Late forties: am I candidate for a neck or facelift? (photos)

Question

Hi I'm in late forties and have hated my saggy neck over last 5 years and wanted a neck lift. Recently my facial lines have deepened and don't like what I see anymore. I can only afford to do this once so want best results. Had a consult which outlined expense, risk but not the result I'd thought. Smooth neck, a jawline and softened face lines would be my goal. So what procedure would you suggest and am I hoping for too much at this age?

Stephen Prendiville, MD · Answer

Based on the photos shown, you have typical signs of an aging lower face and neck.  A neck-lift alone will not make you happy.  A deep plane facelift allows for lifting the SMAS and skin in a composite fashion, release of facial ligaments, and tightening of the platysma muscle to improve the shape of the neck and face. I would suggest a deep plane facelift performed by a Surgeon who does over 100 facelifts per year.

Jonathan Kulbersh, MD · Answer

Thank you for posting your question and photos. You appear to be a candidate for both a cervicoplasty and platysmaplasty neck lift procedure. Cervicoplasty refers to the tightening and reduction of loose skin in the lower half of the face.

Platysmaplasty is performed to tighten the muscles in the neck, known as platysmal bands. Lifting the deeper tissues and tightening these muscles prior to removing excess skin can produce more natural-looking and longer-lasting results. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can make the best suggestion in helping you achieve your cosmetic goals.

Jason Emer, MD · Answer

With significant neck sagging you would need a neck lift / facelift with muscle tightening (platysmaplasty). At the same time, lasers treatments (Fraxel, CO2, Erbium, Halo) or microneedling RF (Fractora, Intensif, Morpheus, PiXel8) can be performed to improve crepey skin or wrinkles. You need a formal consultation, as the neck can be treated with a combination approach:​ - Microneedling and laser treatments for texture - Botox, Dysport, Xeomin, or Jeuveau to help the Platysmal bands - Intensif, PiXel8, Morpheus or Fractora RF microneedling for crepey skin and lifting - Injectable fillers like Belotero, Restylane Silk, and/or Juvederm Volbella to improve lines and folds - Renuvion, ThermiRF, and/or InMode FaceTite for internal tightening - Ultherapy and Thermage for external tightening - regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness - PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production See an expert for a full evaluation and treatment plan based on your individual situation and goals.

Dilip D. Madnani, MD, FACS · Answer

Thank you for the pictures. From what I can see, you have lower face and neck laxity and facial volume loss. These are the main reasons patients present for facelift surgery. 
The surgery will result in a contoured lower face and neck. The neck lift will involve incisions under the chin, to elevate the skin and tighten the neck bands, and the lower facelift involves incisions around the ears, to elevate the skin and then tighten the muscles of the lower face. 
Other options to further enhance the result  are to undergo a facial fat transfer to restore volume loss of the face and laser skin resurfacing to polish off the surface of the skin .

Lucian Ion, FRCS · Answer

To increase the chance of good longevity of the result from facial and neck rejuvenation my observations suggest:
- consistent (daily) use of sun protection two decrease the speed of damage to the elastic fibres of collagen in the skin
- no smoking
- maintaining relatively stable weight
- deep plane neck lift to reduce the volume under the platysma muscle rather than to rely predominantly on tension

Visibility of the labio-mandibular lines (marionette lines) is leaning towards facelift and neck lift rather than just neck lift.

A combination of deep plane facelift and deep plane technique lift is more likely to achieve a combination of comprehensive early improvement and longevity of the result.

Cory Bovenzi, MD · Answer

Hi and thanks for the question! I think you would be a great candidate for a facelift and necklift for the areas that are bothersome to you based on your photos. A combination with liposculpture would help in softening those nasolabial folds as well.
Best of luck!

C. Blake Perry, MD · Answer

You are a great candidate for a lower face and neck lift. This procedure will help tighten the neck and smooth the jawline. Unfortunately due to your excess skin, I do not think non-invasive procedures will give you the results you want.
Best of luck.

William Townley, MD, FRCS(Plast) · Answer

HI there,

Thank you for sharing your profile photos. Based on the images alone, a lower facelift would be the ideal way to create a youthful jawline and neck contour. I favour a deep place approach to help deliver a more long lasting and natural result. This helps lift the jowls and tighten the area under the neck to achieve a crisp jawline. In my practice, this is often combined with fat injections to help refine the overall result. It may or may not be necessary to open the neck separately - the facelift alone will help tighten the neck contour but a small incision under the chin to tighten the deep muscles and remove excess tissue may be beneficial - this would be best assessed in person. Based on your age, you are also at a good starting point for this! Good luck in your journey!

Brian K. Machida, MD, FACS · Answer

You would best be served by doing both a face and neck lift.  It would help the vertical bands in the neck and achieve the nicer jawline and facial lines.

Joseph Shvidler, MD · Answer

You would benefit from a lower facelift, where not just the skin, but a deeper muscle (platysma) is tightened under the skin. The jowls would be lifted and you would regain your jaw definition. The neck skin would be lifted and re-draped to provide a more smooth appearance. Check out our photo gallery in the link below. Thank you.

Late forties: am I candidate for a neck or facelift? (photos)

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