Information Overload - what kind of Facelift would be best for me and how to choose? (photos)

Your overall facial shape and contour is excellent. The areas of your concern, the irregular jawline, loose platysma neck muscle and neck skin plus excess eyelid skin can easily be addressed. The excess skin of the upper eyelids can be well-managed with a skin only upper blepharoplasty. Rejuvenation of your face, jawline and neck contour would be best corrected with some form of a SMAS elevation and tightening (there are several options, and none has proven superior to the others), plus modest skin resection. The best correction of your neck contour would require a small incision just underneath your chin so that the medial edges of the platysma muscle could be suture together to give you the most useful neck contour possible. Although fat grafting is used nowadays, I do not find it reliable nor the results predictable. Regarding choice of doctors, it would be in your best interest to find a board-certified plastic surgeon who has an excellent gallery of before and after photographs as well as good reviews and excellent reputation. This may require some travel but it may be well worth it to you regarding the final result. I don’t believe that it’s necessary for you to travel out of the country as there are so many highly qualified surgeons in country. Any major metropolitan area would have several highly qualified plastic surgeons who you may wish to consult with. Best wishes.

You have a very large platysmal band and will need a tremendous amount of vertical and posterior pull which is typically achieved with a deep plane lift with possibly a platysmaplasty in the submental area. I would not jump to fat grafting until you see the results of the deep plane lift. A SMAS lift with a platysmaplasty might do it but the pulls from a deep plane are much greater.

Personally I think deep plane is no better than standard. As for fat grafting it is a total waste of money. Go to someone who has a good reputation without all the bells and whistles. I'm sure Vancouver has plenty of good plastic surgeons. You shouldn't have to travel to get a good facelift.

Thanks for the excellent question. I would encourage you to seek out a Royal College certified plastic surgeon who performs a large volume for facial rejuventation procedures. Many of the classic signs of facial aging (jowls and neck skin laxity in particular) can be addressed with a facelift. There are many ways to perform a facelift. My preferred technique for facelift surgery is the deep plane facelift as I feel it provides a durable and natural appearing result when compared to skin-only facelift techniques. I will often combine this with facial fat grafting and laser treatment to address facial volume loss and skin degradation respectively -these are signs of aging not addressed by facelift surgery alone.

Deep plain facelift surgery addresses excess skin as well as tightens the muscle in a meaningful long lasting fashion. It produces a natural result. Given the severity of muscle laxity particularly In the lower face as well as excess skin I think this would be your best bet.