39 year old male - What procedures will enhance my lower-mid face appearance? (photos)

It sounds like you are a candidate for a Mini-Facelift. My favorite technique is the MACS short scar Mini-Facelift.
Developed in Europe, it is the ideal approach for the younger patient, not ready for a full facelift, or patients who desire a less invasive procedure with a shorter recovery time. It addresses both the mid face area (especially the jowls) as well as the neck, if needed. Micro liposuction of your jawline is included, and will both tighten and define it nicely. Come see me or another board-certified plastic surgeon in our area to explore the best options for you. Good luck.

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Hello, and thank you for providing photos along with your question. Neck rejuvenation can be achieved in many ways. One option might be a combination of facial liposuction to remove the small pocket of submental fat under the chin and chin augmentation using fillers or an implant. This approach could produce a more defined jawline and a proportional facial profile.

Another option might be buccal fat removal. A buccal lipectomy is an ideal option for patients who have overly round cheeks that lack definition. In many cases, this additional fullness from the cheek to the jawline is due to an excessively large cheek fat pad, and partial removal of this tissue can help create cheek definition and a slimmer contour in the lower face.

To determine the best procedure(s) for you, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, recommend and customize the best procedure plan, and ensure the best possible outcome.

A necklift only addresses the neck skin laxity. It will not improve the jowls or cheeks. A mini-lift and a midface-lift also vary significantly in what is done, depending on the surgeon performing it. They are usually performed in patients with minimal laxity and would not improve the neck. The terms facelift and lower facelift mean different things to different patients and vary in their extent from surgeon to surgeon. A facelift or a lower facelift which would include the neck area would have the potential to produce the best cosmetic result of the neck, central cheek and jowl area. Micro-fat grafts can produce a long term improvement of the areas that are volume deficient. A chin implant can produce a stronger jawline and improve the profile.


It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California