Would a facelift be the right/best answer to my concerns? I’m 44

To start with, you are a very beautiful woman with very attractive facial features as are your eyes, nose and bone frame.
Aging happens in all areas: volume loss, saggy tissues and the changes in quality of skin. You have pretty much all of them.
You are candidate for Deep plane forehead reset, deep plane mid facelift and deep plane neck lift. Facial fat grafting to add volume to temples, nasolabial folds, perioral, marionette lines.
And to improve the quality of skin injection of cultured Fibroblast to produce more collagen and elastin.
Be encouraged.
Dr. Cardenas

First, you recognized what everyone should understand and that is, everyone has some degree of facial asymmetry. This is normal and yours is very minor. Your photo shows excellent facial shape with a minimal amount of midface volume loss, slight irregularities of your jawline and neck skin. At 44, your skin elasticity and strength is likely to be excellent. A mini lift, with SMAS elevation, would likely improve all of your concerns in the least invasive way possible. This would accent your cheek bones, straighten your jawline and smooth the skin of your neck. The temple hallows could be treated with either fat grafting or fillers to add volume. Your nasally symmetry maybe improved with a small amount of filler to alter size or level concerns. Have a detailed consultation with your plastic surgeon. Best wishes.

Have you had Botox in your forehead? It seems the unevenness is similar to situations where Botox lowers the central/medial brow and raises the lateral aspect. If so, I would recommend waiting for this effect to subside. If not, I would contemplate a brow lift. A face and neck lift would be nice to lift cheeks and reduce jowl fullness and tighten the neck.

You would benefit from a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. In your frontal view, it appears you have hanging neck skin and you would benefit from a neck lift more than a face lift. Your photograph of your nose is too limited to make an assessment whether you need a rhinoplasty or not. You may benefit from a browlift to lower the hairline lower and decrease the height of the forehead.

Best Wishes,

Gary Horndeski, M.D.

You have strong facial features and bony structures. This is excellent but can lead to the 'square' face that you are complaining about. A lower facelift, botox to masseter muscle, and facial fat grafting to sculpture your face will help. A brow lift to reshape the brow. The nose is a separate issue and will likely need rhinoplasty surgery.

Much more information is needed, such as a full set of facial and neck photographs and all angles, including both sides and three-quarter profiles to make a determination about being a candidate for facelift at age 44.