What kind of facelift is best for a young patient for mild marionette lines/jowls? (Photos)

Hi there! I see the small areas around your mouth that are troubling you, and because you are young and have great skin quality, you have some great options! Before moving to surgery, I'd consider adding volume to the midface which will prop up some of that hanging tissue. You can also do skin treatments like Sculptra and resurfacing to improve skin quality and thickness. You have great buccal fat- I would not remove this as you may find the drooping worse without this volume in place. If you do decide to move in the direction of surgery, I would consider a neck lift through incisions behind your ear- this can pull on the platysma and define the jawline and neck without having to make an incision in front of your ear. Combined with fat grafting to the midface, you may have a great result without any scars on your face to show for it.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Given your history of jaw surgery and persistent marionette lines and jowls at age 30, a lower face lift or mini-lift focused on the jawline and jowl area could be appropriate. This procedure targets sagging skin and underlying tissues around the lower cheeks, mouth corners, and jawline, lifting and tightening them to restore a more defined contour. Since your primary concern is excess skin and tissue laxity after structural changes from your surgery, a lower facelift alone may be sufficient without a full facelift, though the surgeon might also consider SMAS tightening (lifting the deeper muscle layer) to create longer-lasting support. Sometimes, adjunct treatments such as fat grafting or dermal fillers are used to smooth marionette lines and balance volume loss.

Being so young you could get away with using fillers in cheeks, jaw line etc. However, if you want a more dramatic change then do a Lateral Deep Plane Facelift. A minilift can help but longevity is an issue.
Regards
Dr. J

Hi Lady . You are fully right that decreasing the jaw support is a cause of occuring jawling and labiomandibular folds and this knowledge has impressed me . Currently the best way to correct this area is deep plane composit liegamenteous relaseing of flap up to modiolus , and advencement it. This is deep plane facelift . But yes you are young some noninvasive options can be considered before operation , also this optionss will not prevent your future facelifting operations . That noninvasive options i can reccomend you are fat grafting and endolift laser tightening. dont try threadlift option but radiofrequency also can be considered. Endoscopic lift also is a deep plane tecnique with ligamentous release but results are according to me not still so sattisfied according to me , i am following and observing this technique still and not performing yet . Difference between endoskcopic and classic deep plane is just insicion , but insicion is being healed very well in classic deep plane facelifts so no nessesary for endoscopic.

This is a great question and something I am definitely beginning to see more frequently.
I think any of these options you suggested could get you closer to what you are looking for, but the question is how aggressive do you want to be at 30 years old? In general, for younger patients, I err on the side of "less is more" and try to be as conservative as possible. A mini-lift or isolated neck lift may be the options I would consider in your situation as these include smaller incisions than a full facelift, but would also be able to address any excess skin that comes with lifting the deeper tissues of the jaw and neck.
Hope this helps and best of luck!Kyle Kimura, MD

If you like the appearance when you reposition lower cheeks upward and a bit back with your hand, that is likely the correct procedure. My preference is always deep plane / biplanar technique for long term stability of the result, a natural and beautiful correction, and imperceptible scar. Supplementation with foundational skin care (sun protection, tretinoin) and occasional expertly administered filler, neuromodulator, laser, and/or peels over time will maintain your position as the most beautiful and confident woman in any room.