I want to look refreshed and younger - Do I need another facelift? (Photo)

Question

In September last year I had a SMAS plication and neck lift with fat graft. However now after 9 months my jowls are not adequately addressed and my brow/eye area looks crowded. What procedures should I consider to get my face looking refreshed and younger.

Ali Riza Öreroglu, MD · Answer

Typically, after a SMAS plication and neck lift, it is recommended to wait at least 3 to 5 years before considering another facelift. This allows enough time for the tissues to fully heal and for your facial anatomy to stabilize. Since it has only been 9 months since your previous procedure, it's generally best to wait a bit longer unless there are significant ongoing concerns.
If the SMAS layer was not damaged during your initial surgery, a deep plane facelift can be a highly effective option in the future. This technique lifts and repositions the deeper facial structures, offering significant improvements in areas like the midface, jowls, and jawline. To address volume loss and facial hollowing, fat grafting is another excellent option. It uses your own fat to restore fullness to areas such as the cheeks, temples, and under the eyes, and it can also enhance skin quality over time.
If you're noticing a crowded or tired appearance around your brow and eyes, a blepharoplasty (eyelid surgery) may help refresh and open up that area.
While a few photos can give a general sense of your concerns, multiple high-quality images from different angles—or ideally, an in-person consultation—are essential for developing a personalized and effective treatment plan.

Warren Schutte, MD · Answer

Considering the surgical work that you had last year, I would start focusing on skin rejuvination for full face and neck to improve the dermis; aggressive laser work with deep collagen stimulation. Botox would be great to help animation lines on forehead and glabellar area. An Upper blepharoplasty would make you look very refreshed with less heaviness to upper lids.

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for upper eyelid surgery and browlift. That will take the heaviness off the eyes and give them a more youthful appearance. It's hard to really see your jowls/neck from the photo, but a deep plane face and necklift can give a better appearance, if indicated. Be sure to see a facial expert for consultation.

Ronald J. Edelson, MD · Answer

The thing that really stick out in the photo is that you would benefit from having your upper eyelids done. That will make a huge improved with a very easy procedure to undergo. Occasionally I will re- tighten a facelift after about a year if needed. But it’s hard to tell from the photo

Gary M. Horndeski, MD · Answer

I would recommend a facelift and browlift to you. The browlift will elevate your eyebrows higher, decrease the vertical height of the forehead and remove excess skin around the lateral eye region. You may also benefit from a lip lift. A lip lift does 4 things: shortens the distance between the nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Nk Park, MD · Answer

Hello, this is Dr. NK Park from Noonopi Plastic Surgery in Korea.It appears that the distance between the brow and the eyes is slightly short. An endoscopic brow lift would help create a more youthful appearance.
If you're open to a more comprehensive improvement, I would consider performing a new facelift. Based on the photos, there’s still room for improvement in the jowls and nasolabial folds.Since you've previously had a SMAS plication, a high SMAS facelift using dual-plane dissection can be performed safely.

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