Mid Face Lift or Lower Face Lift with Chin Implant?

Okay, slow down.  You have had 3 procedures that you are not happy with.  I wouldn't jump into another surgery right now.  I agree with your critiques but I still think your aging changes are mild.  You look thin and have some volume loss.  I would start with a conservative procedure such as fat grafting.  That can address several of your issues in moderation.  It is also a way to get to know your surgeon and gain trust.  Discuss further with your surgeon.  Good luck!

Based on your photos, and your recent experiences, I would find a reputable plastic surgeon who specializes in faces and consult with them to first add volume to your face.  Filler or fat transfer would both work well.  You should be able to get away with volume addition.  If you have surgery, you're still going to need the volume so start there.  Hope that helps. 

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. It is possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit PacificCenterPlasticSurgery.com to view a complete list of surgeries commonly performed. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives. It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

You have many issues and I would like better photos. I don't think you are a mid facelift candidate. The excess skin and muscle of your face and neck can be improved with a facelift and fillers. Your nose surgery is not natural. The tip is pinched, the nostrils retracted, etc. These can be improved by grafting your septal cartilage to the areas where too much has been removed and lengthening your short nose to give less nostril show.

Dear Meetingthepoint

You could be one overdone surgery way from becoming a social recluse.  Rather than having an over committing surgery, I would recommend considering fixing your upper eyelid ptosis and getting facial fillers.  I personally think that perlane in the chin is much better than any chin implant that we have.  You could have restoration of cheek volume by having Restylane at the tops of the cheeks instead of a midface lift.  Midface lifts are often associated with unexpected post-surgical changes, not all of which are desirable .

You are a beautiful woman, but that just makes it easier for me to make you gorgeous. Your eyes are pretty but they are surrounded by so little soft tissue that I can almost see the hollows of your skull. Fat transfer all around your eyes would correct that, but it might have to be done twice to make them absolutely gorgeous as the upper lid crease is way too deep especially medially (nose side) and less of the transferred fat lives in areas that move a lot. The wrinkles around your mouth can be corrected with fat transfer to your lips and around your mouth but you should wait for the Juvederm to dissolve. Fat transfer to your temples and upper cheeks will add soft tissue to soften the drop around your beautiful cheek bones. Your nose is best corrected with a composite graft from your ear of a tiny piece of cartilage and skin sewn to the inner aspect of your nostril where it is retracted upwards.

A chin implant is placed through a submental incision and is used to augment the mandible.  The implants are made of solid silicone and come in many different shapes and sizes.  If needed, they can easily be removed.  A lower face/neck lift is best performed on patients with significant jowling and/or laxity in the neck.  A midfacelift will not raise the corners of the mouth.  Consider cheek implants to augment flat cheek area rather than fillers in the lower face area.  

Looking at your limited pictures, I would recommend a mini or lower face lift with a submalar cheek implant and not necessarily a chin implant. You definitely need more midface volume and a conservative mini or even MACS lift can bring the face into a nice balance. I believe you would also benefit from a fractional CO2 peel and routine skin care to improve skin texture and pigmentation. As you have seen, soft tissue fillers and fat grafting are extremely operator dependent and asymmetry and contour irregularities are not uncommon. A conservative mini lift and  submalar cheek implants will likely rejuvenate your face nicely with minimal down time and risk in the hands of a well trained surgeon specializing in facial rejuvenation     

I would start with a conservative approach to address your areas of concern and then take it from there.  I would recommend a personalized consultation in person as your concerns would be better addressed with a more customized evaluation.

I can not agree that face/midface lift is a good choice for you.  I would consider to use fat trasnfer, AFG to restore voulme on midface, filling smile line, use of chin implant to improve your facial profile, revision of rhinoplasty and using Botox to improve the lip's corner position ( to raise the corner of upper lip)