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

I am 45. I am trying to decide on what procedure I will be having for jowls, marionette lines and loose skin on my neck, under the chin. I would like a lower facelift, but I'm worried it will change my natural smile and dimples. Also, what happens to the marionette lines with the lower facelift? Do they go horizontal? I don't want a mid facelift at my age, maybe later, only lower for now. But I'm concerned that a lower lift won't be enough to fix the marionette lines. I've had fillers, no help.

Doctor Answers 14

Lower Facelift, under local anaesthetic

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 facelift
  • There is minimal bruising and swelling, especially when compared to traditional facelifts
  • As the procedure is performed under local anaesthetic, you can go straight home following the procedure
  • Full recovery in a matter of days rather than months
  • Significantly less risk than Facelifts performed under general anaesthetic
  • Fresh, youthful and long lasting results
All The Best

About a Lower Facelift

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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Lower facelift will help

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.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews

Lower Facelift, Dimples, Smile, Marionette Lines

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.

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Lower Face Lift

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!

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

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

If the surgery does change your smile and completely eliminates your marionette lines, you have been 'pulled' too much.  Consult with a Board Certified Plastic Surgeon who is highly trained for a natural facelift.  A good place to start is with the American Society of Plastic Surgeons (ASPS).  Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

Does a lower facelift change the natural smile and dimples?

Most likely you are a candidate for a mini-incision facelift and necklift.  No, it should not change your smile and it will not completely remove your marionette lines.  If it does change your smile and completely eliminate your marionette lines, you have been 'pulled' too much.  See an experienced facial plastic surgeon for beautifully, natural results!

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Lower Facelift does help marionette lines

Dear Delilah5, From the description of your concerns a lower facelift seems like it would be advantageous to correct those areas. A consultation and examination will determine what would be the ideal procedure for you however you are on the right track. The smile and dimples should not be changed. I recently did a lift on one of my nurses who has dimples and that was a concern of hers as well however she still has her dimples and now again resembles her past pictures from ten years ago. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Lower facelift does not change the smile and dimples

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

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Lower face lift

I think to correct what you describe an elevation of the skin and tissue of the cheek and neck are required, that is a traditional facelift. The marionette lines should not become horizontal, rather they should resolve when the skin is repositioned.Some vertical and oblique elevation of the cheek tissue and skin will correct that marionette area.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 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.