Facelift or something else? (Photo)

I'm 47 years old and this is what my lower face looks like. I had Ultherapy last year with no help Plastic surgeon who did Ultherapy stated it was too early for facelift for me I also had fillers to augment the cheeks in hopes to elevate the sagging of lower face without any improvement . The laxity gets worse very fast , I really want to do something about it . I would like to know what is the right procedure for me? And If Facelift , what kind? What are the expected results /recovery?

Doctor Answers 35

It's time to consider a facelift.

The photos show that you would probably be a great candidate for a facelift. The lift will tighten the neck, remove the neck banding, elevate the jowls and remove any excess skin.  Ultherapy will never give you the same caliber of results as surgery, despite the fact that it is marketed as a surgical alternative. Fillers will replace lost volume but will not provide a significant lift. Only surgery will give you the clean neck and jawline you are seeking. 

Neck lift

Based solely on your photo, it looks as if your issue is skin and muscle laxity in your neck and lower face. Neither of which can really be helped with non-surgical techniques. My best advise would be for you to schedule a consultation with a board certified plastic surgeon in your area to discuss a lower face/neck lift. Hope this helps.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews


As I look at your pictures, the main component of your aging seems to be due to muscle looseness in the lower face and neck.  The other component is skin looseness.  Non invasive, minimally invasive, and skin tightening will fall short  when it comes to achieving the results that you want. Based on  your photos, your best treatment option will most likely  be a lower facelift and neck lift (platysmaplasty). Make sure to discuss both of these with the surgeon who is going to treat you. 

Mark Karolak, DO, FAOCO
Bridgewater Facial Plastic Surgeon
5.0 out of 5 stars 36 reviews

Facelift or something else?

It appears that you would benefit from a face and neck lift. Ancillary procedures such as Ultherapy will not give nearly the results that a well performed face lift will. Fillers can be used to augment the surgical results, but they will not lift sagging tissues. Good luck.

Warren J. Katz, MD
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Face lift

Thank you for your question and for attaching photos. From your photos, it appears you are a good candidate for a face lift. This will tighten your platysma bands in your neck and give you a more youthful jaw line. Procedures such as Ulthera do not produce any long lasting results. The satisfaction rate from a face lift is extremely high and the recovery is quite quick. I would suggest seeing aboard certified plastic surgeon in your area for a full history, exam and consultation to determine if a face lift is indeed the right procedure for you. Good luck.

Laxity of the jawline and neck

The ultimate treatment for sagging of the jawline and neck is a facelift. All the non surgical procedures such as thermitight or Ultherapy only give a fraction of the results that a facelift will achieve. 

That being said, I would suggest you visit a plastic surgeon that specializes in faces in order to assess your options. Sometimes even a chin implant can get results for minimal laxity. Other times it can be combined with some of the nonsurgical or minimally invasive options. While other times a facelift is the ideal solution. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Lower face and neck lift

From this photo, it seem like you would get a great result with a lower face and neck lift. An in person exam would be needed to come up with the best treatment plan. Find a board certified plastic surgeon in your area with expertise in facial aesthetics. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck!  Dean Vistnes. 
Vistnes Plastic Surgery #realself #drdeanvistnes #lowerfaceandnecklift

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 40 reviews

Neck Bands

For younger patients such as yourself I have had great success with Botox injections to the platysma for improvement of the bands. This can improve the vertical lines in the neck that you may find bothersome. Good luck!

Anthony J. Wilson, MD
Portsmouth Physician
5.0 out of 5 stars 5 reviews


Thank you for your question and photographs.  The facial laxity that I believe you are referring to would best be addressed with a neck lift to achieve a cleaner, firmer look.  Recovery for my patients is generally 1 week.  Best to consult with a board certified plastic surgeon for an in-person consultation.  Best of luck.

When Non-Invasive Doesn't Cut It

As we age, the soft tissues of our face loosen and begin to descend, we loose volume (fat) in our face, and our skin begins to thin and become less elastic. In the mirror, we see loose, saggy skin, thick jowls, neck bands, and upper face hollowness. For younger patients that are not yet exhibiting these signs of aging, injectables and non-invasive skin tightening procedures such as Ulthera are an appropriate temporizing option. As we get older, however, excess skin begins to dominate the picture and non-invasive techiques become inadequate.Fortunately, the stigmata of againg can be corrected with a neck and / or face-lift. These procedures can lift the soft tissue back into place, tighten the underlying muscle, and remove the excess saggy skin. Fat grafting can also be performed at the same time to restore the lost soft tissue volume. These procedures are often done though incisions that are hidden in front and behind the ear, under the chin, and within the hair.See the link below for more info.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.

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.