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

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 .

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.

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.

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.

One of the most important jobs of a plastic surgeon is to help patients understand what outcome to expect. Did your surgeon not speak with you for a long enough period of time, or did you not like what you heard? I always suggest that patients bring a long list of questions to their consultations. My consultations only conclude after all questions have been answered. While you appear to have sun damage, you would very likely benefit from a facelift and neck lift, as well as laser resurfacing to both. The lifting will address the sagging skin, and the laser will vastly improve the texture of the skin. I recommend consulting with another board certified plastic surgeon to discuss your goals and expectations and to determine which procedures are right for you.

Yes you are a candidate for surgery.
The changes that we see in ourselves over time are due to skin laxity, skin texture changes and loss of facial volume.
A full facelift (one that includes the face and neck) will manage the skin laxity that you have by tightening the skin. A more defined jawline and softened facial lines are excellent goals and these can be achieved.
Because of the textural changes to your neck skin (the fine lines and crepiness), I don't expect that you will have a smooth neck so even though you skin will be tighter, it will still won't look smooth. In my practice, we recommend a neck skin program that includes various combinations of medical grade skin care and laser treatments tailored to your skin, prior to undergoing surgery. This toughens up and the skin in preparation for surgery and gives you a much better result than surgery alone by helping to smooth fine lines, enlarged pores, and discoloration.
With respect to the third component of facial aging, fillers are sometimes recommended after surgery, or in severe cases of volume loss, fat grafting can be done at the time of surgery. This does not appear to be a concern based on the portion of your face seen in the photos, however being assessed in person can confirm this.
In summary, I don't think you are asking too much, however treatments in addition to surgery will be very beneficial for you.
Although you only want to do this once, facial aging will continue, and so you will need to make that decision later in life depending on if you are satisfied with how you age. In the meantime, a healthy lifestyle, good skin care and sun protection will help preserve your result.
All the best to you,
Dr. Nancy de Kleer

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.

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!

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.

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!