Aging of the face is inevitable and consists of loosening of the face and neck. The jaw line softens into jowls and fine lines appear on the corners of the eyes, forehead, and face. Vertical folds and laugh lines appear in the neck and around the mouth as we age. A facelift addresses the folds and jowls of the jaw. More so, a facelift can help boost confidence while returning a more youthful appearance.
Fillers help to address deflation in the face, but will not improve the neck line. Another consideration is facial fat grafting that can be long lasting for addressing the deflation issue.
There are options for your complaints.
Hello. Starting with your eyes, it appears you are a good candidate for fillers (volume replacement) in your lower lids. You do not have very much excess skin of your lower eyelids. Therefore you can forego a surgical blepharoplasty and start with fillers in this region. You will not burn any bridges by starting with filler in your lower eyelids. By that I mean that you can always have surgery if you are not satisfied with the filler. It is very important that you go to an injector who is very familiar with filling the lower eyelids. It is a more challenging area. Use a hyaluronic acid such as Belotero or Restylane. These temporary fillers can be reversed with hyaluronidase if you are not satissfied or too much filler has been added. It is amazing how long fillers will usually remain in the lower eyelid compared to other areas of the face. Go with the fillers for your eyelids before surgery. Your neck is a separate issue. A thorough consultation with a surgeon is needed in order to both examine you and to determine your desires and expectations. You have very little jowling. Therefore you may be a good candidate for an isolated neck lift. This will require an incision at least behind your ear. You may also be a good candidate for neck liposuction alone. It is less invasive then a neck lift and less expensive. Your skin tone looks good and your skin may very well retract nicely with liposuction alone. I prefer VASER or laser-assisted liposuction when performing neck liposuction in isolation. I believe there is better skin retraction when the heat from the VASER or laser is applied to the fat and subdermis. In your first picture it appears that you have some platysmal banding. The platysma is a sheet of muscle in the neck. As we age, the platysma becomes more apparant due to a few reasons. If you do in fact have these bands (a fold or line in the neck, typically on the left and the right that starts under the chin and in a vertical (up and down) direction goes down to the lower neck to a variable degree) then only a platysmaplasty will correct this problem. Platysmaplasty is the surgical unification of the two bands into the midline. The left band and the right band are brought into the midline and sewn together like a corset. Your diabetes shoud not cause much of a delay in your healing as long as it is not severe and you have it under control. Your ADD medication also should not be an issue. There is no cream whatsoever that will help your neck. Any cream you think will improve your loose neck skin will not. Also, radiofrequency devices like Ulthera have limited efficacy in very good correction of lax neck skin. The results are limited both in amount of retraction you can expect and the period of time the treatment will last. Its a good treatment for thinner skinned individuals with little neck fat and for those who refuse to undergo surgery. I think these radiofrequncy devices are "oversold", especially when the operator is not a surgeon and has limited tools in his/her toolbox.
Fillers do not work for a sagging neck.
Fillers do not work for a sagging neck. A facelift is needed. Be careful of surgeons who tell you what you want to hear.
The neck lift procedure can rejuvenate the neck as long as there are is not excess skin present. If there is excess skin present in the neck, then a lower face and neck lift must be performed. The neck lift involves removal of fatty deposits located above and below the platysma muscle, and a platysma plasty to give a better jaw and neck line. For many examples, please see the link below.
Lower Face/Neck Lifting can really combat signs of aging.
A lower face/neck lift which is done under local anesthesia can really improve the areas of concern for roughly $8800 on special and is fairly easy to undergo with only 1-2 weeks downtime. A little filler such as belotero ($550/syringe -needs 2 syringes) or fat injections(($2500) under the eyes will go a long way for that youthful look. Sincerely, David Hansen,MD
Neck lift. What are my options? Can fillers be used?
Besides weight loss you might be a candidate for ThermiTight Rf to the neck. Best to find a ThermiAsethetic surgeon in your area to see you in person...
Facial Rejuvenation surgery
At your age, you will continue to see gravitational decent of your facial tissues, volume loss in your mid face and around your mouth, as well as loss of elasticity.
A facelift would be beneficial coupled with mid facial fillers.
Find a surgeon who offers computer imaging. This will allow you to see realistically what can be done for you based upon your anatomy.
Dont rush into anything. Have all of your questions answered. Enjoy the journey!
Thank you for the photos but you really should go on some consults so your face can be completely evaluated and recommendations made
How to improve your neck and eyes
Let's start with the easier to answer of the two questions:
The biggest improvement you'll get with your eyes is to do a lower eyelid blepharoplasty (eyelid surgery) with a Fat Transposition. It is essential to do the fat transposition in your case to help volumize the tear trough and smooth the transition between the lower lid and the cheek. Non surgical options are to use a filler such as restylane or belotero to help volumize the tear trough, but this is a temporary measure.
For the neck, there are several options and they depend partly on whether or not you've had any work done before on the neck. I wouldn't put too much effort into using creams as they typically don't help the issues you're talking about. There are non surgical options such as ulthera and thermage, but they tend to have little effect. The next up the ladder is submental liposuction. This can be classical or laser lipo and it will improve the area under the chin. The most significant change you can get is with a neck lift. It's a generic term, since every surgeon can use a different technique, but the most significant results are seen with a vertical deep plane lift possibly with the addition of a submental platysmoplasty.
Hope this helps