Am I ready for a Facelift? (photos)

I'm 42 and worried about my jowls. I've had Voluma fillers in my upper cheeks and nasolabial folds but I don't feel like it's helping that much. Am I ready for a facelift? A mini-facelift? Any other options? Thanks.

Doctor Answers 48

Your skin is not Sagging, so contouring, adding volume, and lifting your jawline can be done non-surgically with the Y Lift

Thank you for your question. I can certainly give you a lot of guidance, as your concern is one of the main focuses of my practice. I can also advise you on how we approach cases like yours, based on my experience of performing cosmetic surgery for over 20 years.

Just to give you an idea of my background, I’m a Board-certified cosmetic surgeon, which is different from a Board-certified plastic surgeon. Our certifying organization—The American Board of Cosmetic Surgery—is dedicated solely to training in the various specialties of cosmetic surgery. I’m also a Fellowship-trained oculofacial plastic surgeon, which is a specialty that focuses specifically on surgery of the eyelids and face.

When it comes to facial aging, two things are involved: volume loss and descent. In your case, when you consider a facelift, you have to take a look at your skin and soft tissue and see whether it has descended or not.

Based on your photo, it is not likely that you have descent of the facial skin. What you are probably referring to as a jowl is what we call the mandibular notch. The mandibular notch is an area of the mandible, or the jawbone, where the bone indents. This natural indentation may further accentuate some volume descent of the jowl right behind it, therefore making someone look jowly.

In order to determine whether a facelift is possible, I perform a physical examination of the facial skin to see if it moves or if it slides. If there is no slide to the skin, then a facelift, regardless of what it is called—mini lift, short scar, SMAS lift, deep plane—is not recommended.

I understand you’ve had Voluma in the upper face, which you feel did not help as much. I can tell you that many doctors will try to do something called a "liquid facelift" where they add volume into the soft tissue using fillers to expand the face and create the illusion of an actual lift. The problem with this practice is that, when you add volume to areas with volume loss, and that volume is too heavy, it will only cause more descent and sagging. On the other hand, if you’re adding volume to a certain area just to replenish the volume that was lost, then you’ll just be getting a volume correction and not an actual lifting effect.

In my practice, we perform something called the Y Lift® for cases like these. The Y Lift® makes use of traditional dermal fillers, which are placed at a deeper level, against a more solid structure such as bone, which is why it is described as structural volumizing. By doing it in this very specific way, and at a deeper level, you get that lifting effect that looks very natural.

The Y Lift® allows for the use of much more filler than is used in traditional volume correction—about 14 syringes in total for a full face, as opposed to the 1-4 syringes average in a regular treatment. In your case, I think the Y Lift® can greatly improve your jawline.

Keep in mind that when you have a facelift, you’re not necessarily filling in the areas with volume loss, unless you're also having a filling procedure done concurrently, which would include things like fat grafting or implant placement. I think it would be beneficial for you to learn more about the Y Lift®, and move away from surgical face lifting. Be sure that you do your research well and identify the right doctors to visit as there are only a specific group of people who are Y Lift®-trained physicians.

I hope that was helpful and I wish you the best of luck!

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New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Ready for a Facelift

I would need more photos from different angles to appropriately evaluate what, if any surgical, or non-surgical aesthetic enhancement would help you to achieve your goals. I would  caution you to proceed with caution. You are young and you have a very attractive face. You want to maintain a beautiful, natural look that does not look like surgery. In some cases, minimal, early intervention as needed can be the reason some people never seem to age. On the other hand, too much, too soon can actually age the face. Do a lot of homework, look at a lot of photos and take your time.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews


The face can be thought of as an individual’s unique complex three-dimensional structure, with combinations of varied foundations of solid bone, supporting soft tissue volumes, held together by visible and invisible ligamentous extensions, upon which his or her canvas of life is spread. Environment, time and gravity all take their toll, and this canvas in time bears the blemishes of the process from inside and out, leading to the development of wrinkles, a tired look and changes in the shape of the face, and a loose neck and jowls.

Any rejuvenation needs to take into consideration a harmonious holistic appearance otherwise one would run the real risk of ending up with the terrible operated look. Most recently attention has been paid to volume depletion as part of the ageing process. Unfortunately this has mean that a plethora of volume fillers have been used to address ageing. Kind of like with a hammer only everything looks like a nail. Any rejuvenation even when minor should have sound anatomical and physiological basis with thoughts given to possible future treatments. 

So in principle, the three components :1) Skin and subcutaenous superficial and deep fat compartments, 2) Mimetic muscles of facial expression (SMAS) and 3) ligaments and skeletal support need to be considered and where appropriate manipulated to restore youthful appearance. This is often depending on the person's facial features a combination of nuanced fat transfer for both volume replenishment and rejuvenating effects, redrawing of the overlying skin as well as resuspension of ligaments and SMAS for a balanced look. In younger patients skeletal augmentation is not usually necessary. 

I hope this was helpful. 

Ross Farhadieh, MBBS, MD, FRACS, FRCS
Sydney Plastic Surgeon
5.0 out of 5 stars 11 reviews

Am I ready for a facelift?

Nobody can answer this question for you! Only you can decide but you should seek counsel with a facial plastic surgeon who you trust with your precious face. If you are worried about your jowls, then a facelift is one option to address the cause of your worry. There are others, but all have pros and cons. I would perform a facelift based on your picture and suspect you would have an incredible result like the 41 year old patient of mine int he link below.

Good luck!!

Dominic Bray, MBBS, FRCS
London Facial Plastic Surgeon
4.9 out of 5 stars 169 reviews


It is possible that a facelift can improve your jowl area.  Fillers may be a reasonable first approach. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Am I Ready for a Facelift

During your #consultation with a board-certified plastic surgeon, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your surgeon will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. It is possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit to view a complete list of surgeries commonly performed.

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives. It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Hard to Tell Without a Consultation

Hi, and thanks for your question. The photo that is provided does not reveal the extent of the sagging to which you refer. As we age, we lose volume and the tissues start to sag. The best facelifts address both issues. Volume replacement can be done with fillers such as JUVÉDERM, VOLUMA, or RADIESSE. The best volume replacement is done with your own fat. The sagging skin is addressed by a facelift, and there are many different methods to accomplish the goals. Fat transfer and face lifting can be done at the same time and will render the best results. Only a full examination can allow one to determine what needs to be addressed and the best methods to get you to your goals. Best of luck.

Louis C. Cutolo, Jr., MD, FACS
New York Plastic Surgeon
4.6 out of 5 stars 13 reviews


By looking at your picture (which is a limited view and only a frontal view) it does not appear that you are a candidate for a facelift. My recommendation would be to go to a facial plastic surgeon or plastic surgeon and get a consultation. Many of us do not charge for consultations, some will apply the consultation cost to a treatment. Hope this helps,

Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews


It's really hard to give an opinion with one photograph. One must see various parts of the face that must be improved to justify surgery.

Sam T. Hamra, MD
Dallas Plastic Surgeon
4.8 out of 5 stars 12 reviews

Facelift or not?

Hi & thanks for your question.
In the one photo you provided, you have a nice neckline and jawline.
Based solely on that photo, I'd say that you don't need a facelift yet.  You look very good.

But, if you want to discuss it further, please set up a consultation with a board-certified plastic surgeon, who can discuss the pros & cons of modern facelift techniques with you.

All the best!

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

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.