75 year old healthy woman who wants to look younger. Would I be better off with a lower facelift or fillers? (Photo)

Question

I would like to add volume to my cheeks and fill in my nasolabial olds and lines on my chin and mouth. Would I be better off with a lower face lift and possible fat transfer or fillers like sculpture, radiuses or juvederm?

Timothy R. Miller, MD · Answer

In general, the best recommendations come during an in-office examination and discussion of your aesthetic goals.Typically the aesthetic goals would come from a combination of surgery, volume augnmabntion with fillers ot fat augmentation and laser resurfacing.The attached link provides more infomation.I hope this helps.

Jed H. Horowitz, MD, FACS · Answer

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift. 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, individualized for each patient, 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 can be improved with a Lite Lift™.

Richard G. Schwartz, MD · Answer

Although a personal consultation would allow me to closely examine your face and be more specific concerning what is best for you to look younger, based on your photos, I would offer the following information.  Various fillers can plump up the nasolabial folds and scattered lines, softening them and making them less distinct.  Volumizer fillers can add bulk to you cheek bone areas and temples.  However none of these are permanent.  Fat grafting can add fullness to your cheeks but is a surgical procedure and more involved that just injecting fillers.  Although some of the fat may dissolve, whatever survives the grafting will last for many years.  So if you just want to add volume or soften some lines, then the injectables or fat grafting may suffice.  However, if you are bothered by your loose skin on the cheeks or neck, the bulges (jowls) near the sides of your chin, or even the loose saggy muscle bands I see on your neck, then there is no substitute for a lower facelift to create a smoother, firmer neck and lower cheek.  At surgery, you could always have fat grafted into the cheeks to add some fullness there if desired.  You really should have a thorough discussion with an experienced plastic surgeon to better understand which treatments will give you the improvement you are looking for.

Raymond E. Lee, MD · Answer

Thanks for sharing.  Easily a lower facelift and possible fat transfer will get you the best results.  It does cost more with more recovery time but fillers alone will not get you the results that you desire.  Speak in person with several board certified plastic / facial plastic surgeon.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Hi Mima 10Thanks for posting and your photo. Think you would benefit greatly from a facelift. However you could try PRP with fillers to start and see how you go.Our Concept Facelift is less invasive than a traditional facelift and there is less scarring, bruising and swelling for a significantly quicker recovery period. This innovative procedure combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. This is a combination of a SMAS lift and skin tightening that allows the procedure to have it's longevity without the trauma and invasiveness of a traditional facelift.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPRP is an autologous procedure that involves using the patients own blood to extract plasma and growth factor which is then injected in to the target areas. The PRP stimulates and accelerates skin regeneration and collagen production by the injections of growth factors. PRP injections can also be used in conjunction with dermal fillers if additional volume is required. PRP is selectively and carefully delivered in to specific areas with a series of injections. Before the treatment you should be assessed by an experienced medical professional to see if PRP injections are the right treatment for you. Your specialist will then be able to talk you through he procedure and inform you of what the treatment can achieve.Good Luck

Jason Emer, MD · Answer

you really ned a combination approach1) face/neck lifting2) resurfacing laser for improvement in wrinkles and sun spots/photodamage3) fillers or fat injections to give volume and contour to the faceAfter which I would maintain yearly with skin tightening and microneedling/PRP/sculptra.  Please see an expert in facial sculping.  Best, Dr. Emer.

Zoran Potparic, MD · Answer

In the process of facial aging, loss of fat tissue from the cheeks, lips and around eyes, creates typical stigmata of aging. This is universal process that affects every face after mid-thirties. Loss of volume in the face results in deflation of the face (like deflation of balloon or breasts) and impression of drooping. Signs of aging  are mostly seen as tired eyes, flat cheeks, jowls and, in particular, heavy neck bands.All of these signs are present in your face. In order to restore youthful anatomy you will need both lifting and filling. Surgery should include face and neck lift, upper and lower eyelid surgery and placement of fat grafts in multiple areas of your face to compensate for volume loss. You could do all of these procedures in one surgery or you may select to do it in several stages.Botox and fillers will also achieve significant improvement  but not close to face lift. In the long run, considering cost of fillers, face/neck/eyelid surgery with fat grafts is much more economical, predictable and long lasting procedure. For a healthy person of your age it is relatively easy and very safe surgery.You should consult a board certified plastic surgeon in South Florida with significant experience in facial rejuvenation to discuss your options in details. Good luck.

Sean R. Weiss, MD, FACS · Answer

The best outcomes for you will be realized with a face and neck lift along with fat grafting.  For complete rejuvenation you would also need your eyes and brow addressed.  You appear to have good bone structure and should expect to have a very nice result with these procedures.  Relying on fillers alone for rejuvenation will likely result in a puffy or blown up appearance which is odd and unnatural.  Best regards.

Stephen Prendiville, MD · Answer

Living in SW Florida, this is a question asked by many of my patients in your age group; age is more a question of physiology than a numeric value.  My response is that you have to be considerate of what result you really want to have, because fillers and facelifting are different branches of the facial rejuvenation tree. If you are otherwise healthy, I would tell you that the cornerstone of facial rejuvenation is a facelift.  Nothing else tightens the neck, jawline, and cheek area like a facelift, nor lasts for as long.  Frequently, a patient in his/her 70's may additionally benefit from volume replenishment.  My favorite way to accomplish this is with Sculptra or Voluma.  Lastly, resurfacing of the skin may be an option. I have included a link to a patient in her 70's who chose to have all three methods of rejuvenation.  Fillers in isolation can be beneficial in targeting specific concerns as long as the patient is willing to accept a more limited and temporary result.

Paul Lanfranchi, DO, FAOCOO · Answer

First I would like to say how amazing you look for your age! The evolution of facelifting has come a long way over the past two decades, and it is in my opinion that a lower facelift and necklift would rejuvenate you the most. Many centers, such as ours, offer to perform this procedure under local anesthesia in-office. This makes is very safe (assuming you are in relatively good health) and quite affordable. A great lower facelift and necklift should last you at least a decade and should look more natural than multiple tubes of injected product. Recall that only a lift can truly tighten and smooth drooping tissue of the lower face and neck. Be sure to seek out a board-certified surgeon that performs this procedure a few times per month (at a minimum) and you should will be off to a great start! Best, Doc L.

75 year old healthy woman who wants to look younger. Would I be better off with a lower facelift or fillers? (Photo)

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