Considering a lower bleph and pony tail lift - would I be a good candidate? (Photo)

Question

40ish and wanting something to bring it back, I don’t have a lot of skin laxity but I’ve noticed a squared look emerging at the bottom of my face where it used to be more heart shaped. I would like a minimally invasive pony tail lift (have previously had 2 pdo threads each side and felt they did very little). Would I be a good candidate?

Ali Riza Öreroglu, MD · Answer

To provide an accurate assessment, an in-person physical examination is essential. Based on your description and photos, you may be a good candidate for lower blepharoplasty, especially to improve under-eye hollowing or tiredness. Given your minimal skin laxity and desire to restore a more heart-shaped facial contour, combining the surgery with facial fat grafting would be beneficial. Volume loss in the midface and jawline can create a squarer look, and fat transfer can help restore youthful fullness and enhance the overall outcome.

Alejandro Nogueira, MD · Answer

Threads or thread lifts are a de facto technical scam, if not a source of nerve damage, deformities, etc.

What I see in this photo, you should post non blanked ones and different views for a better opinion, is a overall facial swelling, you should not get any surgery, your eyebrows seem well positioned so a frontociliar or eyebrow lift is not indicated; lower eyelids don't show prominent fat bags but liquid retention.

I suggest you check your thyroid funcion, blood pressure and kidey funcion, in order to rule out causes; also women's hormonal system disorder are a cause of facial swelling.

Young Min Im, MD, PHD · Answer

Thank you for sharing your photos!
As we age, it's natural for skin elasticity to decrease, leading to sagging, wrinkles, and a downward shift in facial volume. This volume often moves toward the jawline, causing a loss of definition and creating an uneven appearance. These changes are most noticeable around the eyes and mouth.
Based on your photos, I would recommend a classical face and neck lift combined with lower blepharoplasty. Using a deep plane technique, the incision typically starts in front of the ear and extends behind it. This approach allows for more effective skin tightening, enhancing the jawline definition, softening nasolabial folds, and refreshing the heavy-looking lower face.
We hope the results bring you a more youthful and confident look.

Muhsin Yilmaz, MD · Answer

At 40, with mild changes and minimal laxity, you may be a candidate &mdash; but results depend on your anatomy and expectations. • Lower blepharoplasty helps with under-eye bags or hollows, not lower face shape. • Ponytail lift offers subtle lift in upper face but won’t fix jawline heaviness or “squaring.” Effects are limited compared to surgical lifts. • PDO threads often disappoint, as you’ve experienced.
If you’re seeking lasting contour improvement, a mini or deep plane facelift might be more effective than minimally invasive options.
An in-person consult would clarify the best path for your goals.

Mats Hagstrom, MD (license on probation) · Answer

I don’t see a strong indication for a facelift at this time.
To me, your best option is mid-face volume restoration. This can be done using fillers, fat grafting, using an implant or a mid face lift.
Fillers are fairly ideal in many ways.
Fillers are specific, precise, and forgiving if patients don’t like the outcome.
To get an idea of what can be accomplished using only fillers consider checking out some of the results of Dr. David Mabrie MD in San Francisco.
Check out his website and look at some of the very impressive before and after pictures using only fillers.
David is a facial plastic surgeon whose practice is exclusively devoted to facial enhancement using only fillers.
His results are the best I’ve ever seen a period of paragraph I’m not suggesting everyone fly to San Francisco to get fillers.
I do believe that seeing his outcomes can be a powerful tool in helping patients understand what fillers can accomplish in the hands of the right provider.
Ultimately provider selection is the most important variable and more patients should focus most of their effort.
Best,
Mats Hagstrom MD

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