Age 49 & concerned about jowls & stringy neck - mini, midi or full face lift? (Photos)

Question

I’m 49 and am concerned with my jowels and stringy neck. Also hooded eyes. I have asymmetry. Would I be a good candidate for a mini lift, midi or would I need a full face lift?

Thomas Trevisani, MD · Answer

In person exam is essential. Based on limited photos- it appears that you may benefit from a facelift/ neck lift with muscle tightening. I suggest that you seek an experienced Board Certified PS

Kshem Yapa, MBBChir, FRCS · Answer

Hi 
Thank you for the question. As we age we develop structural laxity in the face and with gravity tissues moves south . This leads to some hollowing below the lower eyelids and deep fold around the mouth called nasolabial fold and jowls which make the face appear more square rather than oval shaped . In addition our neck also become lax .
The terms mini, midi and full facelift are a little difficult as one surgeon's mini facelift may be another surgeons full facelift . What many surgeons describe as a mini facelift involves tightening on the lateral outer aspect of the face only with sutures which often does not give a long lasting result.
The key to not looking stretched and "windswept " is to not put any tension on the skin at all and work on a layer below the skin called the smas so the skin is tension free . The longest lasting and most impactful and natural results are achieved by a deep plane face and neck lift which avoids any tension on skin.
The upper and lower eyelids mainly affect the central face while the face and neck lift procedures improves nasaolabial folds, jowling and neck laxity. For treating the central face upper and lower blepharoplasty can help and in patients who have lost volume from the face modest fat grafting can lead to a harmonious result.
I hope this helps.

Christopher David Jones, MBBS, BSc, FRCS (Plast) · Answer

The photos that you have provided show that you have mid face descent with very early jowl formation. The neck itself is slim with a nice shape but a small amount of fullness directly under the chin. From the photos it is hard to comment on your eyes. You may wish to defer surgery until the future when the natural changes of facial aging become more apparent. From a surgical position, the only relaible way to address changes to the lower face and neck is with with a full face and lower neck lift. This surgery can be combined with any eyelid and mid face surgery which the patient may also need.

Yannis Alexandrides, MD, FACS · Answer

In these pictures we see the classic signs of ageing on the face with the appearance of deep nasolabial folds and marionette lines, slight jowling and loss of elasticity in the skin and the neck.

In my opinion, in order to reverse these signs, a Full Face and Neck Lift should be considered. In my opinion again, a Deep Plane Facelift would be the right operation to rebalance the face and provide long lasting results.

Selcuk Inanli, MD · Answer

Hello ! Thank you for your question first of all to be honest you have a very beautiful face,you may have a little sagging face with your age, so I recommend you a full face lift with this surgery, your face will look better and more aesthetic.
Thank you ! regards

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

The characteristics of the marionette lines, jawline and neck suggest that a deep plane facelift and neck lift may be an advantageous combination of treatments in your case.

The eyebrow position is good and if you are concerned about the appearance of the upper eyelids it seems like an upper eyelid blepharoplasty would be the appropriate treatment plan.

Bryan Gawley, MD · Answer

Based on the photos submitted, ideally I’d recommend a facelift/neck lift with facial fat grafting. You may also benefit from an endoscopic midface lift as well, or this can be done separately. This plan will give you the most natural and comprehensive approach to address you jowls, neck contour as well as your cheek shape and lift

Ryan Rebowe, MD · Answer

The answer to this question will more or less depend on which surgeon you consult with. In general, the approaches that you mentioned area all dependent on the size of the incision. To get the best facial and neck skin tightening, a full facelift with preauricular (in front of the ear) and postauricular (behind the ear) will results in the greatest tightening effect and the scars are typically very favorable. It is hard to see the contour of your neck in this photo however extending the scar behind the ear (full facelift) typically results in the greatest skin tightening of the neck, which is what concerns most people. If jowling is your main concern, then a preauricular incision only may be possible. Your eyelids will need to be addressed with a separate procedure, a blepharoplasty, which can be performed at the same time or separate from your facelift procedure.

Jag Chana, MD, FRCS(Plast) · Answer

You would be ideally suited to a deep plane facelift and necklift. The Facelift will enhance the jawline, correct the jowls and improve cheek skin laxity. The necklift performed at the same time will improve the lax skin in the neck. You mention a stringy neck which means the muscle may be loose in the neck. This muscle is called the platysma and is tightened during the necklift by performing a platysmaplasty. Hooded eyes are treated by performing a blepharoplasty. All can be performed together. Asymmetry is normal in faces and looking at your face in the pictures this is all within a normal range of asymmetry so is unlikely to be improved upon.

Suleyman Tas, MD, FEBOPRAS · Answer

Dear Awesomeness321,

In my recommendation a full-face lift seems to be the solution, this way it will target the loose skin in the neck, jaw area, midface and and temporal area. Henceforth, it will rejuvenate all the operated areas of the face. Additionally, fat injections in smile lines and wrinkles will help to overcome the lack of volume and in addition you can look into upper blepharoplasty to get rid of excess droppy skin on the upper the eyelid.

Best Regards,
TAS TEAM

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You would likely benefit from upper blepharoplasty and a facelift to address your concerns and help you achieve your aesthetic goals. During an upper blepharoplasty, the excess skin is removed and the fat in this area is modified to reduce the hooded appearance you describe. 
A facelift procedure can remove excess fat in the neck and jowls along with excess skin to create a smooth appearance and angulate the neckline. Underlying tissue that has fallen over time can be repositioned as well to achieve optimal results. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to conduct a thorough physical examination and determine the best procedures for you.

Age 49 & concerned about jowls & stringy neck - mini, midi or full face lift? (Photos)

Answers (22)

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