Endoscopic mid-face lift or short scar face lift? Age 36. (photos)

Question

I've seen 2 Dr regarding sagging on my face.One suggested endoscopic mid face lift saying it would lift up my sagging cheeks and that would be enough to reshape my face to its youthful look.He also said I'm too young for an invasive face lift.Other Dr suggested short scar face lift saying endoscopic lift wouldn't be effective to get the result I wish to get like in my younger picture which is a nice V shaped face.Please tell me your opinions and help me choose the right and the best treatment.Tx

Mark Karolak, DO, FAOCO · Answer

Facial plastic surgery is an art, at least for those who have dedicated their careers to it. It is expected that you will get differing opinions from different surgeons. What is important is that what you see is aligned with what your surgeon sees. They should take the time to explain to you how your face has aged and gotten to the point that you are considering a surgical procedure. Make sure that your surgeons perform a wide variety of facial rejuvenation procedures, both surgical and nonsurgical. If one surgeon does not perform facelifts or endoscopic mid face lifts, then you may be getting a biased opinion. Your pictures are difficult to evaluate, but it appears you may also benefit from volume replacement in the midface with fat transfer or fillers. I recommend seeing a board certified facial plastic surgeon who performs these on a regular basis and will take the time to explain what should be done and why.

Kouros Azar, MD · Answer

Every surgeon is going to have his or her own unique take on the best way to improve your face. The right choice is going to be up to you. Based on your photos, I would encourage you to wait on any surgery and stick with fillers and laser for now since your issues really seem to be about facial fullness and sun damage. So, there you go. Another opinion.

Francis R. Palmer, III, MD (retired) · Answer

Hi, the answer is neither by themselves will create the soft, feminine, heart shaped face of your youth as seen in the photo provided.  I have performed many facelifts for over 30 years and have performed many minimally, invasive type facelifts.  From the photos of your face now, your cheeks are extremely flat anteriorly (in the front), jowls are present and there is some excess fat in the lower face.  These factors combine to create a very, long, rectangularly shaped face. 
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces (similar your face in youth).  Heart shaped faces have cheeks that are shapely, 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.  Simply suspending the existing amount of tissue (endoscopic facelift) will "not' create shapely, full round cheeks.  Further any suspension technique will not provide the lasting results that a proper SMAS imbrication technique achieves.
 "Jowls” are sagging facial tissues and an 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, for the past 15 years, has been the minimally invasive, short incision SMAS 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
  Since facelifts by themselves do not shape the cheek area but are rather designed to reduce the "jowls" and remove excess skin, I combine facial shaping with every facelift procedure to shape the cheeks, chin and or jaw line.  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.

Endoscopic mid-face lift or short scar face lift? Age 36. (photos)

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Endoscopic mid-face lift or short scar face lift? Age 36. (photos)

Answers (3)

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