Procedures to Improve Bottom Heavy Face?

Question

I would like to have surgery to improve my jawline but I'm confused about my options. I assume I will need Liposuction, but what about the neck bands and the front profile?

	Would it be a Neck lift, lower Face Lift, short scar facelift? I am not quite 40 yet, but close. No Chin implants please. I know my profile shot shows a weak chin, but when I smile my chin comes out to play, and I am quite happy with it.

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

Thank you for your picture and questions.  
You would be a good candidate for local anaesthetist facelift and neck lift which will remove any excess skin.  This would help achieve a contoured L shaped neck and remove any jowls, giving a nice sharp jawline.  
Most of my patients want a facelift however do not want the downtime associated.  The Concept Facelift and Necklift is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
 Typically recovery period is 7-10 days as you do tend to bruise more with your eyes than facelift and necklift.  You would need to return for a follow up appointment 7 days later to check your healing progress.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar facelift, although has the same effects as the Traditional Facelift as the SMAS muscle is tightened along with the skin.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPlease make sure you find a reputable and qualified plastic surgeon who can

Jed H. Horowitz, MD, FACS · Answer

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

Richard J. Bruneteau, MD · Answer

Although your pictures are helpful, it’s hard to make a
recommendation without performing a physical examination. Your pictures suggest
submental fat deposition with surprisingly minimal skin laxity. Some of your
lateral pictures suggest redundant skin but your head appears to be turned to
the side. Under these circumstances, skin folds would be expected.Based
on these findings a facelift probably isn’t indicated under these
circumstances, treatment of submental fat with conservative liposuction would
result in excellent contour improvement.If
you’re considering treatment of this problem, consultation with a board
certified plastic surgeon is appropriate. This surgeon should be able to
perform an examination and make an appropriate recommendation.

Michael R. Macdonald, MD · Answer

While you are not fond of the idea of the chin implant, that may still be the best choice. A chin implant would be placed against the bone of your jaw so that it feels like an extension of your natural jawline. Not only would this improve your jawline and front profile, but it would also improve your side profile and the contours of your neck. I believe that a facelift or neck lift are more aggressive approaches than you need at this point.

Brent Moelleken, MD · Answer

Liposuction alone will probably not do the trick. It maytake a tightening of the deep layer, the platysma. We prefer a wide interlacing verison of the platysmaplasty.

	I know you are set against the chin, but it can have some beneficial effects on the profile, the span of the neck, and the appearance from the front (even during periods of "play") if subtly done.

	A minilift can also provide an extra measure of sculpting of the jawline if appropriate.

Eric M. Joseph, MD · Answer

It's possible you would benefit most by a MACS-Lift, short-scar facelift to get optimal face and neck rejuvenation. This is a tough call without seeing your whole face. I don't see the neck bands you're concerned about. 
My hunch is that you might be pleasantly surprised by the improvement you could see with an isolated neck liposuction procedure. Your skin appears to be young and elastic, and these are the main predictors of youthful redrapement after a liposuction procedure.
I hope you find this helpful.

Toby Mayer, MD · Answer

Liposuction is not the best choice for you since it appears that you have neck bands and loose skin. Surgery to just the anterior neck will still leave the excess skin. Some form of facelift is indicated. What type is for an experienced surgeon tdecide and give you the pros and cons of YOUR options, not his.

Elizabeth Slass Lee, MD · Answer

Liposuction can work really well to gently contour the area below the chin and along the jawline, provided the skin is of good quality and the tissues under the skin are in good shape. A short scar facelift can improve the lower part of the face, while a necklift refreshes and tightens the area under the jaw and chin.
It is difficult to tell from photos alone which procedure would be the best for you, but you are correct that liposuction alone does not correct platysma bands. A neck lift can be done through minimal incisions beneath the chin and in the crease behind the ears. A face to face consultation is needed to design an effective treatment plan for you. Make sure you see a board certified surgeon who is familiar and comfortable with all of these procedures.

David Shafer, MD, FACS · Answer

Based on the photographs, it looks like you may benefit from neck liposuction. If you are worried about neck bands, then once you heal from the liposuction, Botox Cosmetic in the neck could be beneficial. Also, you may benefit from some fillers along your jawline to help balance out your chin. I hope this is helpful.

Raj S. Ambay, MD · Answer

The basis of a facelift is not pulling the skin rather it is repositioning of tissues under the skin and then re-draping the skin over the more youthful understructure. In some patients neck liposuction, fat grafting and other procedures to the eyes or forehead are done concurrently.

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