Is a Facelift the Only Answer for Marionette Lines and Jowls?

Hi there!
Thank you for your question. By repositioning the tissues with a facelift, you should see a great improvement in your jowls and marionette lines. Based on your description, I would also recommend redistributing some of the volume in your face with micro-liposuction of the pockets a long your jaw line and grafting fat into the areas where volume loss has occurred such as the marionette lines. That being said, you never want to completely erase the lines on your face at age 66 and look unnatural. A good facelift will soften them and restore a more youthful appearance while still looking like yourself.
Hope this helps!

Hello,

A facelift is the gold standard for treating jowls and for jawline and neck restoration. Other modalities including fillers, Ultherapy, Radiofrequency and thread lifts can help modestly improve this region when there is a mild degree of aging. At age 66 most individuals would best be served with a facelift and possible fat grafting to restore youthful facial contours. Advanced techniques with SMAS flaps and finesse accessory procedures with lasers and fat grafting can help create beautiful, natural looking, lasting results.

Warm regards,
Dr. Pedy Ganchi
Village Plastic Surgery

Although facelift surgery does not always get rid of marionette lines, reducing the fullness of the  jowls  improves the  contour of the area.  A combination of facelift and fat transfer can often correct both problems. The alternative would be facelift and injectable filler to the marionette lines. Unfortunately, using only injectable filler in the presence of  more significant jowls,  can produce a slightly heavy appearance around the chin. Threads or other nonsurgical techniques are also more limited in terms of the degree of improvement they can deliver for this type of problem.