I’m not sure if I need a facelift/what procedure to help tighten and get rid of my wrinkled and crepey skin? (photos)

Dear mamaberr Thank you for your questions and photos! If you are medically well - and no bleeding concerns - then you can consider non-surgical or surgical procedures.  A consult focused on your concerns will help with focusing in on the changes you want .With Warm RegardsTrevor M Born MD

thx for the pictures. You have multiple options depending how far you want to take the rejuvenation. You have some volume loss and skin excess. I understand the concerns about looking fake and that’s something you need to research from looking at Befores and afters pics and speaking to your surgeon.   For the volume loss and skin excess, the best would be a facelift with necklift and consider other options such as a bleoharoplasty and fat transfer. Some kind of skin resurfacing will also help. All this needs to be discussed in detail and performed with your Medical history in mind. 

Thank you for your question.  There are many surgical and non-surgical treatments that can help to rejuvenate your face.  Skin resurfacing, fat grafting, Botox and fillers, upper and lower blepharoplasty are just a few available options.  Each of them would help to some extent.  However, if you are looking for the most effective and long lasting option you would need to look into a facelift.  A facelift can rejuvenate all the areas you are concerned with (except the eyelids).  A well performed facelift can rejuvenate one's face by about 10-15 years.  Please look at a before-and-after photo of a facelift to see what can be achieved with this procedure.Hope this helps!Dr. Konstantin

I can tell you that you are a super candidate for a facelift. No other procedure will resolve the issues that you are worried about as effectively and expeditiously as a well performed facelift. Your high cheekbones and excellent facial proportions make you a great candidate for the procedure. I would definitely address the eyelids at the same time or later. The V LAIDEN is a concern, but I perform all may facial procedure under local anesthesia with moderate intravenous sedation and in your case I may do the face and eyes at two different sessions. Local anesthesia does not dilate the veins in your legs, so it is like sitting in a recliner for three hours. The recover is fast. Within ten days you are healed with minimal bruising and swelling. The facelift will address the loose skin both in your lower face and cheeks. It will also eliminate the muscle band under your chin and the jowls.

Most patients with your facial features in my practice undergo a facelift with fat injections plus or minus eyelid surgery.  You would have to discuss your other medical conditions during the consult and potentially investigate them further prior to undergoing a procedure.

You will need stabilization and medical clearance for hashimoto's and Factor V Leiden from your hematologist and PCP prior to considering cosmetic surgery. In the middle-aged patient (40 to 55 years), submental lipectomy combined with anterior platysmaplasty (tightening of the muscles in the neck) can be performed. I would recommend a full face and neck lift to address your concerns.  This can be performed with a short scar facelift. In addition to a facelift, recommend upper eyelid surgery to complete your transformation. 

Thank you for your question and photo. You have several options both surgical and non. I suggest you seek a board certified plastic surgeon for a consultation to go over what options best address your goals.  Best of luck!
Dr Dhaval Patel
Double Board Certified
Plastic Surgeon
Chicago
Hoffman Estates 
Oakbrook 
Orland Park

Facelift surgery would work very well for you. You have some generalized aging that would respond ver well to surgery. Laser resurfacing might also be an option but has different issues. Go get a good consultation from an experienced facial cosmetic surgeon that can help you decide. Good luck.

Thank you for stating your medical issues. Before you have any surgery, it is mandatory that you get clearance from your PCP and your hematologist. (In my practice, I insist on medical clearance for all patients since safety is #1.) You have excellent bone structure that will likely make for an excellent result. What you are experiencing, and what you dislike, are the telltale signs of the aging female face. The skin of your upper eyelids is sagging, and you have midface laxity that leads to nasolabial folds, marionette lines, jowling and excess skin of the neck. The good news is that all of these issues can be surgically corrected. A conservative eyelid lift (“cat eyes” are not a goal!) that respects and retains the natural shape of your eyelids is commonly performed in my practice, and I feel that it’s immensely important to not change a person’s inherent eye shape because this is key to helping patients retain their aesthetic identity. A midface suspension with a comprehensive neck lift will gently lift the face and correct the NL folds, marionette lines, and the jowling and neck laxity. There is the possibility incorporating laser resurfacing at the time of their procedure which will also smooth your skin and stimulate collagen rebuilding. Choosing the right surgeon is of utmost importance, because we all have different aesthetics and techniques. I would study the befores-and-afters of each surgeon and have an in-person consultation to ensure that you feel comfortable with the surgeon, the aesthetic, the facility, and the focused time spent on you.  

Mammaberr- thank you for your question and some background.  Based on your photos, I can see some of your concerns.  You have a number of options from surgical to non-surgical that can work in tandem to address all of your areas of concern.  I do not like to advise patients on what they "need' but rather help guide you to achieve your goals based on the things that bother you the most, your health, the amount of downtime you can tolerate, and finances.  I would recommend an in-person consultation with a board-certified facial plastic surgeon. If you live in San Antonio, I would be happy to visit with you in person.