Male - Full facelift/deep plane or mini facelift + fat injections is sufficient? (photos)

Question

Attaching photos - jowls, double chin are main concern. But upper cheek has also lost volume so I was considering fat injections. Mainly I'd like my face to look a few years younger. But I'm not sure if I need a full facelift or just lower or lower+mid? I also don't know if lower or lower+mid can be done using Deep Plane technique. ** I'm not interested in Morpheus8/RF/Ultherapy or Synthetic fillers.

Randal Haworth, MD, FACS · Answer

The biggest challenge that you are facing is the ptotic malar fat pads, which are worse on your right side and are bordered by a deep nasolabial fold below and a palpebral malar groove above. Generally, a deep plane facelift tightens instead of lifting, which is not very effective for lifting the ptotic malar fat pad that needs elevation. The other concern is that if a Mid facelift is not performed correctly, it can feminize your face.

Therefore, I suggest that you consult with an experienced facial plastic surgeon who can examine you in person and have a better three-dimensional understanding of what's suitable for you.

I hope this helps,
Best of luck !

Randal Haworth

Therefore, I suggest that you consult with an experienced facial plastic surgeon who can examine you in person and have a better three-dimensional understanding of what's suitable for you.

I hope this helps,
Best of luck !

Randal Haworth

David Tauber, MD · Answer

For men, less is usually more. It is easy for men to take things too far as the stigmata of surgical correction are less tolerated in men than women. Your pictures demonstrate a degree of skin laxity of the face and neck, early facial decent, and fullness of the neck that is exacerbated with the downward view. The mid face has some volume loss but still appears neutral - not hollow. For optimal treatment, a modified, short-scar, lower face and neck lift with liposuction of the neck and deep plane tightening would give you a nice improvement by sharpening your neck and jaw line. In the future, some fat grafting to the cheeks may be needed to correct age-related volume loss. Typically, we do those procedures as part of our Wide-Awake-Surgery program – surgery done under local anesthesia in the office. The same surgery is also available in the OR under anesthesia.
See more info at the link below.
A detailed examination will help delineate the best surgical option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Donald Groves, MD · Answer

Hello and thank you for your question. From what I can tell based on the pictures you have provided, there is obvious fullness to your chin/submental region into the neck, and jowling with loss of jaw definition, as you had mentioned. You have excess neck skin but do not appear to have visible platysmal banding in your neck. Based on all that, you would definitely benefit from facelift/necklift with liposuction to your submental/neck region. This would be the best way to address the jowls and fullness you're concerned about, and restore a more youthful appearance to your face and neck. A facelift or "mini-facelift" (a.k.a. short scar facelift) helps with skin tightening (by surgical removal of excess skin), but also allows for adjustments to some of the deeper face structures- e.g. tightening of the SMAS layer. The nomenclature can be confusing, but a facelift addresses the lower 1/3 of the face and the neck. That is why for someone with prominent jowling and significant neck skin laxity (as in your case), these are best addressed with some type of facelift. At the same time as the facelift, facial fat grafting can also be done to help further correct any asymmetries and restore volume to your cheeks and any other focal areas of concern.
With all that said, it is difficult to provide tentative surgical recommendations, since there is only so much information to be gained from the photos and description provided. It would be more beneficial for you to undergo a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! 
Best wishes, 
Dr. Donald Groves 
Plastic Surgeon

Gregory S. Keller, MD, FACS · Answer

If you really want to look natural, a lower and mid-facelift will last you for years.  I can't see your neck, but from what I see, you need a necklift along with.  Of course, consultation is necessary to be confident in talking about results.  Best see a board certified Facial Plastic Surgeon.

Konstantin Vasyukevich, MD · Answer

Thank you for your question and pictures. Based on your concerns, it looks like you would be a good candidate for a deep-plane facelift. This type of facelift is most effective in achieving a comprehensive rejuvenation by getting rid of the jowls, excess skin under the chin, and tightening the lower face and neck. This technique can also help lift and restore volume to the cheeks without the need for fat injections. When searching for the best surgeon, look for a double-board certified doctor who specializes in facial rejuvenation and facelifts. An experienced surgeon would be able to help you with all your concerns. Wishing you best of luck on your rejuvenation journey! Dr. Konstantin

Keith Hodge, MD · Answer

Based on the photos, I would suggest a deep plane facelift to address the inferior medial cheek laxity combined with neck liposuction and fat grafting to the midface. Good luck!

Cem Berkay Sinaci, MD · Answer

Hello, as your main concerns are jawls and double chin, one of the deep plane techniques will adress these concerns. And high smas facelift will also make the upper cheek volume higher, that would be my choice for your case. This information is only regarding for your photos and my suggestions may change during my examination.  Regards.

Selcuk Inanli, MD · Answer

Hello ! Thank you for you question l recommend you mid facelifting mid face lift is very suitable for lower part of the face drooping stretching,I recommend botox for forehead wrinkles,with these two procedures, your face will look younger and happier.
Thank you ! regards

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You may benefit from a facelift and fat transfer combination to create a more youthful appearance. A traditional facelift can improve your skin’s elasticity, lift fallen tissue, and define the overall shape of your face. Excess fat in the neck and jowls can also be removed along with excess skin to create a smooth appearance and angulate your neckline. A facial fat transfer can be done during the same surgery to restore volume to your upper cheek and create a balanced, natural-looking result.
I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to discuss your concerns and aesthetic goals with you to determine the best approach.

Andrew Miller, MD · Answer

When deciding what procedure to do, I evaluate each part of the face individually. The deep plane facelift does a good job of improving the jawline and neck (much better than a mini facelift). The endoscopic midface lift will help the sagging cheeks. Also you lose fat in the face as you age so fat transfer will also play a role. Be sure to see a facial specialist for consultation.

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