance and make ou look unnatural. In fact, the happiest facelift patients may have a dramatic looking result when comparing side by side before and after photos, but often friends and acquaintances just comment on them looking great and do not suspect surgery.

I often find it helpful for a patient to share photos from their youth during a consultation. The goal is not to make a person look twenty again, but evaluating changes can be helpful. Sometimes subtle changes like hollowness of the upper eyelid or temples, atrophy of jawline and other subtle changes can make a significant improvement in one's appearance, particularly if all ready addressing more obvious issues like excess skin of the jawline, etc. 

I always ask patients for current photos from the front, side and oblique perspective but smiling and not smiling. Most importantly, I like to discuss with a prospective patient the areas of concerns and listen carefully to their goals. 

At this point, find a plastic surgeon who has demonstrated the ability to provide beautiful natural results with many, many before and after images. When you find a plastic surgeon who shares your aesthetic ideal, carefully check their education, experience and safety record. Find out about the surgical team and the facility where surgery will be performed. Look for a facility certified by both the Joint Commission and AAAASF, or at least one of the two. Be sure anesthesia is administered by an MD anesthesiologist. 

Bravo to you for taking your time searching for the plastic surgeon who is right for you.  



Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 117 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
4.7 out of 5 stars 33 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
4.9 out of 5 stars 38 reviews

Opinions on route to take

Thanks for your question!  It would be better to assess in a non-smiling picture (or even better in person), but based on what I can tell, I would possibly recommend a short-scar facelift for you.  Your eyebrows are at a good height so I think that a brow lift would be overkill.  Eyelids look good to me at this point as well.  Maybe consider something like the Precision Tx for the neck and jawline as an alternative to a facelift which may be too much at this point.  Good luck!

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

Find the right surgeon

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for a Facelift Always insist on a board certified plastic surgeon.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 147 reviews

Facial rejuvenation is not just about surgery

Facial rejuvenation is not only about surgery. The most natural results are achieved by combining advanced dermatology treatments, plastic surgery, as well as a results-oriented skincare. Face lift, when done well, involves tightening the muscle layer which restores youthful contours without an unnatural pulled look.  Surgery alone does little for improving skin quality and texture. Therefore, laser therapy, when performed by a skilled Board certified dermatologist, before and after surgery optimizes scar healing, improves texture and skin tone, and fades and softens scars. At the time of face lift, facial fat transfer is effective to restore facial volume and architecture permanently. Maintenance treatments with "laser facials" (i.e. Clear+Brilliant non-ablative laser followed by high quality, results-oriented skincare) can make surgical results last. 

I'd need to examine you in person to present a customized regimen but rest assured that fantastic results are achievable for everyone at any age.  

Ariel N. Rad, MD, PhD
Washington DC Plastic Surgeon
5.0 out of 5 stars 51 reviews

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.

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 88 reviews

Facelift

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.

Kindly,

Kouros Azar

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

Thanks,

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 106 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.