F36, BMI 19, but fat face. Will a facelift be the solution? (Photo)

Question

I am slim and have a rather athletic structure. However, I have a round and chubby face and I don’t know what I should do to fix my ‘problem’. I’ve already had endoscopic midface lift Lipofilling chin and jawline to lengthen face. Please help to point me in the right direction. Surgeons have declines my requests for a full face lift due to my age. But I feel the age of my skin is much older. Will a SMAS lift be the solution?

Yasin Kursad Varsak, MD · Answer

Hello, when I examine your face, I see that endoscopic mid-face lifting is not very effective. After the age of 39, sagging and loosening in the deep tissues of the face, such as the SMAS layer in the mid-face and the platysma layer in the neck, become more apparent and need to be corrected. Currently, the most effective treatment for this is deep plane facelift and deep plane neck lift. In my practice, people who opt for alternative treatments (such as neck liposuction, mid-face fat injections, transtemporal mid-face lift, or just neck lift, or any of the other facelift procedures apart from deep plane) tend to be unhappy regardless of age. Therefore, I believe that regardless of whether you are 39 or 59 years old, you should consider getting a deep plane facelift. This way, you can achieve a more effective and longer-lasting result, leading to a more natural appearance.

Alan Gonzalez, MD, FACS · Answer

Hi @Persistent156677, thank you for your question. You are probably too young to consider a facelift. Before considering such an invasive procedure, it is important to explore the non-surgical options available to you. Non-surgical treatments such as Morpheus 8 or Ultherapy use radiofrequency energy or ultrasound to help stimulate collagen production and generate skin retraction, improving structural features such as sagging jowls or marionette lines. These procedures usually do not involve fat loss. Be sure to talk openly with your physician about all available treatment options so that together you can decide what will work best and work out a non-surgical protocol according to your goals and needs. Best wishes!

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Ali Riza Öreroglu, MD · Answer

From what I gather from your photos, there seems to be some laxity and excess fat in the lower part of your face. I would need more photos from correct angles to evaluate your neck area. Regardless of age, sagging in the facial skin can result from genetics, lifestyle factors, weight fluctuations, and gravity. The sagging in the jowl area can be addressed with a lower facelift. If there's excess fat in the neck area, it can be addressed with an under chin liposuction. If there is  excess skin
An anterior Necklift would be a better option.

John Michael Thomassen, MD · Answer

A facelift will correct the sagging cheeks and nasolabial lines as well as lower face fullness.  In addition it will smooth out the contours of your face.  With care to avoid skin tension you should have barely noticeable scars.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics, especially on young people is primarily determined by bone structure.
Soft tissue coverage tends to be very consistent from person a person and what differentiates each person unique facial appearance, whether attractive or not so much is based on skeletal structure.
Most plastic surgeons are soft tissue oriented and will take soft tissue approaches to treat facial aesthetic issues.
Attempting to correct facial skeletal issues by soft tissue manipulation. Will give partial improvements at best
To make a quality assessment for someone who had previous surgery we always need to see proper before and after pictures.
We cannot make a baseline assessment without knowing what you look like before your previous procedure.
If you don’t have before, and after pictures, then ask your surgeons to forward the ones they took.
 Look at how plastic surgeons take before and after pictures to get an idea of how to present pictures for facial aesthetic assessments.
We generally need a frontal, profile and three-quarter view pictures, taken at correct angles without facial expression.
There are no simplistic answers to your problem.
For a quality outcome the process should always begin by having a clear understanding of what the underlying problem is.
This starts with a comprehensive understanding of facial skeletal structure, which is probably best done by a cranial facial surgeon.
This may include x-rays, and Cephalometric analysis. Some individuals have the ability to clearly see Aesthetic issues and pinpoint problems accurately.
This is not an easy skill to acquire, and this type of work is often highly subjective.
In order for surgical solutions to be successful we always have to start by having a clear understanding of what the underlying problem is.
This is most likely why your previous procedures failed to deliver quality outcomes.
Likewise, you do not need a facelift.
Your facial issues are not related to, what a facelift treats. Simplistic solutions to complex problems will often lead to disappointment.
Best,
Mats Hagstrom, MD

F36, BMI 19, but fat face. Will a facelift be the solution? (Photo)

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