In patients like you—age 54, with minimal wrinkles but noticeable skin laxity—a lower facelift alone is often not sufficient to achieve the best, long-lasting results. In such cases, I recommend a deep plane facelift or a total facelift, which addresses not just the skin but also the deeper facial tissues, repositioning them to restore natural, youthful contours. Given the presence of sagging in the neck area as well, a necklift should be performed in combination to ensure a harmonious transition between the face and neck. To enhance volume, improve symmetry, and achieve a more balanced result, we often incorporate fat grafting to areas of volume loss. Additionally, to further refine facial proportions and correct any imbalance between the upper lip and lower face, a lip lift can be considered as part of the overall plan. Of course, to determine the most appropriate approach for you, an in-person evaluation is essential so I can assess your facial anatomy and tailor the treatment to your unique needs.