I am 50 years old, and I can't look at my face in the mirrors. What can I do to look 15 or 20 years younger? (Photo)

I want to know, if my face need just a neck-lift or a facelift or something else. Thank you

Doctor Answers 34

I am 50 years old, and I can't look at my face in the mirrors. What can I do to look 15 or 20 years younger?

 Hi, from the attached photos your face shows signs of excess/loose skin (jowls in the face, loose skin in the neck) with loss of angularity in the cheeks, chin and jaw line.  This creates a round face.  Men look ruggedly handsome, vibrant and youthful with rectangular or square faces that have angularity in the cheeks, chin and jaw line.  The following procedures would achieve that look in your face.  There are two separate issues.  First is to create a more angular appearing face (cheek, chin and jaw line).  Second is to reduce the jowls and excess skin that ages the face (through a face and neck lift).  Both issues would need to be addressed IMHO to create a more youthful, ruggedly handsome face.
 
  • Cheek augmentation with a dermal filler (I prefer Perlane now called Restylane Lyft) or cheek implants for a permanent enhancement to create angularity in the cheeks.
  • Chin augmentation (your chin is weak which makes the mid face appear top heavy and the nose larger), using a chin implant, will add volume to the chin creating harmony and balance to the lower face.
  • Mandibular angle augmentation using a dermal filler (I prefer Radiesse) will add angularity and flat to the jaw line.

  • If you have "jowls" this is sagging facial tissues and an indication for some form of a facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

    My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

    • very small incisions
    • minimal tissue dissection = less bruising and swelling = rapid recovery
    • can be performed in 90 minutes or less, with or without general anesthesia
    • no incisions within the hair = no hair loss
    • excess fat can be removed
    • excess skin removed
    • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Perlane) or facial implants
    • most patients fly back home to parts all over the world in as little as 3 days post-op
    Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Aging Neck

I agree with some of the answers below in that facial volumization with fillers and biostimulants is important when treating the aging face. 

It is always important to have your consultations in person but from your pictures it appears that you are bothered by the excess skin and fat around your neck.  There are many great options for the neck area.  An option could be a surgical neck lift but I would have to assess you in person. 

A second option is precision neck contouring with Smartlipo treatment.  Precision Tx Neck Contouring  injects laser energy directly through three tiny incisions. Thermal energy stimulates new collagen production in the dermis which promotes improved skin elasticity, thickness and texture. This allows tightening of the treated area, which leads to a more contoured look. If you have any small pockets of fat the laser energy will heat them and allow for extraction of the liquefied fat. Together with the tightening effects, your neck will look more youthful.

The third and least invasive option is the new injectable, Kybella.  Kybella Chin Contouring Injection treatments offer a non-surgical option to redefine the chin and jawline in patients with mild skin laxity and moderate to severe submental fullness.  Kybella (deoxycholic acid) is a cytolytic drug that dissolves the fat under the chin to create an improved contour and jawline. 

I would recommend seeing a Board Certified Plastic Surgeon for an assessment in person.  Good Luck!

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 88 reviews

Wanting to look younger

Thank you for asking about your neck or face/neck lift.

  • Aging is hard!
  • Surgery is a big help -
  • Your photos suggest that a face and neck lift will give you the best result.
  • It will dramatically improve your neck and lower face.
  • Surgery can make people look good - but no one can predict how many years younger you will look.
  • Please see a Board Certified Plastic Surgeon and discuss what is involved and what to expect.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Skin Laxity and Excess Fat in the Lower Face and Neck.

Hello, and thanks for the question and photos. From the photos, you have loose skin at the mid cheek and jowl level, extending down onto the neck. There is also likely fat excess in these areas as well. An examination would be necessary to make a more complete assessment.
A face/neck lift with defatting (by both liposuction and direct excision if necessary) would give you the best result. Incisions for this procedure would be just in front of, and behind, the ears. Tightening of the underlying muscle in the neck can help improve the contour under the chin, and would require a small incision under the chin. A chin implant could also be placed through this incision to add some projection to the chin and improve the contour. The important thing is to do a complete face-neck lift, as this will contour the jawline, jowls, and lower face along with the neck, and results will be much better than with an isolated neck lift.
There are less invasive options, such as a limited liposuction to the neck combined with non-invasive skin tightening (we use a machine called Ulthera which uses deeply focused ultrasound to tighten the skin) with the possible placement of a chin implant. Results here, however, would likely fall short of the results you would get with the face-neck lift.
I hope this helps!

Facelift?

Hello,

Thank you for your question. As we age, skin becomes looser. Underlying tissues (fascia and fat pads) also sag. Excess tissue adversely affects the jawline and neck as the development of wrinkles, creases and sagging becomes more visible. A facelift is designed to remove excess skin and reposition deeper tissues for a smoother, firmer contour. The procedure targets the mid and lower thirds of the face (a brow lift and eyelid lift target the upper third). A dramatic improvement can be achieved in smoothing away the creases and sagging tissues that exist in the areas of your cheeks, around the mouth, along the jawline (jowls) and neck. If you are concerned about how aging has affected any of these areas, then a facelift may be right for you.

A good facelift candidate will have :

  • Realistic expectations
  • The goal of looking like yourself, but younger
  • Relatively good health, both physically and psychologically
  • A stable and healthy weight
  • No underlying health conditions that may make surgery risky
  • A good understanding of the facelift procedure, as well as its related risks
  • The ability to stop smoking for a few weeks before and after surgery, to minimize complications with healing

I recommend that you contact a board certified Plastic Surgeon who's before and after photos appeal to you, then set up a consultation to discuss your options for rejuvenation.

All the best

A facelift almost always delivers excellent result in the neck.

From the photographs I think you would benefit from a full facelift although the neck is going to be the most dramatic improvement. I think if you underwent a neck lift only the contrast with the untreated upper face might be a problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

A Facelift Would Be Your Best Bet

Thanks for submitting your question and photos. You have considerable laxity in the neck and along the jawline. A neck lift would improve your neck but would result in a less complete correction. The deep structures in the neck are continuous with the face (the SMAS platysma), and the most complete correction is gained when you move the deeper tissues up in a more superior direction, which can only be done with a facelift (including both cheek and neck lift). Unfortunately, there is no single procedure that can make a person look 20 years younger, as you hoped; looking 10 years younger is more realistic. The results should last 10 years or more before you have to consider a second procedure. Talk to an experienced surgeon in your area about this option. Best of luck.

#FaceAndNeckLiftCombination

The short answer is that your photos suggest you would be a good candidate for a #FaceliftAndNecklift. For the best result #FindtheBestPlasticSurgeon with the most experience. See the below links for more information.

Facial rejuvenation

Based on your pictures you would be a great candidate for face and neck lift along with some good skin care to help restore a youthful appearance. I recommend that you seek consultation with a plastic surgeon to discuss your options after an in-person evaluation. Good luck! 

#PlasticSurgery #FaceLift #Necklift 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Face/neck lift

Looks like you have a significant amount of excess skin on your neck.  See a board certified plastic surgeon who specializes in facelifts for an assessment.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 426 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.