55 y/o concerned about hanging skin in neck, jowls, upper eyelids. Which technique would work best for me? (photos)

In general, the procedures you are talking about will be a full face and neck lift and upper lid blepharoplasty, with or without a brow lift. I would counsel you to beware of anyone promising results with minimal downtime or incisions. Based on the amount of skin laxity and platysmal banding (neck lines) you are likely to need a full face and neck lift with incisions both in front of and behind the ears. How the surgeon suspends the tissue is a matter of preference but make sure your surgeon plans on anchoring or tightening the SMAS (superficial musculoaponeurotic layer) in some way, otherwise this will be a skin only facelift that will not have the longevity of a full face and neck lift (about 10 years). I would also make sure your surgeon has a specific plan to treat your neck muscles, as this can be a dramatic change in results.

I would suggest a deep plane facelift combined with fat grafting to your nasolabial folds and midface. An upper lid blepharoplasty could be done at the same time for one recovery. Good luck!

Thank you for your question and photos. Based on your concerns, the deep-plane facelift technique would benefit you the most. You would also need an upper blepharoplasty (eyelid surgery) to remove the loose, droopy upper eyelid skin to restore a youthful appearance. A deep-plane facelift is a procedure that is most effective in tightening the neck, removing loose skin, improving jowls, and lifting the cheeks.

When searching for the best surgeon, look for a doctor who specializes in facial rejuvenation and facelifts. A good experienced surgeon who had performed more than a thousand deep-plane facelifts would be able to hep you with all your concerns. Take a look at the attached video as an example of an amazing transformation this procedure can achieve.

Wishing you best of luck on your rejuvenation journey!

Dr. Konstantin

I would recommend seeing a board-eligible or board-certified plastic surgeon with extensive aesthetic training in plastic surgery of the face. This includes a plastic surgeon who performed at least a 6 year plastic surgery residency and an extra 1 year aesthetic fellowship. You need a deep plane facelift and necklift with facial fat grafting. The muscle of the neck needs to be repaired/tightened in addition to removing the excess skin.

Good morning from Washington DC!
Thank you for posting your question with the photos. I would recommend you search for surgeons who frequently perform the deep plane technique for your lower facial/neck surgery. This technique releases all the anchor points in the face/neck so the deeper layer (SMAS) can be repositioned freely. This results in no tension on the skin and translates into a more natural result in my opinion. I hope that helps!
Wishing you all the best,Dr. SitaparaChevy Chase Facial Plastic Surgery

Dear potentate,
Thankyou for providing pictures for reference. As per your pictures you seem to be experiencing face laxity, meaning your skin is losing its firmness and tightness which could be due to many factors like pregnancies weight loss stress, etc. In such a case a full-face lift is most beneficial for a permanent solution it would target neck, midface and temporal area. I would suggest to look into expert surgeons who deals in scarless endoscopic vertical facelift which would give you a natural look after full recovery. Moreover, scarless would mean that the lift incisions will be hidden in your hairline and after full recovery will be invisible to see. I recommend vertical facefiit so that you don't get a pulled or artificial look. Furthermore, fat injections is also a technique I would suggest for the areas around your mouth for any deep wrinkles or smile lines, it would greatly fill in the lack of volume.

Best Regards,
TAS TEAM

In person exam is essential. Based on limited photos- it appears that you would benefit from facelift/ neck lift with muscle tightening, and possibly the upper lid blepharoplasty. I suggest that you seek an experienced Board Certified PS and review your options in detail.

Thank you for your question and for providing photos. You would likely benefit from both a facelift and eyelid lift, known as blepharoplasty, to address the sagging skin you’re referring to. When performed by an experienced facial plastic surgeon, a facelift can provide natural-looking results without the “pulling” effect you describe.
During a facelift procedure, the deep fascia tissue and muscle are identified, then lifted upward in the cheek and outward in the neck area. The tissue is then secured with barely-visible sutures and any excess skin is removed. Blepharoplasty also removes excess skin and repositions the fat in this area to redefine the shape of the eyes. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can suggest the best approach for you and answer any questions you may have.

A mini facelift is a great option for many people. The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day and there are no scars behind the ears and you can wear your hair up anytime and most patients take no pain medicine. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature. I'd recommend not getting into the mindset of thinking the jowls or neck skin will be 100% gone with a mini facelift or neck lift as this might lead to disappointment. It is always best to consider that an area will be improved and discuss how much with your plastic surgeon.

Surgery is not for everyone. In today's day and age, there are many nonsurgical options to consider although surgery usually gets the most improvement specifically of the neck and jowls.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of mini facelifts and neck lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps. If it does, please take a moment to up vote this answer on the “respond” button on the top right. Have a great day.

A deep plane face lift would best suite you. In this surgery, the underlying tissues of the face are lifted and repositioned, and the skin gently re-drapes over top to avoid tension or a "pulled" look. Any excess skin is removed, as well as fatty tissue under the chin. Video linked below with a clear example. A meticulous surgical technique is essential although all incisions are well hidden within natural creases. You will have a great result.