What if anything should I have done? Lift? Fat transfer? Nothing? (photos)

Thank you for your question and your photos. Although I am not too involved or knowledgeable about the laser you had done, I am evaluating your photos. I would recommend a lower face and neck lift if some of the excess skin bothers you or you could consider a deep peel (Hetter Peel) or a fully ablative Co2 laser for skin resurfacing. Hope this helps 

You just need a facelift which always includes a neck lift. This procedure could be done under local anesthesia and would improve your jowls and neck under your chin. Your upper lip is overfilled. The filler needs to be dissolved. Your face is not volume deficient, therefore no fillers of fat grafting is necessary. 

Thank you for your question.Based on your photographs, the best procedure in my opinion would be a Face Lift with Autologous Fat Transfer. You could also choose a non surgical skin tightening procedure like Thermi Tight with some Autologous Fat to improve your skin and to fill out the hollows. Please find an experienced Board Certified Plastic Surgeon who can examine you and help you with your concerns. All The Best !

Thank you for the great question and your photos. It seems like you have gotten as much result as possible from the current laser treatments. In my practice, for a situation like yours, I would recommend a mini face and neck lift with fat grafting and possibly a CO2 laser resurfacing. The lift will help with skin excess and "iron out" some of the larger folds. The fat can be used to add volume in the cheeks to further efface the skin. Lastly, a well-planned ablative laser resurfacing can be done at the time of surgery and will have an additional benefit to the surface texture and pigmentation. Best of luck moving forward! 

Hello and thank you for the question and sharing your photos.  You seem to be a good candidate for a mini face and neck lift, which primarily addresses the jowls and the neck region. Additionally, aging is commonly associated with loss of volume in the cheek area. It's common to have autologous fat graft (transferring your own fat) at the time of facelift to correct malar flattening. It's best to discuss these with a board-certified plastic surgeon. During your consultation, your plastic surgeon should do a full facial analysis and recommend his/her facial rejuvenation plan based on your aesthetic goals. Final decision should be based on a mutual understanding between you and your surgeon. Please also ask to see before and after pictures of your surgeon's results. Best

You have undergone multiple noninvasive procedures which is not giving you the results that you want. Repeating them will not give you the results that you want. Your photos show some skin excess and also a decrease in the quality of the skin. Therefore, I would recommend you have a face and neck lift as your primary procedure and then after you are healed undergo some surface treatments of your skin in order to improve the external quality of the skin. The facelift will be the best option to  smooth the excess skin and correct the banding that’s in your neck. It should reestablish a sharp straight jaw line and a better neck contour as well.   I would agree with you that that fat grafting is not a predictable nor reliable way to put volume into the face.  See a board-certified plastic surgeon for a detailed discussion about how best to move on from here. 

Thanks for the photos and questions. Your face looks a bit thin with moderate aging especially in te lower face and neck. I think the best solution would be a facelift. Non-surgical treatments are not going to tighten our skin how you want it to look and nothing but surgery is going to help the bands in your neck. Good luck.

Hello Seashell,  You've been working on less invasive treatments for a while.  My suggestion is to travel, if necessary, to consult with a plastic surgeon or facial plastic surgeon (ENT) who does mostly facelifts.  Look at before and after photos to see if you like the results.  I would plan on having fat transfer, limited laser or TCA peel, deep plane face and necklift.  You will pay for quality.  Do your research.  After a successful facelift, you are not finished.  Maintenance will be needed.  Don't dabble in partial treatments.

You look like a great candidate for a minilift to lift the jowls and neck, and a Halo laser to improve the skin texture. The minilift is performed in the office setting and has little to no downtime. I personally elevate under the SMAS to release it to get a much more effective lift, but patients still have very little downtime. Sutures come out in one week. Most are already doing normal activities.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

Having received so many different suggestions I feel that you should consult with a board certified plastic surgeontha does a lot of faces. For what I see in the pictures I suspectthat you may benefit from a lower face lift and some volume correction at the same time. The technique chosen is to be decided between you and your plastic surgeon. I preferlifts that correct more vertically but at the end is your plasticsurgeon expertise what will get you the best result. Best wishes.