Would a lower facelift and chin implant be advised?

Question

I'd like to correct whatever is happening with my neck/jawline/lower face. The asymmetry has always bothered me, and now early signs of aging have only exacerbated the issue(s). My cheeks are starting to droop too. I'm tired of wasting money on fillers. I'm 37.

Michael P. Morrissette, DDS, FACS · Answer

You appear to have platysmal bands and a somewhat recessive chin with good overall elasticity. I think that a chin implant and platysmaplasty with a bit of jawline liposuction would provide a nice result. There is only one small incision needed which is beneath the chin. The recovery is much more rapid than a traditional facelift.

Brian K. Machida, MD, FACS · Answer

You would seem to be a candidate for a lower face and neck lift.  I don’t think a chin implant is totally necessary. I don’t see a need for fat grafting.

Zoran Potparic, MD · Answer

It would be very difficult to give you good advise without in person evaluation. I am not sure that chin implant is needed. However, only on the basis of in person consultation one could decide whether neck lift with liposuction or lower face/neck lift is better solution in your case. In person consultation with a board certified plastic surgeon, expert in facial rejuvenation, is recommended. Good luck.

Barry M. Weintraub, MD, FACS · Answer

What I see in your pictures is reflective of normal ageing. Let’s look at the issues you mention. First, the two sides of the face will never be perfectly symmetrical; they are sisters, but not twins, so I wouldn’t focus too much on this. To your point regarding fillers:   I always caution my patients about too much filler; after a while and into one’s late 30s, filler ends up distorting the natural anatomy, and overstretches the skin. The chin implant you mention is difficult to evaluate, because a true profile picture would be needed to accurately judge if this would be beneficial. What I see is some slight laxity of the skin, and a bit of excess submental fat under your chin. A physical exam would be much more helpful than photos to determine the best solution. It could be that you would be very happy with neck liposuction to address the submental fat, and RF Microneedling to tighten the skin of the lower face and neck. I recommend consulting with a board-certified plastic surgeon to discuss your concerns and develop a personal treatment plan for you.

William Portuese, MD · Answer

The pictures are rather limited, but it does appear that you have a recessive chin profile for which a chin implant can improve. The muscle bands can be addressed with a platysma plasty along with a small amount of fat remote in the neck as well. No skin removal should be needed at age 37.

Robert Singer, MD · Answer

A necklift only addresses the neck skin laxity. It will not improve the jowls or cheeks. A mini-lift  and a midface-lift also vary significantly in what is done, depending on the surgeon performing it. They are usually performed in patients with minimal laxity and would not improve the neck. The terms facelift and lower facelift mean different things to different patients and vary in their extent from surgeon to surgeon. A facelift or a lower facelift which would include the neck area would have the potential to produce the best cosmetic result of the neck, central cheek and jowl area. Micro-fat grafts can produce a long term improvement of the areas that are volume deficient.

It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Darryl J. Blinski, MD · Answer

Yes & NO. I might offer mini FL/NL with SMAS plication with added fillers or fat grafts to face. Fee $10,000 ranges. Best to virtual private practice boarded surgeons. Good Luck

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