Facelift with fat grafting
I would suggest a traditional facelift with high smas or smasectomy at the deeper plane. A small amount of fat grafting in your tear trough, a small amount in our cheek, nasolabial and marionette folds.
You would have to be very careful to not get your midface/cheek overgrafted. In your smiling view, you are already apple cheeked. I would start your fat grafting laterally over your zygoma first. As a trial you could use 1-2 syringes of voluma or a one year filler, to see the facial thinning aspect of high zygoma augmentation, but this would last two years.
I thinks you would do very well with a lower face and neck lift. I think rejuvenating the lower jawline and neck will be the most important aspects in order to achieve a more youthful look. One of the important caveats is that I would argue that the platysmaplaty should be performed "aggressively" to make sure that you get a good result in the neck (reducing the horizontal lines and the banding). I think you might need some fillers to compliment the surgical result. The good news is that there is a wonderful and safe filler that is FDA approved as a long term solution. Bellafill has been a tremendous adjunct to the surgical rejuvenations that I perform because it addresses areas that surgery alone can not and again it actually lasts many years. In the end though I think a very nice result can be achieved for you with those two treatments.
Good candidate for face and neck lift
Based on your photos, even without clinical evaluation, one can say that you are excellent candidate for facial rejuvenation by means of face and neck lift. Your next step should be to find a reputable board certified plastic surgeon in your area for clinical evaluation and to discuss your options and results. Good luck.
Facelift #fatgrafting #cosmeticsurgery
Thank you for your questions and photos !! You should be able to achieve the result you are looking for- you need deep layer reshaping, fat grafting to the jawline, removal of excess fat and redraping of your skin - THE 3 R's
With Warm Regards
Trevor M Born MD
Be careful what you wish for! Gland resection during facelift revision.
Reduction in the salivary glands involves surgery near the nerves that control the lower lip, which can be damaged. The salivary glands also produce saliva, and reduction in the glands can lead to dry mouth, root canals, periodontal disease, etc.
Aesthetically, many patients who have aggressive neck work look very 'stringy' in their necks, no longer soft and feminine.
Make sure your surgeon has vast experience with revision facelifts, and is realistic about your expectations, as this next step will be very critical for you.
Don't have an overly aggressive surgery and end up looking odd.
If your marionette line, nasolabial folds, sagging and folds under the eyes and the sagging under your chin are corrected, then you will look younger. A deep plane facelift will accomplish this. I would want to examine in-person, but a slightly larger chin implant might be useful. The submandibular glands will also need to be reduced. Best wishes.
When having secondary facial procedures
with specific problems you now appreciate, your procedure must address all of your concerns or you will still be unhappy after the procedure. Your neck requires a corset platysmaplasty at minimum and with your jowls developing, requiring a full facelift to address it. If you find a surgeon experienced in dealing with the submandibular glands and are accepting of the risks that go with it, you should go with that surgeon. It would also help to know just what kind of a procedure you had the first time to allow better planing by your surgeon. Finally, fat grafting at the same time can help with filling in any concavities or lines.