Which surgical procedures would help me achieve a more rejuvenated look? (photos)

Thank you for providing photographs with your question.
Facial aging often follows a pattern that involves both descent of soft tissue as well as loss of volume. While it is not common to undergo a facelift in your late 30s or early 40s, it is not unheard of. Ultimately the key to any successful surgery is making sure that the procedure offered will improve what bothers you. From these photos I notice that you have excess skin of your upper and lower eyelids as well as moderate bags under your lower eyelids. You also have a moderate nasolabial fold and loss of cheek volume. The distance between your lower eyelid and cheek also appears to be slightly long which is a sign of facial descent.
In my opinion you would be a great candidate for both and upper and lower eyelid blepharoplasty. If you were my patient I would give you the option of fat transfer to naturally enhance areas of your face that appear slightly sunken versus a facelift. I do not believe age alone is a reason to not offer these procedures.

Hello! Thank you for your question.
As far as I can see from your photos you seem to be a suitable candidate for lower blepharoplasty as well as facelift and neck lift if you do not have a medical problem.
It would be better face to face consultation.
Best Regards!

Thank you for your enquiry and sharing your photographs.

In general terms in a situation like yours a combination of upper eyelid blepharoplasty and trans conjunctival lower eyelid blepharoplasty (because there is no lower eyelid skin excess) can help reduce the effects of ageing around the eyes. The lower eyelids shape is probably related more to hereditary characteristics rather than ageing. It is also influenced by the fact that there is very little fatty tissue volume in the face.

The neck contour shows some volume related to the submandibular glands and digastric muscles which could potentially be reduced through an anterior necklift procedure. It is however difficult to evaluate on photographs and the skin laxity could make this an unsuitable treatment pathway. Because the scars around the ears would have a relatively strong visibility, facelift surgery seems like a premature approach.

Hi,

From looking at your pictures, I think you could benefit from the following procedures you mentioned.

I perform a procedure called a Sculpting Facelift on patients who are younger than the typical age people usually have a Facelift (around 50s-70s), and it produces great and preventative results. It will especially help tighten the lower face, nasolabial folds and skin beneath your chin – and give you better jaw definition which I can see has been lost.

I also think a Lower and Upper Blepharoplasty could help you achieve a more youthful appearance. However, I would recommend Facial Fat Injections in the tear trough region to help improve the hollowness there.

Based on these photos it looks that anterior neck lift, upper and lower blepharoplasty, and possibly periorbital fat grafting would be a set of procedures that I would more or less suggest. Hope this helps.

Your neck looks quite good and I would not recommend a neck lift. I would recommend an extended browlift. An extended browlift will lower the hairline, minimize the wrinkles from your forehead and correct the asymmetry of your eyebrows. This will also pull the periorbital tissue tighter and help your nasolabial folds. After this has been completed, you can consider lower blepharoplasty to transpose fat to decrease the tear troughs.

Best Wishes,

Gary Horndeski, M.D.

Thank you for the question. The correct approach depends on your series of concerns, general health, and the Surgeon's bias. If you visit 10 Italian restaurants, you are going to have 10 different marinara sauces.
I am assuming that you are in good health, but only a history and physical examination would allow for compete evaluation. Regarding the upper third of your face, an upper and lower eyelid blepharoplasty would be most appropriate and most effective in addressing the signs of aging/ tired look noted in the photos. In general, I am not a believer in fillers in the lower lid region. In fact, I dissolve hyaluronic acid filler performed elsewhere frequently in my practice.
Regarding your neck, you may be a candidate for a limited incision deep neck lift, but examination of your skin would provide more information. Sometimes a deep plane facelift is more appropriate, because it allows for skin removal.

I agree that a facelift is not really necessary. I think you would do great to have your upper and lower lids done. I don’t know why the surgeon didn’t recommend lower lids. I think it would be a nice improvement without the facelift

I agree with at least lower bleph, laser, upper bleph for you. I can't tell for face/neck for sure without seeing side photos of you. The biggest thing I believe you could benefit from that is not currently on the list is to consider some fat grafting if you have some to donate.