Not ready for a facelift but looking for results - what options do I have? (Photo)

Question

Is it time for a facelift or are there other things I can do to improve my look? For my jowls, I have had one treatment of Ellacor Would another treatment of Ellacor benefit? I have also had Sculptra over the last 5 years but would fat transfer help with the lack of fullness on one side of my face? I have been told a Blephoplasty would be of benefit but only for 1 eye. Not sure I feel comfortable with that strategy I don’t feel emotionally and financially ready for a lower facelift yet, but don’t want to have procedures done that will be of little benefit either.

Julia Spears, MD · Answer

Hello, and thank you for your question. Based on your photo and description, it appears that you have a combination of early jowling, mild facial volume loss, and some asymmetry. The challenge is determining which concerns are related to volume loss and which are related to tissue descent, as the treatment for each is different.

If your primary concern is jowling, it is important to understand that treatments such as Sculptra, fat transfer, and Ellacor can improve volume and skin quality, but they do not reliably reposition descended tissues. A second Ellacor treatment may provide some additional improvement, but it is unlikely to create the type of jawline definition that a lifting procedure can achieve.

That said, if you are not emotionally or financially ready for a facelift, I would be selective about pursuing multiple treatments with modest returns. Fat grafting may be worth considering if facial asymmetry or volume loss bothers you, as it can restore fullness and improve facial balance in a very natural way.

Ultimately, the most effective treatment for jowling is a facelift because it addresses the underlying tissue descent. However, there is nothing wrong with waiting until the timing feels right for you. In the meantime, thoughtful volume restoration and skin quality treatments may help maintain a refreshed appearance while you decide on your long-term plan.

A consultation with a board-certified plastic surgeon can help determine which concerns are volume-related, which are structural, and which treatments are most likely to provide meaningful improvement.

Semih Yildiz, MD, FEPOBRAS · Answer

Jowls are mainly a laxity and descent problem, so fillers, Sculptra, fat transfer, or skin-tightening can soften the face but usually cannot replace a lower facelift when the main goal is jawline improvement. In the photo, there appears to be lower-face laxity and jowling with some midface volume loss; photo review is limited, so an exam may change the plan.
If you are not emotionally or financially ready for a lower facelift, it may be wiser to avoid stacking procedures with small returns. A second Ellacor treatment might help skin texture or mild laxity but is unlikely to create a true jowl lift. Fat transfer can help asymmetry or hollowing if volume is the issue, while one-sided blepharoplasty can be reasonable only if the asymmetry is clearly eyelid-based and the plan is measured.

Mehmet Ozdemir, MD · Answer

Thank you for your question. From your photo and description, you appear to have early jowling, slight volume loss, and some asymmetry. A deep plane face and neck lift could be a suitable option for addressing these concerns. I hope this helps.

Kadir Berat Oyur, MD · Answer

Thank you for your question. From your photo and description, it does appear you have early jowling, mild volume loss, and some asymmetry. Based on this, you could be a suitable candidate for a deep plane face and neck lift. I hope this helps.

Ali Riza Öreroglu, MD · Answer

Facial sagging and jowl laxity are mostly due to gravity and genetics. I use volume-enhancing treatments like fat transfer, but this alone doesn't reposition the tissues. I can correct asymmetry and volume loss on one side of the face with fat transfer, but it doesn't address sagging of the lower face or chin.
For lasting and natural results in the lower face and neck, I prefer a deep plane facelift. This technique goes beyond simply tightening the skin—it repositions the deeper tissues to their natural location. This provides significant, long-lasting improvement in the nasolabial and marionette lines while maintaining a natural appearance without an over-pulled look.
For the eyes, I perform blepharoplasty to address asymmetry and excess skin. If a unilateral procedure is needed, I decide this after an in-person evaluation.
A physical examination is essential to determine the surgical plan. If you are not ready for surgery, I clearly explain that non-surgical options will offer only limited benefits.

Vipul Gargya, MD · Answer

Based on your goals, I would be very selective about what you do next, because many “in-between” treatments cost a lot and deliver subtle change.
Ellacor and Sculptra are unlikely to give you the kind of visible, meaningful improvement you are hoping for in the lower face and jowl area. Jowling is primarily a structural issue, related to ligament laxity and soft tissue descent, and Ellacor or biostimulators do not reliably reposition tissue.
If you are not emotionally or financially ready for a lower facelift yet, the one option that can truly move the needle for many patients is facial fat grafting (fat transfer) performed by a board-certified plastic surgeon who does a high volume of facial fat work. Fat transfer can restore the “missing” support and softness in the midface, temples, and perioral area, which often makes the lower face look less heavy even without a lift. In patients with asymmetry, it can also correct one-sided hollowing more naturally than repeated rounds of fillers.

Mark Beaty, MD · Answer

Based on what you’ve shared, I do feel you would ultimately be an excellent candidate for a deep plane face and neck lift; however, it’s important to move forward with that type of procedure only when you feel both emotionally and financially ready.

In the meantime, there are meaningful, non-surgical and minimally invasive options that can provide improvement without undergoing procedures that offer limited benefit. Rather than a unilateral blepharoplasty, I would be more inclined to recommend a unilateral brow lift, which can address the asymmetry in a more natural and balanced way.

I also agree that restoring volume would be beneficial, particularly in the temple and under-eye areas. This could be accomplished with either fat transfer or injectable fillers, depending on your goals and preferences.

Additionally, CO₂ laser resurfacing could significantly improve skin quality and texture and would complement any of the above treatments well.

George Marosan, MD · Answer

Thank you for your question and photo. Based on this single frontal view photo, you would do best with a full facelift, neck lift, upper lip lift and fat transfer to the upper face. The brow and eyelids can be done later. Now you can waste your money on smaller, ineffective procedures like what you have done already, which BTW, will make a facelift more challenging. You do have an asymmetrical face with one side significantly smaller, significant perioral aging, loose ski and platysmal banding in the neck is evident even with your hair arranged to cover these changes. See a board certified plastic surgeon experienced in advanced facelift techniques for an in person consultation/evaluation. Good luck.

Thomas A. Mustoe, MD, FACS · Answer

You have enough ski. Laxity around the mouth, jowl and neck that your only truly good option is a lower facelift.  It is also more cost effective over the long turn because a skillfully performed deep oak r facelift with last 19-15 year predictably.  fillers or fat by themselves , if added in enough volume to fil out the relaxed skin will not look entirely natural. Smaller volumes will look fine but not give much benefit.

Gerald Minniti, MD, FACS · Answer

Machines don't tighten skin or deep tissue, and volumization (from fillers like Sculptra) don't address soft tissue positional changes associated with aging. You would benefit from a facelift, brow reset, and lid surgery (both eyes would benefit).

Not ready for a facelift but looking for results - what options do I have? (Photo)

Answers (17)

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