I'm 61, and although I've been injected with lots of things, I think I need surgery. What are my options? (Photo)

I'm so confused by brow lifts, face lifts, neck lifts, eyelid lifts. What the heck do I need done? I don't want to look like a paralyzed Barbie doll, just energetic and better.

Doctor Answers 42

I'm 61 and I think I Need Surgery..........but what would work for me?

All of the jargon about upper/lower lifts, mini this, and less invasive that is very confusing to the average person. Much of the terminology is not really about substantive differences in technique, but really more about marketing, and convincing you that you are getting something special that other surgeons don't deliver..........so how does one decide what to do?

For starters, a photo of you in full smile does not allow for a considered analysis of the changes of facial aging that you would want to see reversed as part of a process of facial rejuvenation. There does appear to be some significant laxity in your neck which would not be unusual for someone at age 61. So some variation of a facelift that would correct your neck and lower face is likely to be a part of the prescription. You also appear to have excess skin in your upper eyelids thus an upper eyelid lift or upper blepharoplasty may also be a part of the correction. 

Your cheeks appear unusually full and this is probably related to the multiple injection procedures that you indicate you have had. Injectables are useful in slowing down or reducing the signs of facial aging, but they can only take you so far - as you have discovered. Overuse of injectables can lead to an unnatural appearance and can potentially interfere with facial rejuvenation surgery through scarring of the deeper tissue layers. 

Thoughtful consideration of the various surgical options and careful meticulous execution of the procedures should give you a natural rejuvenated appearance that won't leave you looking like a plastic Barbie Doll. 

I'm 61, and although I've been injected with lots of things, I think I need surgery. What are my options?

If you are not happy with the look of your face, you feel that you are getting older, your skin started to lose its elasticity and if you think that this situation is going to get even worse if you do not take any precaution; then you can be a good candidate for “Spider Web Aesthetics”. Most people are afraid of surgical interventions since the complication risk and the results can frighten the patients. Therefore patients are seeking for non-surgical solutions more and more. Spider Web Aesthetics is a non-surgical lifting method developed by plastic surgeon Bülent Cihantimur MD. If you are afraid of having a surgical intervention and you are not happy with the sagging of your skin especially in face, inner arms, buttocks and neck; you should consider undergoing this minimal invasive, safe and effective method.

Aging in the Neck and Around the Eyes

It is difficult to evaluate your face based on the one view with you smiling, but your prominent cheeks suggest that you have had a lot of filler in your cheeks, which in my opinion can be a misguided way to avoid surgery, and can change the shape of your face. I see a fair amount of aging changes in your neck, and a lower facelift with emphasis on the neck is the only approach to improve that part of your face. Although there are many kinds of facelifts and neck lifts, the key for you should be to evaluate your surgeon based on before-and-after pictures. If done well, the surgery should look completely natural. Unfortunately, as your question implies, many procedures do not result in a natural appearance. You do have some aging changes around your eyes, and an upper blepharoplasty with or without a conservative browlift would help. I am confident that you can find an experienced surgeon who can advise you on what is best, but choose carefully. A “mini lift” procedure has become quite popular, but is more of a marketing approach that, in my opinion, will not give you an adequate result.

Address Lower Face Aging & Eyelids

I certainly understand how easy it is to be confused by the amazing variety of options available for surgical facial rejuvenation. Of course, the best way to get a good sense of what options can best benefit you is to have a face-to-face consultation with a board-certified plastic surgeon. However, I see a few areas for potential improvement in your photos. A facelift could remedy the laxity around your jawline and neck, and it would lend an overall more defined appearance. Eyelid surgery, technically called blepharoplasty, can reduce the excess skin hanging around your eyelids and give you that energized look you mentioned. Please see a surgeon near you to learn more!

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
4.6 out of 5 stars 22 reviews

A Facelift May Be a Good Option

It's difficult to tell what's needed from this photo. A photo of someone smiling does not allow the viewer to properly evaluate the aging issues that you might have. It does appear that there is neck banding and excess skin present, so a facelift is probably in order. This would address the lower third of the face by tightening the jawline and neck. This might also improve midface volume, depending on the technique used by your surgeon. Since you have already been injected with fillers, and maybe BOTOX®, surgery is probably the next step for you to obtain a more youthful appearance. BOTOX can be used for the forehead to reduce the wrinkling and this is an easy way to improve the upper third of your face. Good luck to you.

It May Be Time to Consider a Facelift

If, after trying injectables and dermal fillers, you remain dissatisfied with either wrinkles or sagging facial skin, a facelift can provide more dramatic and long-lasting results, targeting the lower two-thirds of the face. It's also very common to combine procedures if you're looking to address droopy brows (brow lift), skin laxity in the neck (neck lift), or bags under the eyes (eyelid surgery). That said, any more specific advice would be speculation; it's best to meet with a board-certified plastic surgeon in person to go over your goals so that he or she can explain what's best in your particular case.

What are my options?

I can understand that it might be confusing to know what is best for you.  Honestly just by one picture it is difficult to say with 100% certainty but just based on picture and age alone I would say you would benefit from a lower face and neck lift plus eyelid lift (blepharoplasty).  Make sure you see a Board Certified Plastic Surgeon who performs a lot of face/necklifts before committing to your surgeon. Also make sure you look at a lot of good before/after photos. Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 31 reviews

What do I need?

Firstly, it is truly hard to judge your face on one view, especially a full smiling view.

I think the best way to go down this road is to make a few consultations with well regarded surgeons and get their opinions.  Be honest with respect to your expectations, your areas of concern, and your budget.  The more I know about your needs, wants, and hopes, the easier it is to give you recommendations that are tailored to your case.  Facial rejuvenation is not a one stop shop.  It is a spectrum ranging from Botox all the way to surgery, and you will likely need multiple items on that spectrum.

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.7 out of 5 stars 80 reviews

What Options for Facial Rejuvenation?

It can be very confusing with so many procedures available today for facial rejuvenation. There is a lot of terminology sometimes for the same procedure! You should get a consultation with two or three Board Certified Plastic Surgeons to help you understand what options are available to you. I offer my patients computer imaging to help them visualize what they would look like after surgery. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 63 reviews

Aging face surgical recommendations...

With one photo, it is difficult to make any concrete recommendations.  An in person exam is best.  

Seeing a facial plastic surgeon or plastic surgeon skilled in face lifting procedures (ask for photos and to meet with previous patients) is the first step for you.  Seeing before/ afters and previous patients is the best way for you to see the type of results that that particular surgeon can achieve.  

I always say that my goal is to just turn back the clock...not make you look like a different person.  Just a younger YOU!

I wish you well,
Parker A. Velargo, MD

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.