What is the best procedure to lift face and get rid of wrinkles and 11s? (photos)

Question

Need to get rid of forehead wrinkles, number 11s, and marionette lines. Also lift my face to look younger

Donald Groves, MD · Answer

Hello and thank you for your question. From what I can tell based on the pictures you have provided, going top down, you have some prominent horizontal wrinkles in your forehead. You do not appear to have brow ptosis. You also have the vertical glabellar rhytides (number 11's) that you mentioned. Regarding your eyes- there is some possible upper eyelid skin redundancy on both sides. I cannot really discern the details of your lower eyelids so cannot comment. Based on this, I would recommend a browlift, botox to your glabella, and possibly an upper eyelid blepharoplasty. 
Moving to your mid/lower face and neck- there is some minimal/moderate jowling, prominent nasolabial folds, downturned mouth corners. 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 some minimal excess neck skin. I cannot tell if there is any platysmal banding in your neck. I would recommend a facelift/necklift, as this 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. 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 particularly focus on grafting to the cheeks to restore volume there.
With all that said, it is difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the two photos you have provided, both with only a frontal view. 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

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. Based on your photos, treatment of forehead and "11s" are best treated with botox or Daxxify. To lift the face, a facelift is a great option. This can be done wide awake using local anesthesia and oral medications to help you relax. Patients do incredibly well with this and it avoids the side effects of general anesthesia.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. The forehead wrinkles and 11 lines you’re referring to may be best treated with Botox or another neuromodulator. These injectable treatments relax muscle activity to reduce the appearance of lines and wrinkles caused by muscle movements. Dermal fillers are another injectable treatment that can minimize the appearance of marionette lines. You may also benefit from a mini facelift to treat subtle signs of aging, such as jowl formation and mild skin laxity. This procedure can rejuvenate the appearance of your face by tightening muscles and smoothing your skin for a youthful, natural-looking result.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to assess your concerns and determine the best treatment plan to help you achieve your aesthetic goals.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to assess your concerns and determine the best treatment plan to help you achieve your aesthetic goals.

Cory Bovenzi, MD · Answer

Hi there, thanks for the question, there are a couple parts to it:

Re: 11 lines and forehead wrinkles- these are best treated with botox/dysport

Re: cheeks and lower face/ marionette lines: these are best treated with a lower facelift +/- fat grafting

Jeffrey M. Darrow, MD · Answer

Your forehead lines and your 11’s are cause by muscular action and are most easily treated with Botox or a similar product.  To rejuvenate your facial appearance, you may be a good candidate for a mini facelift, as your photos show good overall facial shape and contour.  A consultation with a board certified plastic surgeon will allow an in-depth examination and discussion of your concern, so this should be your 1st step.  Best wishes.

Zoran Potparic, MD · Answer

It would bevery difficult, based on these photos, to make suggestion about surgery like face and neck lift. In person evaluation or better set of photos is needed. However, forehed wrinkles, marionette lines and nasolabial folds could be nicely managed with Botox and fillers. Hope this helps.

Ronald J. Edelson, MD · Answer

Wrinkle on the brow and marionette lines are challenging. A facelift would help the marionette lines. The brow wrinkles typically benefit from Botox and fillers

Michael I. Echavez, MD · Answer

I would say one of the best treatments to improve wrinkles on the forehead and the 11's would be Botox injections.  This directly treats the muscle, which causes the wrinkles to form in these areas.  Marionette lines can frequently be improved with injectable fillers.  For some people, fillers can also help with lifting in some areas of the face.  A facelift can also be used to lift and tighten the lower face and neck.  An examination of you would be helpful to give you the best advice as to which procedures might be best for you.

Connie Hiers, MD, FACS · Answer

I would recommend Botox for the forehead and the 11's and micro-needling with radiofrequency to help tighten and treat the whole ace and neck.  These would not be done at the same time.

Sudeep Roy, MD · Answer

Great and very important question! As far as the reduction of forehead, glabellar and crowsfeet wrinkles, procedures such as browlifts and eyelid surgery can certainly help in reducing the gravitational component that sometimes worsens these lines. However, most surgeons will choose not to cut the muscles that lead to those dynamic wrinkles because these muscles actually stabilize brow position and losing their activity or function in a surgical manner may cause the brow to "drift", leading to unnatural brow positions and divits/contour irregularities at the site of muscle resection/removal. We often tell patients that a browlift will lift and stabilize your brow position so it does not look as heavy, but you will still need neuromodulators like Botox, Dysport or Daxxify to help reduce dynamic wrinkles (i.e. those caused by movement). For marionette folds, a lower facelift (plus or minus some volume correction (with fat or fillers) across that junction between the jowls and the lower lip) will help the most. A lower facelift will also help restore that youthful heart shape to the face that you probably had when you were younger. All the best!

What is the best procedure to lift face and get rid of wrinkles and 11s? (photos)

Answers (15)

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