51 years old - Should I have a surgical or nonsurgical facelift? (Photos)

Dear sdnatvbb,
Thankyou for your attaching pictures for reference. It seems you are experiencing face laxity where the skin is losing its firmness and tightness especially in the mid-face area. If you are looking for a permanent solution, I would recommend a full facelift combined with neck lift, the lift will eliminate the sagging cheeks/nasolabial folds and target the neck, mid- face, and upper temporal part. This procedure combined with the neck lift will remove the excess skin under the neck and prevent your skin to collect under the chin.. Make sure to search for an expert surgeon who can target all problematic areas using a scarless and endoscopic method as well as a vertical not horizontal facelift to make sure the saggy and droopiness can be fixed without giving an artificial and pulled appearance. Furthermore, you can additionally benefit from fat injections into your deep nasolabial folds to fill in the lack of volume.
Best Regards,
TAS TEAM

Thank you for your enquiry and sharing your photographs.

There are some simple ways to try and understand what type of treatments would offer you solutions that you like or would address problems that you want to deal with.

If you want to evaluate what a deep plane facelift can offer, a relatively similar appearance is achieved when you lie down completely flat. It is best to use the mirror to examine the face as mobile phone photographs produce substantial distortions.

Typically the volume in the lower face and jawline decreases, the volume in the mid-face increases and the marionette lines fade or disappear in combination with a change of the corner of the mouth.

In the neck area, your photographs show also moderate visibility of the digastric muscles and lower part of the submandibular glands. This is a genetic feature and influenced by the fact that the lower jaw is slightly small. When the jawline is lifted, the volume underneath is likely to become more visible. It is not properly controlled by tightening of the skin either in a simple neck lift or a deep plane facelift.

A deep plane neck lift procedure will address the volume under the jawline and create continuity of the shape . To understand better whether this is something you would like to pursue, you can examine the appearance of the neck when you are looking down and the neck is slightly flexed. If there is volume excess in that position (in surgery we referred to it as the Connell view) then and neck lift intervention in the deep plane is likely to be a suitable complement for the facelift.

Great questions; thanks for posting. If you have tried non-surgical procedures like injections, a surgical facelift can provide more significant results that you have not experienced with fillers. It sounds like you are looking for long-term results, and a facelift can provide the changes you seek without regular maintenance. It also comes with a more extensive recovery, and as long as you understand the process, it could work well for your needs. A combination procedure can also use both surgical and non-surgical treatments to achieve natural results. Consult with a skilled, board-certified facial plastic surgeon to learn more about a facelift and receive a personalized treatment plan.

Hello, thank you for your question and for your photos. If you have had fillers and dont feel like it doing the trick to address your concerns then I would consider the surgical option. Of course it is difficult to definitely tell you yes or no to surgical option. The best place to start is with a consultation with your plastic surgeons to go over your expectations.

I think that you would benefit from a lower neck and facelift. However, your jawline loses definition at the mandibular angles and improving this definition and contour first would provide a better result for the neck and facelift.

In person exam is essential. Based on posted photos it appears that you may be a good candidate for facelift/ neck lift with muscle tightening. I suggest that you seek an experienced Board Certified PS to review all of your options

This is an excellent question and many patients would like to know this specifically for themselves. You will need to see a specialist facial plastic surgeon to get an accurate assessment.
There is no right or wrong with this as each procedure carries its own risks and benefits. Patients choose a procedure for them depending on recovery time, their aspirations and costs.

Given your concerns and degree of facial aging, surgical intervention (neck and lower facelift) is the best option. You've already experienced the limitations of the nonsurgical options. Neck and lower facelift would address sagging skin of the neck, improve the jawline and nasolabial folds. You may get some additional benefit in the midface and lower eyelid area as well, depending on the surgical technique employed. If you're amenable to considering surgery, you might consider consultation with a board certified plastic surgeon or facial plastic surgeon. In either case, you'll want to choose a surgeon that performs a large number of facelift and neck lift operations, as your result and overall experience will be better with an experienced surgeon. Review the surgeons real patient's before and after photos to be sure they are in line with the degree of result you are hoping to achieve. I hope you find this information helpful. Best of luck!
Kind regards,
Dr. Harmych

Dear @sdnatvbb, thank you for your question and showing your pictures. Based on the photos, and considering the results you want, I recommend a facelift for the second and third thirds of your face. This includes the first third of the neck. With upper and lower blepharoplasty and an eyebrow lift (pexy), this would be a complete surgical plan for you to obtain better results. During this type of procedure, it is important to develop a surgical plan that considers the relationship between the areas to be treated and the other areas of the face to achieve a balanced, harmonious and long-lasting result. Although non-surgical treatments would be helpful, they require constant use and do not produce the results you hope for. Best wishes! Alan Gonzalez MD, FACS.

Where do you start? I think you’ve already started by asking the right questions. Read up on the various procedures and go on some consults. You’re perfect for a basic facelift. No bells or whistles needed.