Does a lower facelift change the natural smile and dimples? Does it fix marionette lines?

There are several different types of facelift techniques that are currently performed by facelift surgeons. The most important factor is that the technique that is used by a facial surgeon will create a youthful, natural with long lasting result. Experience is the key in facial rejuvenation. Vectors of facial tightening vary from patient to patient. For a 45- 50-year-old patient, I would not apply the same vector and tension that I normally apply to a 70-year-old face. In addition, direction of vectors must be modified during secondary or tertiary facelift to avoid artificial look.  I have performed well over 3,000 facelifts and published a specific technique that describe the rotational angles and amount of tension that must be applied during SMAS plication to avoid over or under tightening.  A well-performed neck lift during facial rejuvenation is the paramount in a youthful-appearing face. I apply gradual tension on my SMAS as follow: starting at temple area there is only 20-30% tension on muscle plication, once at the jawlines the muscle is tightened 100%. This prevent pulled looked at the corner of mouth. In neck area the muscle must be tighten with greater tension than 100%, depending on the neck laxity.  Look at the doctor’s before and after pictures, a talented and experienced facelift surgeon will have a smooth and well-contoured neck that enhances the facelift results.  There is no substitute in experience and artistic eyes.

Thank you for your question.I have pioneered my Concept™ facelift which is suitable for men and women who wish to reduce sagging in the lower face (jowls) and neck and regain a more natural, rejuvenated appearance. The procedure is less invasive than a traditional facelift and there is less scarring, bruising and swelling for a significantly quicker recovery period. This innovative procedure combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days.The marionette lines will be smoothed by tightening the skin however without tightening the muscle unfortunately the lines will still appear.  A lot of my patients will have fillers or chemical peel to reduce these lines.What are the benefits of the local anaesthetic Concept™ Facelift?Minimally invasive as it is a short scar faceliftThere is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsAll The Best

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. The LiteLift™ is an innovative facelift developed by board-certified plastic surgeons Dr. Larry Nichter and myself which benefits many male patients. The goal of the #LiteLift is to provide a less invasive natural looking option for both men and women desiring to refresh their appearance with less downtime and risks. The LiteLift® is a “real” facelift, which does address the underlying muscle, tissue and overlying skin.The technique requires limited incisions and takes a vertical lifting approach, in contrast to the traditional facelift, which requires extensive incisions and lifts or pulls the face towards the ears horizontally. The modern techniques used allow us to perform most LiteLift® procedures in the office under local anesthesia. Also, removing the risk of general anesthesia opens the door for more people to pursue facial surgery. All too often people do not move forward with undergoing the desires facelift surgery due to their overwhelming fear of the risks associated with general anesthesia.This is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.The best candidates for #LiteLift are patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

With regard to your stated concerns, a lower facelift will definitely help. If you've already tried fillers without help, you've already done the alternative. At this point, its best to go for the surgery.

Thank you for your question. A lower facelift targets the lower 1/3 of the face (and neck) and would improve any jowling and marionette lines. The shape of the smile and dimples should not change. I hope this helps!

At age 45 you are probably a very good candidate for somewhat lesser procedures (see attached link) and can expect nice improvement especially in the jowls and jawline as well as upper neck. Marionette lines are more difficult because muscles that animate the corner of the mouth can be very active in some people and the lift effect is minimized by the downpull of these muscles which are not operated upon by a facelift. Dimples are created by deeper facial muscles and usually remain as part of your normal appearance. After the surgery filler to the marionette line usually achieves more result and can further improve the overall result.

    A lower facelift can improve the jowls most reliably.  The marionette lines may only experience subtle improvement.  The smile should be preserved if the vector of pull is correct.  Dimples should remain as well.Kenneth Hughes, MDLos Angeles, CA

The goal of a facelift is not to make you look like you've had surgery, but to provide you with a natural, more youthful and refreshed appearance.  Your smile should not be affected.  When the muscles are tightened to elevate the jowls, the marionette lines are corrected.  The skin has some "memory" and it is possible that some deep creases that have formed over many years will be reoriented when the skin is pulled up, however this appearance is usually temporary.  The upward pull on the cheeks will also soften deep dimpling, however this typically remains as one of your unique facial characteristics. 

A lower facelift should not change the smile or dimples unless these features are directly addressed with surgery.Tightening of the neck skin requires a direct approach to the neck. Options include the Precision Tx internal laser to improve the wringling, tighten the neck and reduce jowls. Liposuction of the submental region and jowls will tighten and smooth these areas and marionette lines.  Fillers including fat injection may be required to smooth the crease between the chin and the jowls.  A neck lift will tighten neck skin; some patients are dissapointed due to recurrence of the fine wrinkles under the chin.Please consult in person with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.

A properly performed lower facelift should produce a very natural result. The  primary goal is  to lift the jowls and help slightly with the marionette lines. The smile and dimples should not be changed with a lower facelift. A lower facelift will also remove fatty deposits in the neck and tighten the neck muscles and excess neck skin. For many examples, please see the link and video below