Would a mini lift be a better option for sagging on one side of my face? (Photo)

Question

I am 40. I get Restylane twice a year for marionette lines and nasolabial folds and lips. My right side still has the shadow and shows more droop. Would a mini lift be a better option?

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime. Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  Your picture doesn't show enough of your face for me to comment on whether you would be a good candidate for a facelift. I performed a lower facelift under a local anaesthetist which means significantly reduce downtime due to minimal bruising.  The stitches are all dissolvable under the skin.  Please do have a consultation with a board certified plastic surgeon to discuss.  All The Best

Francis Johns, MD · Answer

Thank you for your question.You do have some laxity on that side of your face. It is hard to determine what exactly would be your best option based on that photo. I would recommend an in person consultation to discuss all your options and concerns.

Cameron Chesnut, MD, FAAD, FACMS · Answer

It’s quite difficult to tell from your photo, but there may be some energy based, injectable or minimally invasive surgical options that are better then lower face filler to address your issue.

Gregory S. Keller, MD, FACS · Answer

A minilift would be helpful, and a correction of your cheek ptosis is important.  It is also important, with asymmetry, to look carefully for asymmetric cheek and chin bones.  You may have bones that are different sizes.  As a result, your skin and structures can drape differently over the bones.  An old trick that we used to play to show this, was to take an imaging machine and take two right sides of the face and two left sides of the face, and with reversal imaging put the rights and lefts together.  The result would be two different people.

John Michael Thomassen, MD · Answer

A mini lift that addresses cheek ptosis and lower face skin tigthening would correct this.  It can also improve any small wrinkles in the neck.  At some point, fillers are counterproductive and a skin procedure is necessary.

Tom D. Wang, MD, FACS · Answer

Hi there, thanks for your question and photo.  Please keep in mind that our face usually has some mild degree of asymmetry so that one side may appear more saggy than the other.  This appearance of sagging or tissue descent will only increase with the aging process.  Both fillers and lifting are options to correct tissue descent.  In general, surgical lifting offers longer term improvement than fillers alone.  Of course, the best option is to consider both lifting and subtle augmentation to help correct both descent and deflation.  Hope this helps and good luck to you!

Myriam Loyo, MD · Answer

Hi there, thank you for your question.The marionette lines are lines that extend from the lips down to the jawline. Marionette lines form because of aging. As we age, we loose volume in the face and we progressively loose strength and elasticity in the skin and ligaments of the face. Ultimately this leads to folds and wrinkles. Marionette lines can be treated with either injectables (such as Juvaderm or Restylane) or with anti-aging surgery (such as a facelift). Injectable treatments are meant to augment the volume in the area and camouflage any depression. These treatments are great for early folds and require minimal to no downtime. They can be fabulous treatments and very effective, but they are temporary and repeat treatments every 6 to 12 months can be necessary to maintain the results. Facelifts can provide longer-lasting results than injectables. They are highly customizable to address the marionette lines, jowl, jawline, or loose neck skin. Facelifts are more extensive procedures and do require a recovery period. Costs and risks need to be taken into a account, but ultimately the results "set back the clock" in terms of your appearance and can last up to a decade (if not longer).The decision is very personal. If you are finding yourself considering something other than injectables, consult a board certified surgeon who can give you honest advise. A good surgeon will tell you when it is too early to consider surgery and you are better off with other options, and will also honestly tell you when a facelift might be a better investment. I hope this is helpful. In your case, I would be interested in assessing your chin and neck on a profile to give you better advice. Being able to have a discussion of your goals, and do a full assessment by watching your speak and move and touching your face and skin will be important to best counsel you. Have a great day!

Mary Lee Peters, MD (retired) · Answer

Thank you for your question.  Your photos do not show enough face for me to provide useful advice.  A facelift can treat skin laxity, but symmetry usually requires the surgeon to have control of both sides of the face at the same time.  Therefore a unilateral surgery would be difficult to give a reliable results.  From what I can see from your photographs, you are not quite ready for a full facelift and you might consider using injectables for a little bit longer.  Most plastic surgeons offer this service, and can advise you properly after examining you in person.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many SMAS facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  From the photos your left cheek is flat in the front, jowls are present and the chin is very weak.  These factors combine to create a rectangular shaped face. 
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection  less bruising and swelling  rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair  no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Would a mini lift be a better option for sagging on one side of my face? (Photo)

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