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 32

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.

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

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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.


I would recommend a facelift and chin implant.  You are young and have good skin quality and elasticity therefore should get nice results.  The chin implant would help balance your lower face and even improve the neck results.  Best wishes, Dr. T.

A lower face and neck lift gives beautiful long-term results

Hello!Ulthera hasn't proven to offer tightening or lifting benefits remotely comparable to what a face and neck lift can achieve.  You have prominent neck folds that represent skin laxity and "platysmal banding", strands of muscle that "bowstring" over time. Although facial shadows are accentuated by the harsh overhead lighting, you appear also to have "marionette lines" which extend from the corners of your mouth.  I recommend a lower face and neck lift through an incision largely hidden behind the ear and down the hair line. If you wear your hair down, these scars are virtually invisible. Through this incision I elevate the neck and facial skin and I place permanent sutures (you need permanent sutures for a permanent result) in the platysma (neck muscle) layer. The sutures are placed in a "suspension" pattern that extends from the central neck and anchor to the strong tissue behind the ear (much like a hammock has 2 anchor points and strong suspension ropes).  Elevation of the muscle layer are critical for longevity of the result since a skin-only lift will last just a few months since the skin just stretches back out.  Recovery is about 10 days and my results generally last up to 15 years before a revision becomes necessary.All the best in your search!-Dr. Rad

Ariel N. Rad, MD, PhD
Washington DC Plastic Surgeon
5.0 out of 5 stars 41 reviews

Face lift at 47?

Thank you for asking about your face lift.
  • I agree with your interest in a face lift -
  • Your photos show the lower face looseness and slight jowls that a lower face and neck lift will improve dramatically.
  • The ideal age for a face lift is between 35 - 55, based on research so you are not too young.
  • Recovery usually takes two weeks - 
  • Your surgeon can show you what to expect but it will tighten the loose skin and lift the face where tissues are gettng loose.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

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.