Facelift or lipo or cheek buccal removal? (Photo)

Based on your photos, I would recommend micro fat grafting of the tear trough, cheek, pyriform aperture, pre jowl sulci and angle of mandible in combination with a deep plane face and neck lift. The neck lift must address deep structures including the subplatysmal fat, submandibular glands, digastric muscles and platysma muscle. Best of luck and thank you for your question!

Thank you for your question! As we get older, facial aging can cause our skin to become more lax/droop. Based on your pictures provided, achieving a slimmer and more youthful face is achievable! The best way to tackle the "double-chin" a lot of people struggle with would be to remove the excess fullness. This can be done with liposuction to the neck/jowls. Once the extra volume has been taken down, there may be loose skin depending on the patient. Neck and Jowl liposuction can also be combined with a Necklift to get rid of any excess skin. It is important to find a provider who is qualified and knowledgeable in these procedures to ensure best results. Your physician should do a full facial evaluation, understand your goals, and provide the best treatment plan to get to your desired results.

Thank you for your question. Most likely a combination of the above procedures will get you the best result. Liposuction will be helpful for addressing the adipose contribution to the neck, while a facelift will suspend the tissue back into a more youthful position. Buccal fat removal can help slim the face and can be performed in conjunction easily. I hope this helps, and all the best to you.
Dr. P

Hello EmilyOMG,
Thanks for sharing photos and your question!
It is hard to tell by some of the photographs, but I do agree that you have a full face (which in some ways does help provide youthful volume!). There are areas that tend to be stubborn and resistant to weight loss and exercise, such as the double chin area. There are several options for you ranging from minimally invasive all the way up to surgery.
Just to name a few:
Kybella - would not recommend, very painful, costly, leads to lots of bruising and swelling and suboptimal results. Plus it often needs to be repeated several times before achieving anything worthwhile.
Submental liposuction - one of my favorite procedures to help eliminate that stubborn fat pad under the chin. Depending on your skin quality, this can be performed in isolation or with a skin tightening procedure (such as facetite). Takes about 30 minutes in the office, can be done under local and will get you a nice result without a lot of downtime.
Deep neck lift - this involves an incisions made in the crease under the chin to allow access to the fat of the neck and deeper structures that can be tailored and contour to give you a better defined jawline. The downtime is typically 1-2 weeks and the results are truly phenomenal. Longest lasting of the procedures discussed.
Face and neck lift - depending on your goals, this could be an option for addressing both the double chin and neck area, as well as the lower and midface. I used an extended release deep plane approach which allows me to reposition the cheek fat to a more youthful position. This is truly the gold standard for facial and neck rejuvenation. Reverses aging by about 10-20 years and lasts forever! Downtime is about 3 weeks and the final results really start to shine by about 3 months!
Hope this was helpful!
Good luck with your decision and stay safe!
Dr. Dominick GadaletaFacial Plastic SurgeonPalo Alto, CA

Faces are not all alike. The surgical procedures can vary depending on what the anatomy is. In general heavier faces with loose skin need a full facelift and possibly browlift surgery in order to keep the face in balance. In my world the facelift procedure includes fixing the neck, which can include the removal of fat and tightening the muscles.

There is no doubt that you have significant amount of fat tissue and skin laxity in your neck, jawline and lower face that it only can be addressed with face and neck lift. In person consultation with a board certified plastic surgeon with expertise in face/neck lifts is recommended. Good luck.

Unfortunately there is a common misconception that buccal fat removal will help this condition. Also Lipo alone will not solve your condition. Only a face and neck lift with liposuction will help.

You have both extra facial fat and skin and deep tissue laxity. You really should have all three which Woukd be done at the same time. Simply removing fat will nit give a pleasing result.

Thank you for your pictures and questions. There is no doubt that if you want to see a significant change in your facial aging and appearance, then the most involved surgical procedure is the right answer. I would recommend a facelift and necklift to achieve your goals. Make sure to see a plastic surgeon who is board certified by the American Board of Plastic Surgery.

Good luck!

Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Definitely a facelift and liposuction of the neck. I'm not surprised that pdo threads didn't work well for you. A facelift is a much more predictable procedure. Buccal fat pad removal can be done as well and will also give a slight improvement.