Lower Facelift and Other Options for a 66-year-old?

With any surgical procedure, patients make choices. One of the most important is how good a result the patient wants. Most of our patients want to achieve the best result possible.
In almost all 66 year old women, there are many changes in the appearance that cause the face to appear to sag, the jowls to form, the face to lose volume, and neck to appear indistinct.
The most effective way to rejuvenate these areas, and to do so with the least amount of.artifact (the "done" look) is with an expertly done facelift and necklift. To do just the neck alone makes it impossible to do the beautiful restructuring of the face. It can also create a bizarre if the neck but not the face are rejuvenated.
Statistically, many patients are in a position where they cannot spend money on an initial surgery, then pay even more to redo unsatisfactory work.
So my advice to all patients is to do it right the first time. Choose an experienced facelift expert whose board certification, reputation and results you have researched.

Jowls are sagging of the facial skin and underlying tissue over ligaments attaching the skin to the bones that can cause a droopy face even in the mid 20s and 30s. They can never be corrected by  filling the face with fillers alone.
There are various types of facelift procedures that can be helpful to different age groups. A mini-facelift working on SMAS and minimal scar can help a young patient with lower face sagging (early jowls) however an older patient with sagging of the brows, midface and neck would require a full face and necklift. A facelift procedure involving pulling the SMAS should be performed for best results on the jowls. I personally in many among other techniques use the composite mini-facelift technique where a SMAS flap is elevated with minimal skin dissection, a very quick recovery and very long lasting result  (ideal for younger patients). Some parts can also be filled with fat grafting (Lift & Fill) to enhance to overall result and make you look even younger. 
In general I advice my young patients to undergo preventative care procedures. These include regular botox injections, fat grafting if a depletion in volume is starting to occur and superficial skin tightening procedures that DO NOT damage the underlying tissue (a good option is needle RF). While these procedures usually make the younger patient looking for facial rejuvenation happy, not all will be satisfied if the deformities are severe (regardless of age). As a rule of thumb, if there is sagging of tissues and excess skin, a facelift operation is inevitable!

In the mid to late 60's, injectable products and "minimally-invasive" techniques can often simply be a waste of time and money. Most patients at this age are starting to see significant signs of aging that need significant correction. The only way to achieve dramatic and long-lasting results is with surgical intervention. Traditional facelift, neck lift, and lower face lift techniques are designed to rejuvenate the face safely with excellent results. A facelift is designed to lift and tighten the cheeks, jawline, and neck and can be customized to meet the needs of the individual patient. Injectable products and other less-invasive techniques can be a nice supplement to polish off and maintain surgical results, but are often not enough on their own.
Be sure to see an expert who specializes in facial aesthetic procedures.
All the best,

Different people age differently.  In general, by 66 years of age, most individuals have some component of facial inelasticity as well as midface and lower face volume loss.  To get the most natural result in the end, your surgeon has to diagnose the different ways you are aging and reverse each problem individually.  So, if you have excess skin and volume loss, then a facelift followed by adding volume to the face with fat, filler, or implants would be ideal.  

 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

At 66, most people have significant skin laxity and jowls due to gravity and slowed collagen production. While there are non-surgical options such as fillers or skin tightening lasers, these will most likely not be effective enough. Likewise, although it is impossible to say without seeing you in person, a “mini-lift” would likely not be enough either. I perform mini-lifts, which involve fewer incisions and less aggressive surgical techniques, most often on people in their 40s or 50s who are just beginning to see skin laxity or jowls. A full face and neck lift, which lifts and repositions the SMAS layer as well as re-draping the skin to recreate a more youthful and contoured appearance, would most likely be best for you. Please visit a board-certified facial plastic surgeon for a consultation to see what options you have. I hope this helps.