Facelift and breast augmentation on 66 year-old woman. Suggestions? (Photos)

Based on your goals and current anatomy, a breast lift (mastopexy) would be an ideal solution to restore a more youthful and lifted appearance. Depending on the volume you wish to achieve, we can also consider placing implants; however, your existing breast tissue may already be sufficient to give you the desired shape without the need for implants. This will be carefully evaluated during your consultation.
Additionally, considering facial aging and the natural downward pull of gravity on the tissues over time, a facelift would be a strong option for you. This procedure repositions the deeper facial structures opposite to the direction of gravity, which not only provides a natural lift but can also restore a more youthful contour. Patients often see a rejuvenation effect of 15–20 years, depending on their skin condition and facial structure. Our approach always prioritizes a natural-looking result. The goal is to help you look like a refreshed, younger version of yourself .

First of all, you don't appear to be in your 60's at all! You're looking great. To maintain graceful aging, you might consider a revision lower facelift to reposition the tissues back to where they used to be–lifting the cheek mound and refining the jawline/jowls will make a huge difference. I also highly suggest fat grafting with your facelift to restore the loss of volume. Particularly, fat grafted to the temples, mid-cheek, nasolabial folds and jowl area. For the breasts, the best option for upper-pole fullness is an implant. You could consider a lower profile implant to avoid too much projection. However, because your breasts are naturally large, it will be important to consider that the implant size itself would need to be on the higher size in order to fill out your natural breast envelope.

Thank you for your thoughtful question, and for sharing your journey so far. It’s great to hear that you're in excellent health and leading an active lifestyle—that certainly works in your favour when considering facial and body rejuvenation procedures.

As a facial plastic surgeon, I’ll focus on the facial aspect of your inquiry.

Since your previous facelift was nine years ago, it’s very normal to notice some recurrence of skin laxity due to the natural aging process. What would be helpful to know is the type of facelift you previously underwent—particularly whether it involved deep plane lifting or was more superficial (e.g., skin-only or SMAS plication). This can impact both the longevity and quality of the initial results, and guide recommendations moving forward.

Based on your age, the time since your last procedure, and the desire for a refreshed yet natural look, I would recommend a deep plane facelift and neck lift, which addresses not just the skin but also the deeper facial structures. This provides more comprehensive and longer-lasting results. Additionally, combining it with a keyhole (endoscopic) brow lift, upper and lower blepharoplasty, lip lift, and facial fat grafting could achieve full facial rejuvenation—targeting volume loss, sagging, and skin texture in a harmonious way.