I Had a Facelift 4 Years Ago and Don't Want Another One What Can I Do to Help Sagging?

I had a facelift approximately 4 years ago and have started to get the deep fowls around my mouth. I'm 60 years old and want to look vibrant for my age but do not want a another facelift. Are there other alternative that will help the wrinkles and jowls?

Doctor Answers 28

4 years after face lift want to fix jowls and wrinkles

If you don't want a traditional full Face Lift to remove and tighten the jowls you have 4 options, IMHO:

  1. A Minimum Incisison Face Lift that's much smaller, of an operation, recovery and healing time to tighten the joowls and remove excess skin.
  2. Skin resurfacing with chemical peel or laser to tighten the skin (somewhat) and reduce wrinkles
  3. Use fillers liek perlane to fill in the Marrionnete lines (Jowls) and peel, laser or use skin care for the wrinkled skin
  4. Use a RF treatment to tighten (somewhat) the skin with one of the above to decrease the wrinkles

Hope this helps.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

There are many non surgical options for facial rejuvenation

You have not posted a photo, so my answer will be generic, not specific towards your particular needs.  Many things can contribute to making a face look older.  The skin ages and sun damage makes wrinkling and pigmentation problems worse.  The soft tissue or fat of the face changes.  We lose volume in our cheeks and gain it in the lower part of the face.  This contributes to jowling, nasolabial folds and lower eyelid poochiness. Injectable fillers can be used to restore fullness in the cheeks.  They can also be used to improve lines such as the nasolabial folds and the marionette lines (those that run from the corners of the mouth to the jaw).  Skin care and/or laser resurfacing and/or photofacial can improve wrinkles and dark spots from aging and sun damage.  Some of the broad band light treatments such as Skintyte can firm up loose skin, but you should be aware that this is temporary. I know that you do not want further surgery, but in some cases, minor procedures such as liposuction of the jowls can be beneficial and easy to do under local anesthesia.  Even a mini face lift can improve the jowls through your previous facelift incisions.  There would be no additional scarring and the recovery is often significantly easier than that of a full face lift.  Make sure your surgeon is appropriately board certified and can offer the variety of procedures I have illustrated.  That way you know that your treatment options are broad, not based on the limitations of the physician's experience.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 54 reviews

Nonsurgical options

Nonsurgical facelifts are generally treatments that involve a combination of fillers and Botox or equivalent. It can also refer to treatments using laser skin tightening technologies. All of these attempt to rejuvenate the face without surgical means. They do work, but you need a physical assessment by a PS to determine suitability.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Deep folds after face lift

Although it is difficult to answer your question without seeing your pictures – based on your description it appears that you may be a good candidate for facial fat grafting

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Face Lift

You should be wearing a facial sunscreen preferably zinc or titanium based physical blocker every day, and over neck and chest, reapplying every 4 hours.  Then, consider fillers or fat transfer, whichever is applicable.  Speak with a Board Certified Plastic Surgeon on how to manage your maintenance.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Early Sagging After a Facelift

Usually you should not have a lot of facial jowls or sagging so early after a facelift. If the sagging is just skin and in the cheeks only, you can do a short incision face lift with deep layer SMAS manipulation and filling of the deep malar compartments for a youthful longer lasting facial rejuvenation.


Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 63 reviews

Facial Fillers and Volume Replacement

Without a photo it is difficult to say. But, in general, as one ages they loose facial volume and the face begins to sag.  You have had a face lift so your skin is fairly tight.  I would consider fat injections for facial volume replacement and possible a light tca chemical peel.  I would also add fillers for the wrinkles that concern you.

The fat injections can soften the jowls only.  Surgery is obviously the best.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 75 reviews

Jowls four years after facelift

It's difficult to respond meaningfully without a photograph, but the first question would be the nature of the facelift you underwent. If it was a minimal lift, then I would not be surprised that the results have not lasted more than four years.  There are many non-surgical options including Thermage, facial fillers and laser therapy and you should seek a board certified plastic surgeon to assess which of these would be viable for you.  None are as efficacious as surgery but may offer some improvement.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Conservative management of jowels after face lift

If you are starting to notice sagging of jowls and deepening of the nasolabial and marionette lines, you have a few connservative options before resorting to a second face lift in 5 years.

Botox injection (nefertiti injection) can cause a subtle but noticible elevation of the jowles.

Non-invasive soft tissue tightening with Thermage and the new Ultherapy may be an excellent maintenance strategy.

Fractional CO2 peel will not only inprove the texture of the skin but it also causes tightening and a microlift

Cheek and or chin implants can reestablish good facial skeletal projection and elevate the jowls effectively

finally, if jowls are the main concern, and the above conservative options are not appealing or appropriate, you may see significant improvement with a midface lift as opposed to another traditional or mini-face lift.


Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Non-Surgical options for wrinkles

There are many non-surgical options for wrinkles.  Unfortunately no substitute for surgery to treat jowls.  You can consider CO2 resurfacing to treat wrinkles on the face.  This will provide some degree of skin tightening as well.  It is important to be on a medical skin care regimen as well.  Botox/ Dysport will treat facial wrinkles as well depending on where they are.  Fillers can be used to treat smile lines very well.

Melanie L. Petro, MD
Birmingham Facial Plastic Surgeon
4.7 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.