Is a Facelift the best option for my sagging lower face? (Photo)

Question

I'm 43 years old. I work in healthcare and the past four years have aged me 15 years. I feel my face resembles a triangle, with everything drooping and sagging down - my thin, crepey undereye area, my drooping nasiolabial folds, marrionette lines, my lack of any cheek fullness etc. My lower face particularly bothers me. What treatment options would you recommend to lift things up? There are so many different types of facelifts etc it all seems very overwhelming. Thankyou.

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs.

Based on your description and the images you have provided, it appears that a facelift could be a very suitable treatment for you. When there is moderate laxity along the jawline or volume in the jaw area, combined with visibility of the labio-mandibular lines (also known as marionette lines), facelift surgery tends to be the most effective treatment to address these concerns.

A deep-plane facelift, in particular, is well-suited to produce these effects. This technique lifts and repositions deeper layers of tissue, providing a natural and long-lasting improvement to the contours of the face and jawline.

Additionally, the deep-plane facelift has the added benefit of improving the appearance of the neck. In your case, it seems that this procedure would be sufficient without the need for additional interventions.

I hope this information helps you as you consider your options.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  I can’t comment on your neck contour as it is not included in your photos.  Your upper lids have some redundant skin and a skin only upper blepharoplasty would markedly rejuvenate them.  Your lower lids have minimal fat herniation and should also be nicely improved with a lower blepharoplasty with possible laser resurfacing of the skin.  Your skin looks to have excellent quality.  To clarify your confusion about the “different types” of facelifts: different doctors name their facelift operations by different names suggesting there is something unique about their operations, however, in EVERY facelift there are 2 layers that are dealt with, the skin and the next layer down, the SMAS.  The SMAS is the fascia/strong layer of your face and is the exact same layer as the platysma muscle in your neck, as the platysma muscle changes to the SMAS as it crosses the jawline.  The best face/jawline/neck contours result with elevation of the SMAS layer.  The simplest way to elevate the SMAS is to suture the SMAS to itself, ie SMAS plication.  No incision is made in the SMAS, it is just pulled upward and sutured to itself and tightened.  The facelifts were the SMAS is incised and elevated are: the high SMAS, the extended SMAS and the deep plane.  These differ in WHERE the SMAS is incised and subsequently elevated.  The high SMAS incises the SMAS above the cheek bone and elevates the SMAS off the underlying tissues then sutures it upward.  The extended SMAS incises the SMAS below the cheek bone then elevates the SMAS off the underlying tissues and sutures it upward.  The deep plane incises the SMAS over the anterior part of the parotid gland, elevates the SMAS a short distance and sutures it upward.  As they ALL elevate the SMAS, they are ALL deep plane facelifts.  Most importantly, there has never been a definitive study showing any of these techniques produces a superior result when compared with the others either early or long term.  So simplicity is best and I’d recommend a SMAS plication facelift to accent your cheekbones, slightly volumize your cheeks, straighten and smooth your jawline and correct any minor muscle banding you may have in your neck.  Discuss this in detail with your plastic surgeon.

Ali Riza Öreroglu, MD · Answer

Based on your photos, you seem to be a good candidate for both Facelift and Fat Grafting procedures. There are two effective options to correct the sagging and volume loss in your face: Facelift and Fat Grafting. A facelift is ideal for addressing sagging and looseness in the lower face and neck area; the underlying tissues are tightened to create a younger and smoother appearance. This procedure offers long-lasting results. Fat grafting, on the other hand, involves harvesting your own fat and injecting it into areas where volume has been lost, providing a natural and fuller appearance. It is an excellent option for correcting volume loss in areas such as the cheekbones, under-eye area, and cheeks. Of course, in order to make a decision about these procedures, a physical examination is essential.

Marvin F. Shienbaum, MD · Answer

A facelift may be a good option for sagging lower face skin, but it's important to consult with a qualified plastic surgeon to determine the best approach for your specific needs.

Here are some factors to consider when deciding if a facelift is right for you:

The severity of your sagging: The more severe your sagging, the more likely a facelift will be effective.
Your overall health: Good overall health is important for any surgical procedure.
Your goals: Be clear about your goals for the procedure and discuss them with your surgeon.
Other options: There are other options available, such as non-surgical treatments like thread lifts or fillers.
A consultation with a plastic surgeon will help you determine if a facelift is the right course of action for you. They can assess your specific situation, discuss your options, and answer any questions you may have.

Jacob Tower, MD · Answer

Hello, hope you are well. Based on the photos that you have submitted here, I would recommend a deep plane facelift. Having said that, the technique is less important than the ability to deliver a good result. Research prospective surgeons and question if they have patients of similar age and appearance in their portfolio of work.

Best,
Dr. Tower

Is a Facelift the best option for my sagging lower face? (Photo)

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Is a Facelift the best option for my sagging lower face? (Photo)

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