Face/ necklift, any concerns for underweight patients?

Question

Hi doctors. Im 65 yo, 98 lbs, in the process of choosing a surgeon for neck/face lift. One dr declined me due to my weight with no other explanation , while two other doctors didn’t mantion any concern . I have Hashimotos and thyroid is stable. Haven’t found research on this . Your thoughts ? Thanks

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Costanorte,

If your thyroid is stable and you’re otherwise healthy, your low weight alone isn’t usually a reason to avoid a facelift or neck lift. At 98 lbs, you may just have less natural facial fat, so the best results might include adding some volume (fat transfer or filler) and improving skin texture with a peel or laser.

Before surgery, it’s smart to check that you’re well-nourished and able to heal well. Simple blood tests like **pre-albumin** and **transferrin** can help. If you’re low in certain minerals—like zinc or calcium—supplements can help, but taking extra when you’re not deficient doesn’t speed healing.

In the right hands, with a plan tailored to your anatomy and nutritional needs, you can still be a good candidate for surgery and get a great, natural result.

Earl Stephenson, Jr., MD, DDS, MBA
ESJ Aesthetics – “Where Confidence Takes Shape!”

Zoran Potparic, MD · Answer

In patients with thin faces it is equally important to replace lost facial volume (fat) as to reshape, lift and tighten SMAS and skin. We were doing facial fat grafting for over 25 years and it is part of my face lift procedure in 90% of patients. In your case face and neck lift and  facial fat grafts should be done in the same time. Very likely that you will need another fat grafting procedure 6-8 months later in order to build sufficient  volume. Hope this helps. Good luck.

Gary M. Horndeski, MD · Answer

Your photograph is somewhat limited. However, from I can see you would benefit from a face lift, which will include the neck. You will need medical clearance before undergoing surgery. The surgery usually takes 2 hours to perform under general anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Generally speaking, I would never turn away a patient based on weight alone. It is just a number, kind of like age. Evaluating a patient to be a good candidate for surgery is based on several factors, and there are no hard and fast rules (with some exceptions). If a surgeon turned you away, it was likely because they came to the conclusion that the risks of surgery for you were too high to proceed. With patients who are underweight, the concern would be that if they were malnourished, they would not have the capability to heal properly after surgery. This could be evaluated prior to surgery with some basic lab work to alleviate any concerns. I would suggest you schedule a consultation with a plastic surgeon who is willing to take the time to discuss your case and go over concerns and do whatever it takes to achieve your result while minimizing risk and optimizing your ability to have an amazing outcome. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Darryl J. Blinski, MD · Answer

Based on your nicely posted photo I see no probably doing a full face neck lift with muscle complication fee $15,000-$25,000. You would need a full medical clearance. Best of virtual consult with for more information. Regards.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment, we need quality information.
Ideally, that should include a full set of facial pictures, including profile pictures.
From the picture you didn’t include it appears you have significant loss of skin, elasticity, and facial volume depletion.
I’m guessing some of the aged appearance is due to sun damage. Some of it is age and the low amount of subcutaneous fat is also contributing.
 A facelift combined with volume restoration would give the best results.
Volume restoration can be done with fillers, but it will require a substantial amount of product and this needs to be maintained.
Fat transfer is also an option that my experience has been that facial fat transfer can be inconsistent and doesn’t have the best overall patient satisfaction long-term.
there is also a form of neck lift often called a cervical plasty where the skin is removed under the chin.
The procedure is more commonly used on men, especially those with facial hair because it can camouflage to potentially visible scar.
You have fair skin with some wrinkles.
This may be an option because scars will blend and fade out nicely and not be very visible long-term.
Have a complete set of facial pictures.
I think mug shots.
Bring those pictures with you to use as a reference during every consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar facial characteristics.
 While each face is unique, they should be able to find some representative pictures so you can get a better understanding of what your results are likely to look like.
After surgery, you may want to also consider a chemical peel or laser resurfacing treatment.
These procedures do have some drawbacks and asked with everything else Who you choose as a provider or how the procedure is performed has a major impact on what the results are going to look like.
In the end provider selection is the most important variable to focus on finding the best surgeon for your needs.
Best,
Mats Hagstrom MD

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