Which procedure would be best for minimizing angry appearance? (photo)

You may be a good candidate for a facelift. Your area of concern is minimizing an angry appearance. A facelift can help reverse these signs of aging and give you a dramatically more youthful appearance. While some signs of aging can be addressed without having surgery, a facelift can help correct them long-term and give you a more youthful appearance for the next 10-20 years. The procedure involves lifting and tightening the skin and repositioning the underlying fat and muscle. Many patients benefit from having complementing procedures such as fat grafting, an eyelid lift (blepharoplasty), a brow lift, or laser resurfacing with their facelift to create a natural appearance.

Your face reveals both deflation in the cheeks and general sagginess to the entire lower face. The face lacks the curves of youth. I would suggest both a mini facelift and fillers and or fat injections to provide more balance to your face. I would consult with your plastic surgeon and discuss these issues.

There are a number of features resulting to an "angry look" even when we are not angry. Overactivation of frown muscles can create vertical lines between the eyebrows and horizontal lines at the root of the nose. This can be best addressed by neuromodulators or botulinum toxins. Tightly pressed lips with or without thinning of lips and perioral lines can be addressed by lip lift surgery in combination with energy-based devices and collagen stimulators to ease the perioral lines. Non-surgically, downward turn of the corner of the mouth can also be addressed by precise neuromodulator injections to depressor of mouth. Hyaluronic acid fillers and be applied to the lips and with specific technique, can improve and upturn the corner of the lips. A dimpling chin or tensed upturn chin can be addressed with injecting neuromodulators to relax the chin muscle. Dark undereye circles and sunken eye can be addressed by lower blepharoplasty with or without canthoplasty or canthopexy and energy-based device. Deep plane facelift can address the overall mid and lower face heaviness. If a patient also presents with low set brows, which may present as angry-looking, browlift can also be performed in conjunction with facelift.

Thanks for the questions! As we get older, our skin does not bounce back as it once did, causing increased skin laxity. There are a couple of suggestions that could help. One of the areas you mentioned, the eyes: that is caused a blepharoplasty. It removes excess skin above and below the eyes. It does not change the shape of your eye, but rather it opens and reveal the natural shape of your eye. We also add a little fat to the upper cheeks for volume. For a more thorough review and ideas on how to reach your goals, schedule a consult with a Board Certified Plastic Surgeon.

Hi from Istanbul. An angry look can result from the downward shift of facial features and overactive muscles between the eyebrows. Botox is an effective treatment for this. However, jowl sagging and pronounced nasolabial folds can also contribute to this appearance. A facelift, brow lift, and eyelid surgery can reverse this look, giving you a more refreshed, energetic, and softer appearance. Hope this helps, best of luck!

Generally speaking, when people say that do not enjoy looking "mean" or "tired" looking, we start with periorbital, or eye rejuvenation. This would typically entail a brow lift, upper lid lift, and lower lid lift. That being said, a lip lift and comissureplasty (corner of the mouth lift) would also help the lower face look better. A facelift would give you a more "refreshed" look overall but I think if you were looking for something more minor those procedure would be a good place to start.

Hello from Maryland!

Just today I saw a patient who said "Everybody keeps telling me they think I'm angry at them. I'm not angry!". One of the major contributors of this is the jowl fat pad pulling down the corners of the mouth. Another contributor is the upper cheek falling down which causing the smile lines (nasolabial folds) to become deeper as well. The only way to address this in a comprehensive way is to reposition that jowl fat pad back to where it used to be through a deep plane facelift.

There are things that can do that very temporarily like a thread lift, which I do not recommend. There are other treatments that can be used to reduce the overall weight of that jowl fat pad (facetite, RF microneedling) but none of those treatments really move the position of the fat pad. At most, I believe they only get 20% of the result of surgery, but for some people that is enough. Botox can help younger patients that have excess muscular pull of the frowning muscles, but I find that that is better suited for patients under 40. Botox can also help with frown lines between the brows but yours don't seem that deep at rest.

I hope that helps! As always, an in-person consultation will help you find the best surgeon for you.

Wishing you all the best!
Dr. Sitapara
Prime Facial Plastic Surgery

You have a very active set of frown muscles (procerus and corrugator) along your glabella, which is the area between your eyebrows. They are 1) pulling down your eyebrows 2) creating frown lines and horizontal lines along the top of your nose bridge. Botox or Dysport will help immensely in brightening your baseline appearance and allowing you to look less angry.

Once this baseline is established, other things can be discussed with an experienced facial plastic surgeon, such as upper eyelid surgery with brow repositioning, and deep-plane facelift surgery. These will help not only to make you appear less angry, but also more youthful. A comprehensive consultation will be able to flesh out and prioritize your goals to determine the optimal plan forward.

Usually anger is associated with lower medial brows and a downturn in the corners of the mouth. I would recommend a brow lift and a SMAS facelift to address these 2 areas.

thank you for posting your question. I think, correcting perceived emotions are one of the most important goals to address in facial surgery. It is often missed, while being focused on "ideal beauty" and rejuvenation. I think you have great facial features. Yes, there are some age related changes, but those can be addressed. You would be greatly benefitting from what has circulated in social media as a " deep plane facelift and deep plane neck lift ". From a professional, facelift history standpoint the term is not used correctly. But a facelift and necklift, addressing the deeper structures below the SMAS and the different fat compartments will restore your facial features. Reducing the age related upper lip enlongation will be a great ancillary procedure. The eye area and the eyebrows are important when it comes to perceived emotions. Some improvements could be done here as well. Botox can help with some lines, that are caused by the mimic muscles. Other skin lines should be addressed either by laser or stronger chemical peels. I hope this helps.