I had a facelift 7 years ago, but the lower part of my face has fallen and crumpled. Would I be better off with a mid-lift?
Is Sculptura Good for Sagging Skin Around the Mouth and Jaw Line?
Doctor Answers 9
First, you have to analyze what is making you look older.
Hi! Looking at your photo, I think the main area that is making you look older (and a little sad) is around your eyes.
1) The outside of your eyebrows is drooping. This can be improved with Botox.
2) You have sharp lines between your inner cheeks and your lower eyelids (called a teartrough). This can be improved with small amounts of Restylane injected DEEPLY.
3) Around your mouth, I would use Juvederm injections. I don't use Sculptra. Sculptra requires more than one treatment, is not forgiving, and cannot be reversed.
4) When you are ready for surgery, a mid facelift (through the mouth) and a lateral browlift would be good.
A different opinion
Using a single view for analysis is hard, but my recommendations would be different than the others. I believe the central face and the area about the mouth is the key to rejuvenation of a face like yours.
In addition, your eyes could easily be improved by having someone who is skilled in plucking and medical pigmentation narrow and shape the inner portion of your brows, and add density with tattoo to the outer portion. This would easily and non-invasively change the whole character of your eyes and upper face.
The rest of your look could be greatly improved by a "S" lift, which is one of the lesser but not "mini-lifts," combined with placement of "Permalip" implants to create a more youthful upper and lower lip (your upper lip appears too long and flat).
In addition, the naso-labial and marionette folds would be treated by Radiesse fills. This would all be done at the same session as an out-patient and restore your entire face and neck to both being more youthful, as well as prettier.
Facial volume restoration
A mid lift will not restore the facial volume that it appears you have lost in the lower cheeks. Sculptra and Radiesse, both would be utilizing the products as an off-label use (not a specific indication for which the FDA approved the product). Fat injections can also be used and the hyaluronic acids but the latter would require many syringes and could be quite costly.
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Liquid Facelift is an option
Injection such as Radiesse, Restylane and Sculptra add volume to volume deficient areas.
Sculptra, as you would be using it off label, does add volume over time, and is a good option, however it requires several injections to get the volume needed. If it is a particular small area then restylane or radiesse may be a better option.
Have a re-do facelift is also an option. Just depends on how and what you would like to achieve.
Hope that helps.
Were you happy with your facelift?
If you were happy with the work your doctor did 7 years ago, I would suggest you go back and visit them for a review of your current options. It is well within reason that at this point you would consider re-doing your surgery in some form to tighten the sagging you are beginning to notice.
You can also use fillers in the cheeks and jawline to perform a "liquid facelift" if you want to hold off on surgery for awhile but please realize that Sculptra is not FDA approved for use in this arena, only for HIV lipoatrophy. I would advise using Restylane and Radiesse as your superficial and deep fillers instead.
Solutions to Sagging Skin Around Mouth and Jawline
Nothing can match what surgery will ultimately do, but looking at your photo, the best non-surgical alternative in my opinion would include the combination of filler injections (Sculptra, Radiesse, Juvederm) to help restore volume and Ultherapy to tighten and lift.
Sculptra ideal for filling lateral face and temples
Your photo shows loss of volume in the temples, lateral cheeks and probably at the lateral jawline. Boosting the volume of these areas can resore a natural appearance to your face and the volume will create lift of the skin. Surgical facelifting will tighten the skin but will stretch it over already thin areas making your face look more bony or angular rather than full, youthful and fresh. I would definitely consider sculptra with a physician experienced in injecting the above areas.
Midface vs Sculptra
To answer your question simply, it is hard to tell. A midface lift will get your cheeks up but I don't think that the lines in your lower face will be improved much from that. Sculptra could help in that area very well. You may need both.