Do I need a facelift or midface fillers? (Photo)

Question

I'm nearly 42 years old and have had Morpheus 8 (currently on 1 of 3) microneedling, Sculptra, full face including lower face and neck botox. I've previously had filler in my jaw, pre jowl, chin and lips but 2 years ago was last time. I have let it dissolve naturally as I wanted to see my natural (ish) face and I font want to get in the trap of repeatedly filling my face and becoming distorted. My question is, do I need mid face filler or a facelift?

Richard G. Schwartz, MD · Answer

Based on your photos, I would suggest mid face fillers to add volume in the upper cheeks where I think I detect a slight depressed shadow, along with filler in the pre-jowl depression to smooth out front of jawline.  You don't seem to have enough laxity of skin and soft tissue to warrant surgical lifting at present.

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

There doesn't seem to be much laxity in the lower face which is one of the primary goals of a facelift intervention.

As a way of determining potential benefits from a facelift intervention I advise patients to examine their features lying down completely flat with no pillow. In this position, the face typically looks similar to the impact of a facelift intervention. If you feel that at this point in time it would give you a group of changes that you like over and above what you can achieve with nonsurgical treatments, it may be worth having surgery. In general terms though, your facial configuration is very good and facelift surgery seems counter-productive at this stage.

Mats Hagstrom, MD (license on probation) · Answer

A mid facelift is completely different than a facelift.
The two procedures really have nothing in common other than the name.
A mid facelift restores mid face volume and a facelift treats jowls and neck activity.
To make a facelift assessment we need to see proper facial pictures especially profile pictures. For a mid facelift we need to see the mid face or the transition zone of the lower eyelids to the mid face(blocked in 2/3 pictures) 
I don’t think either procedure is indicated. 
Best,
Mats Hagstrom, MD

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