64 years old - what procedures would benefit me most? (photos)

A facelift (which includes a neck lift as well) will be your best option. Once the main structure has been repositioned to a younger look then you can start working on skin with lasers, fillers, botox etc.
The first step should be a facelift.
Regards
Dr. J

Thank you for the question. I recommend doing things in stages. Based on your photos I would suggest to start with a face and neck lift as well as a lip lift. Those procedures will go a long way to restoring a more youthful look. You can then decide if skin resurfacing and treating your eyelids would further enhance your outcome. I wish you all the best!

Hello, and thank you for providing images along with your question. Based on these images, you may benefit from a more comprehensive approach to skin rejuvenation. You may consider a facelift or mini facelift to address multiple signs of aging at once. Such procedures will produce the most dramatic and long-lasting results too.

A qualified surgeon can customize a facelift using various techniques and procedures that would work best in enhancing your unique features. To optimize your results before and after surgery, other procedures can be combined with a facelift to achieve your aesthetic goals. Common recommendations include facial fillers, laser resurfacing, chemical peels, fat transfer, and chin augmentation.

The best way to know for sure is to schedule an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can answer your questions, address your concerns, and learn your goals before developing the best treatment plan for the best possible results.

Honestly, the procedure that would benefit you most depends on what upsets you about your face! Plastic surgery is not a need, but a want -- and only you can decide what do! To be the most helpful, I would first like to tell you what *not* to do. I would certainly say that if you got a brow lift, it would be a surefire way to look unnatural and older, as your brows are already high, as is your forehead. So please avoid that. Lip lifts never look natural, and I would avoid that as well. It would be hard, based on the photos, to make an educated recommendation about your under-eye area, so I wouldn’t know how to comment on a lower bleph without an in-person consultation. I see a bit more overhang of your upper right eyelid, so possibly an upper bleph but again, I’d need to see the anatomy in person to be sure. It does appear that a midface lift, and a neck lift, would be beneficial, and perhaps a subtle bit of volume in your lips. I would definitely advise you to seek more opinions, and to spend time prioritizing what matters to *you.*

The answer to these questions really depends on what concerns you and what degree of rejuvenation you wish to have. Although I generally agree with all of the procedures mentioned (with the exception of fat transfer) as being aesthetically indicated, Only a consultation would determine if they are appropriate for you. I perform a deep plane facelift procedure which is self volumizing, repositioning facial soft tissues, obviating volumization is most cases.

Based on my review of your photos, I think a standard face/necklift would correct your loose sagging neck and lower jowl bulges, creating a smoother jaw and neckline. This might also raise the fat in the lower cheek up into the mid cheek, filling in some of your cheek hollows. Otherwise the purpose of fat grafting is too add volume to the mid cheek if you desire. Since your brows seem high enough, I suggest the upper lid bleph to smooth and open up the upper lids. Honestly, I can't appreciate enough from your photos to offer insight into your lower lids. The co2 laser treatment is meant to improve your skin texture and complexion. Try to prioritize what areas you notice most and seem more of a problem to you. Discuss correction of those areas with your surgeon.

Hello, a face and neck lift will provide the greatest rejuvenation in your appearance. This can be combined with eyelid surgery. I wish you the best of luck. Vasileios Vasilakis, MD. Double board certified, fellowship-trained plastic surgeon. Houston, TX.

Hello Pamengland,
Thanks for sharing your photos and question.
Choosing the right procedure can be difficult, it truly depends on what your goals are. As we enter the 6th decade of life, we tend to have global facial aging, meaning the entire face has succumb to the effects of gravity, sun damage, and other factors related to genetic and environmental conditions.When analyzing the face, we tend to break it up into horizontal thirds. The upper most third is the forehead and brow area. There is certainly a heaviness in your upper third that is typical and comes with age. This area tends to make us look tired or even angry, as the brows sit lower on the face. Your eyelids are also showing some signs of aging, with excessive skin in your upper lids and some hollowing of your lowers.
Your midface and lower face have also began to droop, leading to more apparent nasolabial folds (smile lines) and howling. Finally, the neck is also showing signs of excessive skin and laxity.You do have good bone structure and appear very fit. Assuming you're a good candidate for surgery, treating all of the areas at once tends to give the best, most profound, and balance results. That said, some people prefer to break up the surgeries into smaller operations to address one area at a time.If you were my patient, I would at least have a conversation with you about the following:Brow lift - either full endoscopic brow lift or temporal (lateral) brow lift depending on your goalsUpper and lower blepharoplastyDeep plane face and neck liftLip liftIn addition, you have lost a lot of volume to the face and have the typical signs of sun damage to the superficial layers of the skin. These issues can be addressed with a fat transfer and CO2 laser, as one provider suggested.
I am not sure if this answers your question completely, but I hope it helps with your decision making! Goodluck!
Dr. Dominick GadaletaFacial Plastic SurgeonPalo Alto, CA

Hi, the surgeries that will benefit you are deep plane facelift, necklift, upper and lower bleph, lip lift, fat injections (maybe tear trough area, malar pad area, marionette area) and chemical peeling, respectively. These all issues can be done at the same time if you have not any chronic disease. Because the duration of the operation is long. Have a nice day.

Your neck and jowls would benefit from a face/neck lift. Your lids may benefit from upper and lower blepharoplasties.Fat grafting to your lips or a filler would improve your lip fullness. I can't tell the quality of your skin from the photos you have provided. CO2 LASER, Fractionated Erbium or peel may benefit fine wrinkles. Good luck..