46 yr old considering mini / neck lift in Houston (Photo)

46, 145lbs considering mini lower face lift but confused as to whether Kybella or liposuction would work as well, getting mixed signals. There are so many options, I'd prefer a more permanent result than my disappointing ultherapy which only seemed to last 3 months. Also, can a bullhorn lip lift be done at same time?

Doctor Answers 4

Mixed Signals

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Thank you for your question. Unfortunately from the single photo I am limited as to the degree of changes in your neck and jawline. Mild signals are very common and can be challenging for patients who are often looking for consistency. Often there isn't a definitive answer but rather several opinions on how to get to the end. From the photo it looks like Kybella would not be the best option. Kybella tends to be more focused on the central neck although the lateral, outside, can be addressed but the major indication is for the submental region Liposuction may be a great option for you. Its a "one and done type procedure that can address the neck more thoroughly and has limited down time. A neck lift or mini may be a good option but from the only view available its difficult to say. I would recommend a consultation with a board certified plastic surgeon to discuss your options and to help you achieve the result you are searching forBest of LuckDrG

Miami Plastic Surgeon

Considering a Mini/Neck Lift at age 46

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A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.
During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

46 yr old considering mini / neck lift in Houston

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.  From the photo included, the chin is weak, there is excess fat under the chin and in the lower face.  You appear to be pouting the lips which might hide the presence of "jowls".   

  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  I combine liposuction to remove excess fat for further shaping of the cheeks.

  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  I perform chin implant surgery in 30 minutes or less using a local anesthetic.

  If you have "jowls" these are  sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine whatever facial shaping that's necessary with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews


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It sounds like you are a candidate for a Mini-Facelift. My favorite technique is the MACS short scar Mini-Facelift. Developed in Europe, it is the ideal approach for the younger patient, not ready for a full facelift, or patients who desire a less invasive procedure with a shorter recovery time.
Long term results from Kybella not in yet, and it takes at least 6 months to see final results from the 6 treatments needed. Mini-liposuction of neck region better in my opinion. Not a fan of lip lifts because of scarring, fat transfer to the lips is a nice option.
Check out the link below to an article I wrote about the subject on
f Mini-facelifts. Be sure to consult with a board certified plastic surgeon.  Good luck.

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 33 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.