Is it time for a facelift/neck lift? (Photo)

Question

I'm 39 and gained about 20 lbs in the last few years. I can't tell what's happening to my lower face/chin/neck. Do I need a lower facelift/neck lift or will losing weight help improve the area? My right upper lip turns in in the strangest way. Can that be correct via a facelift? I want to weigh in all my options before seeking a facelift procedure. I had rhinoplasty two years ago and I feel it's too small and too turned up for my face, maybe that's throwing off the balance as well?

Stephen Prendiville, MD · Answer

Based on the photos, I would answer "No".  However, you will probably find a Surgeon who will do it, so be careful. Surgery without indications is risk without benefit.

Donald Groves, MD · Answer

Hello and thank you for your question. In general, it is always a good idea to maintain a healthy lifestyle and do any intended diet and exercise prior to any potential elective surgeries, as losing the weight can result in distortion or asymmetries which can be corrected during your ultimate surgery. If you already have plans to lose weight, I would recommend this first before seeking out surgery. From what I can tell based on the pictures you have provided, there is a little submental fullness (underneath the lower jaw), more noticeable in the right profile picture than the left. If this is not fully resolved after your planned weight loss, you might benefit from some submental liposuction to that area to improve the definition of your cervicomental angle (the junction of the lower jaw to your neck). It is difficult to provide tentative surgical recommendations, however, as there is only so much information to be gained from the photos you have provided, and your appearance can change with weight fluctuations. Once you have lost the intended weight, if there is still a concern to your lower face/chin/neck region, I would recommend for you to come see me or another plastic surgeon for a formal consultation at that time to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!.Best wishes,
Dr. Donald Groves
Plastic Surgeon

Brandon Richland, MD · Answer

Dear cosmic,
Thanks for your question and photos. Based on the photos you have a well defined jawline with mild skin excess. A facelift/necklift is generally to remove moderate to severe excess skin in the neck and jowls. You may want to look into minimally invasive skin tightening options such as morpheus 8, renuvion or others. Chin liposuction would help remove fat under the chin. I would suggest a consultation with a board-certified plastic surgeon for further information and recommendations.

Cem Berkay Sinaci, MD · Answer

Hello, you do not have a lot skin excess, or soft tissue ptosis. In your case I would not recommend a classical face&neck lift approach. You may benefit from non-incisional face rejuvenation techniques such as thread lifts or endoscopic lift. Nose looks fine in proportions but you may also benefit from augmenting the chin for a better profile view. And losing more weight will not improve the sagginess. For the double chin you may benefit from neck lift or thread lift aswell. Best regards

Ronald J. Edelson, MD · Answer

I think your nose looks good. It’s too early fir a facelift. You would get no benefit from it at all. Wait another five years at keastb

Michael S. Kluska, DO · Answer

As we age, the bones in the face shrink and the fat tends to atrophy over time. There are multiple options out there for facial volume loss and restoration. That being said as I have been practicing for over 25 years, I am starting to realize that autologous Fat Grafting is the best option available for volume restoration and facial balancing in the face. Additionally, fillers can be extremely costly when you start to need large volume and most of the time don’t look natural. In your case, fat grafting can create a very natural look but, all subunits of the face should be addressed simultaneously in order to maintain balance and shape.

Mehdi Sina, MD · Answer

Hi,

You have mild fullness under your chin, but still have a nice jawline. In order to tuck up the skin and soft tissue centrally, you would benefit from a central deep neck lift. This is not a procedure that all surgeons are proficient at, you I would recommend finding a facial plastic surgeon who specializes in deep plane face and neck lifts for a consultation.

Best,
MS

Connie Hiers, MD, FACS · Answer

No, you do not need a facelift and no, a facelift will not help your lip. You could consider noninvasive micro-needling with radiofrequency to tighten your skin like Secret, or minimally invasive radiofrequency treatment like Renuvion, to help define your lower face and neck more.

William Portuese, MD · Answer

Before making a decision on facelift or a necklift, probably best to lose that 20 pounds that you gained first. Then reevaluate. Rather doubtful that you would need any work in your neck at age 39. With respect to your nose, you have a residual hanging columella which can be reduced along with a mild amount of de-rotation can be accomplished as well.

Joshua Jacobson, MD - Account Suspended · Answer

Hi. It looks like you have some extra fat in your chin (submental) area. You don’t seem to have extra neck skin. So I think chin (submental) lipo will take care of the problem. Regarding your upper lip, the problem is too subtle to need facelift.  Fillers to the lip or botox below the lip corner can fix the asymmetry. It’s hard from the pictures to tell if botox is more appropriate or filler but I can tell you facelift is not the answer.

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