Chin/Neck Lipo or Facelift? (Photo)

Question

Hello! Pregnancy drastically changed my face. I'm 39, which seems young for a face lift, but is that what I need? I have already done morpheus 8 and I had a threadlift, which I'm not interested in doing again because it didn't last. My neck and jawline were snatched before pregnancy but I gained a lot of weight (which I've lost all but 10 pounds of now). One surgeon I consulted with said facelift, another said smart lipo. What do you all think?

Michael P. Morrissette, DDS, FACS · Answer

You do have some facial and neck laxity but not much subcutaneous fat. The excess skin is best addressed through a short incision facelift or a "weekend" facelift. A more traditional lower face and necklift would better address the neck but the recovery is substantially more. There is insufficient fat for liposuction alone to be effective.

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs. It very much depends on how much change you wish to achieve with treatment. In general, I would say that the facelift procedure can produce changes relatively similar to the appearance of the face when you lie down completely flat with no pillow. If that is the impact you wish to achieve, smart lipo will not produce it, but the facelift can.

Another aspect is related to the contour of the neck, and if you want to achieve a full complement of changes, a combination of deep-plane facelift and deep-plane neck lift is the most effective. The deep-plane neck lift also caters for some of the characteristics of the neck that have hereditary origins and are not related specifically to the effect of pregnancy.

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for posting your information and photos. I think you would be disappointed with liposuction alone. There is enough soft tissue laxity that tightening of the soft tissue envelope should be part of the approach. You could certainly accomplish a very good result with a facelift, but you would have to accept the scars of surgery, potential risks, and the investment of downtime, discomfort during recovery, etc. I would suggest a "middle path" procedure like FaceTite. This is a minimally-invasive procedure (no incisions) that will tighten the soft tissue envelope, slim/contour the lower face and neck, and reduce fullness from subcutaneous fat. It's ideal for a situation like yours. It is a smaller investment (time, money, discomfort, downtime, etc), and can be performed under local anesthesia. But, it's also a solution that's proportionate to the issue at hand. Good luck!

Best,
Dr. Tower

Best,
Dr. Tower

Stephen Prendiville, MD · Answer

As you noted, energy devices like Morpheus and Ultherapy don't do much to address the problem that you describe (which is why I no longer recommend them).  You do have indications which a facelift would address, possibly along with a small chin implant.  Whether or not you are comfortable with this solution is up to.  Surgical candidacy relies on 1) good health, 2) indications, 3) desire to address those indications.  If you feel more comfortable waiting, that's entirely up to you.

Lexie Wang, MD · Answer

Do not do lipo. I barely see any fat in your neck so the lipo is not going to treat your problems. It looks like, and sounds like, you need to get some of the skin tightened and possibly address the muscle underneath the skin too. That can only be accomplished via  a lift procedure. 39 is not too young; we can start doing face lifts on people as early as 34-35.

William Portuese, MD · Answer

The limited photographs demonstrate a recessive chin profile from the side profile, and a prominent pre-Jowl sulcus. Consider placement of a chin implant to augment your chin both forward and slightly widen that area for better structural support for the soft tissues in your neck. You also have fat deposits located both above and below the platysma muscle in your neck. At age 39, your skin tone should be acceptable. Also consider a surgical neck lift to remove the fat deposits above the platysma muscle with liposuction, and surgical extraction of the fat deposits below the muscle, in addition to a platysma plasty to significantly improve your jawline. The chin implant can be done simultaneously.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics are in large part, determined by facial bone structure.Individuals who show premature signs of aging of the lower 1/3 of the face such as the formation of jowls , a poorly defined jawline, a double chin, and early nasolabial folds often have amendable that is small or lacking in projection in comparison to the maxilla.To make a quality assessment, we generally need to see quality pictures.Take a look at how plastic surgeons take before and after pictures to get an idea.Each part of the face is in relationship to the adjacent areas so we do need to see the entire face when making an equal assessment. in relationship to the adjacent areas so we do need to see the entire face when making a equal assessment.A facelift is an option.It typically does a good job at treating jowls , and tightening the neck. A facelift treats, the lower 1/3 of the face and neck.I suggest having multiple in person, consultations with plastic surgeons in your community who seem to have a solid track record for facelift surgery.Look for providers who have at least one or two decades of experience in facelift surgery.Look for plastic surgeons who specialize exclusively in facelift surgery, or those who have a proven track record with a large percentage of their case load being facelift type surgery. Bring proper pictures of your face to use as a referenced during the 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 to your own.Having had previous thread lift is not ideal But hopefully they will not get in the way of doing a proper facelift.Doing quality facelift surgery is an art that takes a lifetime to master.There’s going to be a significant difference among providers.For that reason, I suggest having multiple consultations before selecting a provider.I generally recommend people avoid virtual consultations, and instead have in person, consultations to get a quality assessment, and to better be able to vet the provider.Best,Mats Hagstrom, MD

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