What type of facelift would be best for me? Follow-up to previous question & providing additional pics

I'm updating with different expressions & angles in hopes of making it easier to answer my previous question re: the procedure(s) that will give me a balanced, overall youthful appearance. I am sincerely grateful, thank you.

Doctor Answers 19

Concept Facelift to turn back the years

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Thank you for your question and pictures

Your pictures show to me you would be a good candidate for a local anaesthetic facelift and necklift.

Most of my patient want a facelift however do not want the downtime associated.  The Concept Facelift and Necklift is the procedure I perform, which 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. 

If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.

What are the benefits of a local anaesthetic facelift?

  • Minimally invasive as it is a short scar facelift
  • There is minimal bruising and swelling, especially when compared to traditional facelifts
  • As the procedure is performed under local anaesthetic, you can go straight home following the procedure
  • Full recovery in a matter of days rather than months
  • Significantly less risk than Facelifts performed under general anaesthetic
  • Fresh, youthful and long lasting results

Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best 

What type of facelift would be best for me? Follow-up to previous question & providing additional pics

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 I'm afraid that there are no photos visible with your question.  I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS as well as facial shaping procedures.  

  Following my beauty principles, 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 with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  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, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed from the face and neck
  • excess skin removed from the face and neck
  • 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 combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Lower facelift

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You are a good candidate for a lower face and neck lift.  This procedure will restore you to your youthful self by lifting and tightening sagging muscles and removing loose skin.  A mini lift is often desired but usually not provide enough lift for most patients.  Consults with several experienced board certified surgeons to review you candidacy. I perform alot of these under local anesthesia and oral sedation.  

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 reviews

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What would the best type of facelift be?

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Dear QueenBe

Many thanks for your question and photographs. You have a slim face with laxity to the lower facial skin, neck skin, as well as banding from the underlying neck muscle laxity and some mild howling.

The most reliable way to achieve a harmonious and natural result will be to have a lower face/neck lift, with further work on the platysma muscle in the neck through a separate incision in the chin. 

I agree with my colleagues' comments about fat grafting, as used judiciously, this could help restore some lost volume which in turn will further help your rejuvenation.

I hope this helps, and good luck moving forwards

Facelift options part 2

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Thanks for more pictures!  The recommendations are going to be very similar, you need a platysmaplasty (neck lift) as well as a SMAS facelift. Its unlikely that a mini lift will suffice (a shorter incision), and instead, a lower facelift would be better to ensure longevity of your results. Once again, the full decision is best done at a consultation however as you can see from the answers, treatment of the SMAS and the platysma are needed to address your concerns. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 105 reviews


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Based upon your photos I would recommend a full face peel or laser prior to any traditional facelift. This should improve your submental area as well, but probably not completely. Facial cosmetic surgery is often a multi step process, but getting the sequence is paramount. Be sure to consult with a board certified plastic surgeon.

Stefan Rene Adair, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Best procedure for a balanced youthful appearance

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  • The simple answer to your question is that you would benefit most from a standard face lift to address your midface, jowl, and platysmal banding under your chin. Most likely, an incision around the ears with a SMAS lift, platymal plication behind your ear, and excision of excess skin laxity will accomplish the goal. There is one picture that makes me think that you may need to have some skin removed under the chin, but I prefer to avoid this if possible. There are different approaches to handling the banding problem (leading edge of the platymal muscle separating and loosening). Pull it from the sides or stitch them together in the midline through another incision. Some need both done to take out significant laxity. Less is more in some cases, and if the midline approach can be avoided, so much the better and I think you are a candidate for the simpler approach. 

Robert H. Woods, MD
Scottsdale Facial Plastic Surgeon

What type of facelift would be best for me? Follow-up to previous question & providing additional pics

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Thank you for your question.   The most noticeable changes that I see on your face is in the lower face and neck region.  There is loose skin underneath the jaw line and two vertical folds or cords caused by the platysma muscles on the neck.  A SMAS face and neck lift with platysmaplasty with suturing of the neck muscles together will be the most effective facelift for you.  Please consult experienced board-certified plastic surgeons.  For more information and to see results please read below:

A to V natural facelift

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You are showing early signs of sagging.    What sags is the muscle under the skin (SMAS and platysma), and when it sags, it pulls skin with it.    Without the muscle sagging, the skin would not droop.   There are mini lifts and other quick fixes that just pull the skin but the results do not last - why fix what is not broken and leave what is broken unfixed?    You will get the best result with one of our A to V natural facelifts in which the muscles are put back where they were when you were 25 years old and the skin redrapped without tension.

FaceTite and Platysmaplasty produce beautiful results

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The photos are very helpful!  A combination of a platysmaplasty and FaceTite probably will help you the most.  FaceTite is a newly FDA-approved system that tightens skin and removes fat to produce amazing results.  A complete examination by an experienced plastic surgeon can tell you what you need.

Randy J. Buckspan, MD
Austin Plastic Surgeon
4.6 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.