Hi, I have performed many facelifts over the past 30 years. From the attached photos, the cheeks are flat anteriorly (in the front), there is excess facial and neck fat along with excess facial skin evidenced by jowls and nasolabial folds. These combine to create a rectangular shaped face. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation using a dermal filler (I prefer Restylane Lyft) or with cheek implants for a permanent enhancement will create full, round cheeks anteriorly that will feminize the entire face. I would combine liposuction to reduce excess fat for further shaping of the cheeks. Jowls are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured. The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane and subperiosteal facelifts) but with these added benefits: •very small incisions •minimal tissue dissection = less bruising and swelling = rapid recovery •can be performed in 90 minutes or less, with or without anesthesia •no incisions within the hair = no hair loss •excess fat can be removed •excess skin removed •cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants •most patients fly back home to parts all over the world in as little as 3 days post-op I tell potential facelift patients to think of creating a more beautiful or handsome face by working on three tissue levels. The bony structure should be appropriate to make a woman’s face heart shaped and a man’s face chiseled and angular which is described below. Next the fatty layer should be reduced or shaped allowing the shape to be seen and finally excess SMAS and skin (evidenced by the presence of jowls) should be removed from the face and neck.Hope this helps.