Are neck/face lift my best options? Which kind should I pursue? (Photo)

Question

Female, 39 years old, 5’9”, 140lbs., White//Hispanic, genetically predisposed to jowling (dad's side) and slack neck skin (mom’s side)

J. Timothy Katzen, MD, FACS · Answer

Hello CJT875362. Thank you for your question regarding the best surgical options to address jowling and slack neck skin, concerns that you've noted are genetically predisposed in your family.

Based on your description and the photo provided, the most effective solution for rejuvenating your aging face would be a combined approach of a facelift (rhytidectomy) and a neck lift (platysmaplasty). This comprehensive strategy will address both the lower face and the neck, providing a harmonious and youthful appearance.

Types of Facelifts:

SMAS Lift: This is the most recommended type for your needs. The Superficial Musculo-Aponeurotic System (SMAS) lift involves repositioning and tightening the deeper layers of the skin and muscle, providing more durable results. It effectively lifts the jowls and restores definition to the facial contours.
Skin-Only Lift: While less invasive, this type tends to have shorter-lasting results and is less effective in addressing more significant signs of aging.
Deep Plane Lift: This more extensive procedure addresses the SMAS and deeper structures, ideal for those with severe sagging but may come with a longer recovery period.
Platysmaplasty:

Alongside the facelift, a platysmaplasty involves tightening the platysma muscle in the neck through a small incision under the chin. This procedure corrects the appearance of a "turkey neck" by redefining the neck's angle and smoothing out the skin.
Procedure Details:

Facelift Incision: The incision typically begins in the hairline at the temples, continues around the ear, and ends in the lower scalp. This placement allows the scars to be well-concealed.
Platysma Technique: Tightening the platysma muscle not only improves the neck contour but also enhances the overall result of the facelift by providing additional support to the lower face.
Given your age and the description of your skin's laxity, undertaking these procedures sooner rather than later will allow you to enjoy the rejuvenating effects for many years, potentially preventing the need for further interventions as you age.

Consulting with a board-certified plastic surgeon who specializes in facial aesthetics will enable you to get a personalized evaluation and ensure that the chosen procedures are tailored to meet your aesthetic goals effectively.

I hope this response clarifies your options for a neck and face lift and helps guide your decision toward achieving the best possible outcomes.

Good luck, and may your surgical journey be both successful and satisfying.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photographs. To start with, I would say that if you do not yet have the habit of using sunscreen every day, irrespective of the weather, it would be beneficial to change your daily habits. This helps protect both the elasticity of your skin and the results of treatments through surgery. Surgical interventions do not create elasticity, and ultraviolet light, even on cloudy days, tends to reduce the elastic fibers in the skin which adults do not re-build.

A deep plane facelift and deep plane neck lift intervention are more likely to create a coherent correction for the contours, both under the chin and for the labio-mandibular lines and the contour of the jawline. The facelift also tends to improve the nasolabial lines somewhat, but the effect is not as powerful as it is for the labio-mandibular or marionette lines.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Thomas Trevisani, MD · Answer

In person exam is essential , as well as good set of standard  photos - all angles.
Based on limited photos- it appears that you would benefit from a lower facelift/ neck lift with muscle tightening. I suggest that you seek an experienced Board Certified PS to review your options

William Townley, MD, FRCS(Plast) · Answer

Hi there. Many thanks for submitting your question and photo. It looks as if you may have tried some less invasive approaches to the neck already? Although it is big step up and you are young, I would be considering either a full deep neck lift or combined deep plane face and neck lift. Often improvements in neck contour make the biggest overall change in facial rejuvenation surgery and may even sharpen up the jawline (without committing to facelift). A deep plane facelift will be the most effective at lifting the jowls and creating a crisp jawline contour. You are young so it would be very reasonable to defer this as it is a major undertaking but would provide a definitive solution. Less invasive approaches such as threadlifts are unlikely to lead to satisfactory or long-lasting outcome. Always best to consult an experienced plastic surgeon with a facelift practice as there will be nuances in the examination that can help develop a more accurate and tailored plan. Good luck!

Zoran Potparic, MD · Answer

Based on this single photo that does not reveal all what is needed for good evaluation, it appears that lower face/ neck lift vs. extended posterior neck lift would be a good option for you. In person consultation with a board certified plastic with expertise in face/neck lifts is recommended. Good luck.

Camille Cash, MD · Answer

Based solely on the submitted photo it appears you would be a candidate for a lower face and neck lift to address the skin laxity.  I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation.  With a full exam and discussion of your goals you may be a candidate for less invasive options such as FaceTite or Morpheus8 for improvement.

William Portuese, MD · Answer

From the one very limited photograph, it appears that you have mild jowls, but you appear to have significant laxity of skin in your neck, platysma muscle bands, and fat deposits as well. A lower face and neck lift procedure would probably be the best procedure for you. A full set of facial and neck photograph from all angles would give you a better determination. Study your prospective surgeon's Before and after facelift photo Gallery to make sure that it is extensive with natural appearing results. Probably also best make appointments with three facelift specialists in-person or virtual

Darryl J. Blinski, MD · Answer

Based on the only one posted photo, recommend in person or virtual consultation. Recommendation of mini face necklace with muscle plication. Fees from $5000-$15,000. Again best to virtual consult with.