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,