Do I Need Lipo or a Facelift? (photo)

I am 50 years old and have noticed fat under my chin, slight jowling and some slight puckering/wrinkles in my neck. I have seen two plastic surgeons. One says I am a good candidate for neck lipo with fat injections to the pre-jowl area and a small sub-mental skin excision. The other said my skin is borderline and may sag after lipo. Both are Board Certified Plastic Surgeons. I don't know which opinion to trust more. Any help would be greatly appreciated.

Doctor Answers 15

Do I Need Lipo or a Facelift?

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 I have performed Face Lifts for over 20 years and IMHO, from these photos your face has excess fat and skin.  A minimal incision Face Lift with micro-liposuction of the excess face and neck fatty tissues of the face would address these issues.  The chin is weak which could be balanced using a chin implant placed through an incision under the chin.  The same incision could be used to remove some of the excess neck skin.  These limited dissection Face Lifts can be performed in about 90 minutes and have a recovery that's measured in days, not weeks or months like traditional Face Lifts.  Hope this helps.

Face lift or camouflage

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The changes in contour that your have described are common. The laxity and descent of the cheek fat pads tends to roll around the more fixed mouth muscles which leads to jowling and submental skin excess.  Performing liposuction of the submental region regardless of the method used will help remove volume but will not typically address the skin issue. Fat grafting will serve as a camouflage technique, while a high SMAS lift will reposition the cheek fat and correct many of your concerns.  The limited scar SMAS lift in conjuction with neck contouring (lateral platysma tightening) would in my mind be the most definitive approach for a long term result. Best of luck

Do I Need Lipo or a Facelift? (photo)

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Some type of expertly preformed mini face/neck lift. Additionally, Smart Lipo 12 t0 18 watts to treat the submental area. Fat grafting enhanced with PRP to areas of the face. 

Liposuction versus facelift

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Most women that are 50 years old will need a facelift or neck lift to improve the submental area and jowls.

Alternative plan would be lipo and a Mixto "shrink" of the neck and face

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We have done patients just as you with a combination of liposuction and laser.

The new fractionated CO2  lasera in experienced hands can be used for skin tightening of the neck.

This allows us to use liposuction in the neck at the same time as the Mixto in the entire face and neck to get some very nice results. It is done under just oral sedation and some local anesthesia and is less expensive than a surgical neck lift.

However, it does not give as dramatic a result as an invasive neck lift with tightening of muscle and removal of skin.  The other important factor is that it does not get in the way of any future surgery.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Lipo, Facelift, or Both?

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You have fullness in the region under your chin as well as sagging fat in your cheek which has created some jowling. I think that you would be a great candidate for lipocontouring of your neck as well as a lower facelift. This would create a much more defined jaw line and neck and make you look much more refreshed.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Facelift or liposuction of the neck.

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A facelift with liposuction is what you need to correct the sagging skin and fat. Your skin will sag if you do not remove the excess with a facelift.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Facelift and liposuction

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Usually after the age of 40, liposuction alone won't get you your desired results.  When you remove the fat, the skin will then hang.  Unless you have the elasticity of younger skin, you will need a tightening procedure.  A facelift is a good option.  If you are mainly interested in just the neck, then our trademarked U-Lift would be a good option.

Good luck.  

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Facelifting or Liposuction?

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Thank you for the question and pictures.

Although it is hard to give you good advice without direct  examination, based on your description of “slight gelling and puckering/wrinkles in the neck", I think it is relatively clear that you will have a better result with face lifting rather than liposuction surgery.

Liposuction surgery is very dependent on skin elasticity which may be  decreased about the age of 40.

I think you will be able to make the best decision yourself when you look in the mirror. If you like to look of the face and neck achieved when you  a place light upward and lateral tension on the skin of your face and neck,  then face lift surgery is likely to be your best choice.

I hope this helps.

Do I need a Facelift?

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Thank you for sharing your images and questions. A combination of conservative liposuction of the submental and jowl areas with a facelift/necklift would best address your concerns. Although liposuction alone is a consideration for patients in their 30s/40s, I don't feel the elasticity in your skin will allow it to re-drape into a new, tight, neckline after such a procedure. I feel you would be best served with a grade I facelift utilizing well camouflaged incisions. If you are not ready to undergo a surgical intervention, filler injection into the prejowl area may help to smooth your jawline and mask the early jowling. If so, seek out an experienced injector. In my experience, there are not any non-surgical treatment options that specifically target the submental area and give predictable, clinically apparent results.  I hope this helps. Take care.

Robert Brobst, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 5 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.