Do I need a mini lift and/or cheek implants (age 32, jowls, sagging skin)? (Photo)

ErinWhile I appreciate your concern, I still think you are too young, and don't need a Mini-Facelift. Fat transfer, in the long run, is more cost effective than fillers because studies show that around 85% of fat transferred to the face remains. Be sure to consult with a board certified plastic surgeon with lots of experience with fat grafting to the face. Good luck!

In our practice, we perform a non-surgical face lift / skin resurfacing treatment using Renuvion Helium Plasma Radiofrequency. ​To get the most improvement with skin tightening, we combine Renuvion (formerly J-Plasma) with lasers (Fraxel, Clear + Brilliant, CO2), microneedling/PRP, Ultherapy and InMode FaceTite. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer​​​​

A #facelift is a surgical procedure designed to smooth and remove  major folds, wrinkles and excess skin around the #neck and #jawline; which form on our faces with age. Gravity, sun damage, smoking, living in a dry climate, and a variety of factors contribute to the aging process of our faces. The best candidates for facelifts such as #LiteLift are patients 35-60 years old with early changes of the lower face and the neck.It is important to understand that facelifts are not intended to remove fine wrinkles. A facelift which removes every line and fold would be too aggressive resulting in an unnatural result. Fine lines and #wrinkles are better addressed by non-invasive skin treatments such as chemical peels or microdermabrasion, which we also offer at our office. At this point and your age, you may not be a #facelift candidate. However, there are many other cosmetic options to accomodate your goals at your age all while providing great results. Consult with a board-certified plastic surgeon or their licensed esthetic staff to learn more about treatments best for you.

If you look at your picture - front facing, fro 29.5 to 32, you will see that your cheeks have lost a lot of volume. Thats the reason for the 'deflation' and appearance of some jowling. Replacing the volume lost in the cheeks, will provide some lift to the jowls, thereby returning your face to its more youthful heart shape. 

Hi there,In your case, I would consider liposuction to the neck and a small chin implant. You have a slightly weak chin and that is contributing to the sagging. Liposuction will help improve the jawline and some tightening will occur even without having the pull from the mini lift particularly in someone young like yourself.  If you want to try to avoid surgery you can consider Kybella injections to dissolve the fat under the neck. For the cheeks, I still think fillers are a good option. You can consider fat instead of fillers if you are trying to avoid the need for multiple injections. Although it is common to still need fillers after the fat transfer, less filler product is need. I would be cautious with cheek implants. There is always the risk of infection requiring removal and as you age the edges can become palpable or even visible. By the way, I am glad you are recognizing the importance of good skin care. Start on sunblock and consider starting a retinol to improve your skin. This can go a long way in improving your face!Good luck

Good questions.  The answers are not easy.  Smoking and sun exposure are not friendly to the skin and in some people they can be more sensitive.  If you want to see positive change you will need to address those two issues.  Fillers do not last as long in people actively smoking.The main issue visible in the photos are your skin texture and irregular pigmentation, with areas of red and brown spots.  First, I would recommend a good skin care regimen.  Second after starting the skin care regimen incorporate skin treatments guided by an "expert".  You would benefit from peels and various laser treatments including IPL.  There are many treatments that will produce positive change but you need to develop a relationship with a professional who can guide you on the best options.1. Stop smoking and avoid or protect yourself when exposed to the sun2. Good skin care program3. Treatments under the supervision of a professional who can follow your responses to treatment and recommend the best options (things that are worth it) for you.This can be a very rewarding process as long as you take care of yourself and you accept guidance from a professional who understands your goals.

Hi, I have performed many facelifts
over the past 30 years and a significant number of these on women in their late twenties to early thirties that had pre-mature jowl" formation.  From the attached photos, the cheeks are flat
anteriorly (in the front) but quitw wide and high at the sides, the chin is weak, there is excess facial fat below the chin and some signs of lower face sagging as evidenced by jowls.  These combine
to create a top heavy, wide oval shaped face.  

Following the beauty principles
outlined in my book on face and body beauty, women look the most feminine,
youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks
that are full and round in the front.  Cheek augmentation using a dermal filler
(I prefer Restylane Lyft) or with cheek implants for a permanent enhancement
will create full, round cheeks anteriorly that will feminize the entire face.  Since your cheeks are quite wide and high, IMHO you aren't a candidate for cheek implants but would rather benfit from add specific volume to the front and outer lower edges of the cheeks to create a full, round and softenbed version of your cheeks.  I prefer using Restylane Lyft for this procedure.When the chin is weak, this creates an
imbalance making the nose appear larger, the mid face top heavy and the lower
face appear shorter which de-emphasizes the shape and fullness of the lips.   A weak chin also leads to pre-mature formation of a "double chin".  Chin augmentation, using a chin implant, will add projection to the chin
creating harmony and balance to the lower face.  I have found placing a silastic
chin implant through a small, curved, incisions under the chin to be very safe,
quick, highly effective and far less invasive than a sliding genioplasty that
requires bone cuts with placement of screws and metal plates. When "jowls" are present, these represent sagging facial tissues
and are the primary indication for some form of a facelift.  The underlying SMAS layer,
of the face, must be dissected, lifted, trimmed and re-sutured. The excess skin
is then removed and the facelift incisions closed.  I shape the face with every facelift that I perform to make the face appear more youthful and naturally attractive.  Despite its popularity, using fat trnasfer or injections to shape the face carries far less reliability IMHO than either a dermal filler or facial implant and as such should be avoided.

My most popular facelift is the
minimally invasive, short incision facelift that has all the benefits of more
invasive facelifts (traditional, mid-face, deep plane 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 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 Restylane Lyft) 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.