Mid 40s & visible NL folds & marionette lines - do I need a facelift or just fat transfer or fillers? (Photos)

Given your concerns about the visible nasolabial folds and marionette lines, as well as the sagging skin in the lower face, the most suitable approach would be a combination of a mini facelift and, if necessary, fat injection. A mini facelift is a less invasive facelift technique performed with smaller incisions. It specifically addresses the sagging skin in the lower face and offers a quicker recovery time and less extensive intervention compared to traditional facelifts.
With a mini facelift, we can reduce the appearance of nasolabial folds and marionette lines. Additionally, excess skin in the lower face can be tightened, resulting in a more youthful and firmer profile. If there is volume loss in the lower face, fat injection may also be considered. Fat injection provides natural and youthful volume, and its necessity will depend on the structure of your face and the extent of volume loss.
The combination of these procedures will lead to a natural tightening and rejuvenation of the lower face. However, to determine the most appropriate course of action, I recommend starting with a physical examination. This will enable me to design the most effective treatment plan based on the specific characteristics of your face.

Dear Fierce,From the photos you are aging well and very gracefully! Many would say you don’t need to do anything and I would agree but I do see many patients in more recent years who want to do preventative surgery earlier in life. And what I have noticed is that the results tend to heal better and last longer the earlier the intervention is done (younger skin and soft tissue usually will heal better than older soft tissue). So this makes sense to me. Fat grafting or filler can make the area more subtle, the more modern approach is to combine that with a mini facelift.