Which procedure would deliver the best results for targeting the jowls? Previously had a mini facelift and Restylane (photos)

Dear whodeewho1,

Thankyou for providing pictures for a better recommendation. I recommend you to have a full facelift and neck lift surgery with fat injections to give you a tightened lifted and younger appearance. I am attaching a link for before and after if you would like to look deeper into the procedure and what to expect.

Regards,
TAS TEAM

Hello and thank you for your question. From what I can tell based on the pictures you have provided, there is some moderate jowling present on both sides and some prominent nasolabial folds. This occurs with age as the soft tissues of the face start to descend and as we lose volume from fat atrophy and bone loss, resulting in the characteristic changes of facial aging. You also have rhytides (wrinkles) present throughout your midface, lower face, and neck- especially noticeable around your mouth. This is a result of skin damage and laxity which occurs with age. You have some excess neck skin but I cannot tell if there is any platysmal banding in your neck. Based on all that, I would definitely recommend a revision facelift/necklift for you. A facelift would be the best way to address the soft tissue descent and jowls to improve jaw definition and restore a more youthful appearing face and neck. It would also help remove some of the excess lower face and neck skin which is contributing to all the wrinkles. At the same time, facial fat grafting can also be done to address volume loss and help further improve facial balance and harmony.
I would want to see how everything looks after you heal from the revision facelift. From these limited pictures, it looks like your skin would likely also benefit from laser resurfacing to really give you the best possible results, but I would NOT do this at the same time as the facelift. When you perform laser resurfacing, you damage the skin from above, as you remove some of the outermost layer(s) to allow new, better quality skin to heal in from below. As a result, when you perform both a facelift and laser resurfacing at the same time, you are introducing insults to the skin from both above and below, further stressing/compromising the vascularity, and increasing the risk of skin/wound complications (e.g. delayed/poor wound healing, skin ischemia/necrosis, infection, etc).
With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos you have provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

To treat the wrinkles around your mouth a would suggest microneedling, profractional laser resurfacing or an ablative laser resurfacing which is more aggressive with more downtime. Regarding the jowls, I would suggest a deep plane facelift which is the most powerful lift of the medial cheek and jowl area. Good luck!