55 - under eye bags, wrinkly eyelids, and the jowls. What procedures would you recommend for the best results? (Photos)

Question

Hi there. I am 55. Over the past two years, my age has really caught up with me, facially. That said, a Google search is almost unhelpful because my inclination is to say my God, I really need any help you can throw at me. LOL. Most noticeable to me are the lovely under eye bags, the wrinkly eyelids, and the jowls. I would love an educated suggestion as to a reasonable procedure(s) plan to achieve good results. Figure I've got $15-20K to spend. This is my first real exploration of potential face/skin procedures and I would benefit by some broad-strokes direction.

Kyle Kimura, MD · Answer

Thank you for your question and photos! 
Some procedures you could consider for different areas of the face: - lower eyelids (lower blepharoplasty vs fat augmentation of the lower lids), I personally prefer lower blepharoplasty with fat transposition which maintains some of the natural fat and uses it to fill the tear trough below the eyelid- finer wrinkles on the face: laser resurfacing or chemical peel can be helpful to improve the overall quality of the skin of the face - jowls/neck: I honestly think this is on the more mild side and may consider waiting before face/neck lift 
Your best bet is to schedule a consultation with a plastic surgeon that specializes in facial rejuvenation.
Hope this helps and best of luck! Kyle Kimura, MD

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear jacquiecdv,

Thank you for the question and for sharing your photos. You actually do a very nice job of identifying the main issues yourself. I see lower eyelid fullness with under-eye bags, some upper lid skin redundancy and wrinkling, and early to moderate jowling with loss of jawline definition. The good news is that these are very common concerns, and they can usually be addressed quite effectively with a thoughtful plan.

In my opinion, the biggest improvements for you would come from separating the face into zones and deciding what really bothers you most. The eyelids and the jowls are different problems anatomically, and they are treated differently. If the under-eye bags and wrinkled upper lids are your priority, then upper and lower blepharoplasty would likely give you a very meaningful refresh. That tends to make patients look less tired and more like themselves without changing the overall character of the face.

The jowls are a different matter. Jowling is not really a skin problem so much as a deeper support problem involving descent of the facial soft tissues. If that is one of your main concerns, the most reliable correction is some form of lower face lift with appropriate treatment of the SMAS layer. That is what restores jawline definition in a meaningful way. Skin-only approaches or surface treatments will not do much for that.

With your stated budget of roughly $15,000 to $20,000, I think it is important to be practical. In many markets, that budget may cover eyelid surgery very nicely, or it may get you part of the way toward a facelift depending on the surgeon, facility, and whether procedures are combined. Trying to do upper lids, lower lids, and a full lower face lift all together may be difficult within that range, particularly in Los Angeles.

So if I were thinking in broad strokes, I would frame it this way. If your eyes bother you most, upper and lower blepharoplasty is probably the strongest first step and may give you the most noticeable refresh for the money. If the jowls are truly what make you feel older, then I would lean toward putting more of the budget toward a properly done lower face lift rather than spending on smaller treatments that do not really solve the problem. In some patients, staging things is the smartest approach: address the eyes first, then plan facial lifting later, or vice versa depending on your priorities.

I would also include the foundation of good skin care before and after any procedure. That means daily sunscreen of at least SPF 30, a good facial moisturizer such as Prequel, and Retin-A if your skin tolerates it and your physician agrees. Those steps will not lift jowls or remove under-eye bags, but they do improve skin quality and help support the overall result.

I do not think you need “everything.” I think you need the right combination, in the right order. Based on your photos, a very reasonable surgical discussion would include upper blepharoplasty, lower blepharoplasty, and a lower face lift, but the exact sequence may depend on budget and which feature bothers you most when you look in the mirror.

An in-person consultation would help determine whether your lower lids need skin tightening alone, fat repositioning, or a more formal lower lid approach, and whether your jowling is best addressed with SMAS plication or a more extensive lift. But overall, I would say your concerns are very addressable, and a staged, sensible plan will usually give a better outcome than trying to chase every issue at once.

Best,

Dr. Stephenson

Mehmet Ozdemir, MD · Answer

Thank you for your question.
Based on your concerns, I would recommend a deep plane facelift combined with a neck lift, along with upper and lower eyelid blepharoplasty. This combination can address jowls and neck laxity while also improving under-eye bags and excess eyelid skin, creating a more refreshed and youthful appearance.
A consultation would help confirm the most suitable approach based on your anatomy and goals

Guray Yesiladali, MD, FEBOPRAS · Answer

Hello, the concerns you describe are very typical around this age and can be addressed effectively with a structured plan that can also fit within your stated budget.
For the eye area, an upper and lower blepharoplasty would likely provide significant improvement. Upper eyelid surgery can remove excess skin and restore a more open expression. Lower eyelid surgery can reduce under eye bags and smooth the contour beneath the eyes.
For the lower face, both endoscopic facelift and deep plane facelift are options, and the choice depends on how much structural correction is needed.
An endoscopic facelift involves minimal incisions, often hidden within the hairline. Small cameras are used to elevate the midface upward. Recovery is generally easier and scars are limited. However, the amount of tissue that can be repositioned is more limited compared to deeper techniques.
A deep plane facelift, on the other hand, works at a deeper anatomical layer and allows for more significant structural repositioning. Excess skin can also be removed. Incisions are typically placed in natural creases and hidden areas around the ear. Recovery may be slightly longer than endoscopic techniques, but the structural change is more powerful and long lasting.
With your stated budget, these combined procedures can be performed at a very high level with experienced surgeons in Turkey.
I have included a video below where I explain different facelift techniques in more detail and discuss how to determine which one is most appropriate.
Wishing you a thoughtful exploration process and a result that restores confidence without looking overdone.
Güler Güray Yeşiladalı, MD

55 - under eye bags, wrinkly eyelids, and the jowls. What procedures would you recommend for the best results? (Photos)

Answers (4)

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