What type of facelifts are appropriate for someone who is 38 and lost 130 pounds?

Question

I lost about 130lbs, and left my face looking deflated. I know I definitely need a fat transfer to my cheeks and possibly temples, but otherwise I'm kind of lost on what type of facelift I need. I only have mild looseness in the neck and in the face, not a ton. I really just want the Midface lifted on the deep plane, but I don't understand what the difference between doing that via the endoscopic and via the ear incision is? And if a Midface lift is going to require an incision all around the ear, then what's the point of doing that and not just doing a full deep plane?

Alejandro Nogueira, MD · Answer

Your sagginess, both at face and neck/jowls, does not pay off the costs and risks of any tipe of face/neck lift, probably you are magnifying your situation, which can be fairly said is very good after that massive weight loss. I had the opportunity to receive and do surgery on post-massive-weight-loss patients with dramatic aesthetic situation, you'd be their envy :)

Topic aside, getting an endoscopic facelift, of any kind, is guarantee of money and opportunities wasted, if not of deformities.

Topic aside, getting an endoscopic facelift, of any kind, is guarantee of money and opportunities wasted, if not of deformities.

Ronald J. Edelson, MD · Answer

It would be highly unusual to perform any facelift on someone your age and judging by your photos.  I would truly not do a thing although there are plenty of surgeons who would give recommendations ranging from conservative to aggressive

Gene Sloan, MD · Answer

The beard and lens distance make it difficult to assess by photos alone.  An in-person consultation is always preferred. I suggest you have 2 or 3 consultations and, instead of going in and telling the surgeon what type of facelift you need, tell them what your problems are and let them tell you how they would address them. Then decide which surgeon and what procedure makes the most sense to you.

Scott C. Lindsay, DO · Answer

Thanks for your question! Based on your photos, I wouldn't do anything. You are right - your laxity is mild and doing too much, too soon, at a young age can actually do more damage than good. Best of luck!

Mats Hagstrom, MD (license on probation) · Answer

The only facelift I think you should consider is a mid face lift.
Despite having the word facelift and its name, it is not at all like a regular facelift.
The midThe only facelift I think you should consider is a mid face lift.
Despite having the word facelift in its name, it is not at all like a regular facelift.
The mid face lift gives volume in the upper mid face just below the lower eyelids.
 Volume in your mid face is probably going to help the most.
This can be done with fillers, implants, fat grafting, and a mid face lift.
Each of these procedures has advantages and disadvantages.
A mid face lift when done correctly can give a very impressive and natural outcome.
It can be a long lasting.
The procedure tends to leave people swollen for quite a while, which is one of the drawbacks.
There are a lot of different approaches and you’ll find each plastic surgeon may have their own recommendations.
Personally, I think mid face fillers would be the best place to start and the best treatment option.
Fillers are very effective, predictable, and forgiving if patients don’t like the outcome.
The key for fillers as it is with any procedure is to find the right provider and this turns out to be much more difficult than most people realize.
 Finding the right provider generally requires a vetting a lot of plastic surgeons.
In my opinion, this means having a lot of in person consultations.
Bring pictures of yourself to use as a reference for each consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar facial characteristics as you do.
An experienced provider should have no limitation of before, and after pictures to show you.
If someone has done a lot of procedures, they should have a lot of before and after pictures.
You may want to consider looking at the website of Dr. David Mabrie MD in San Francisco.
David is a facial plastic surgeon whose practice is devoted exclusively to working facial volume enhancement, using only fillers.
His work is the best I’ve ever seen it.
In my opinion, his outcomes represent the gold standard of can be accomplished using only fillers.
I’m not recommending people fly to San Francisco to get fillers.
David has an incredible number of examples on his website.
I think reviewing his results can be a powerful tool to understand what just using fillers can accomplish in the hands of the right provider.
 Once people know what can be accomplished for a certain procedure they can set expectations accordingly.
Average providers do average work.
If you want an exceptional outcome, you’ll need to find an exceptional provider.
Most people don’t have much experience consulting with plastic surgeons.
By having lots of consultations, you’ll get better at the process and understand the different procedures and your own assessment as well.
Best,
Mats Hagstrom MD

What type of facelifts are appropriate for someone who is 38 and lost 130 pounds?

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