Full Facial Rejuvenation - Am I a Good Candidate for a Facelift? (photos)

Question

Hello, I want to rejuvenate my face and I would greatly appreciate advice regarding what surgeries would benefit me. | want to treat: Vertical depressions on forehead due to loss of volume, Horizontal wrinkles on forehead, Lower eye bags, Nasolabial folds , Hanging cheeks when looking down or tilting head. Volume / sagging in the area of submandibular glands and digastric muscles. Sun damaged skin. What surgeries or treatments would you recommend? Your advice is greatly appreciated! Thanks, J

Steven H. Wiener, MD · Answer

You have asked for recommendations for multiple issues, and I will begin at the top and work down. Vertical forehead depressions are most often treated with botox, which lasts about one year.  I often transfer fat to these vertical depressions.  A surgical procedure of cutting the muscles that create the vertical depressions is a longer acting procedure.  Horizontal forehead wrinkles can be treated with botox.  A hairline incision would allow access the muscles creating both the vertical and horizontal wrinkles, with excision of the muscles, a longer lasting result will follow.  Lower eyelid bags would best be treated with a lower lid blepharoplasty. A mid-face lift or a face-lift will address the lower face skin laxity.  I would advise seeing several plastic surgeons in consultation.

Alan Gonzalez, MD, FACS · Answer

Hello @Pioneering228290, thank you for your question. I would recommend non-surgical treatments and the use of technology that provides solutions for cheek volume and butolin toxin for laugh lines and wrinkles. Your skin is too young for a minimal facelift as from the photos you show me, you do not have enough sagging or significant wrinkles to warrant a mini facelift. Instead, you may benefit from non-surgical treatments such as Botox, fillers or treatments with ultrasound or radiofrequency technologies such as Ultherapy or Morpheus 8, which can help address early signs of aging. If you are concerned about sagging and premature aging, it is best to consult with a board-certified plastic surgeon who can evaluate your skin and provide personalized recommendations on the most appropriate treatment options. They may recommend lifestyle changes, skin care and non-invasive treatments before considering a surgical procedure such as a mini facelift. Best wishes!

Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Societ

Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science  Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Societ

John Michael Thomassen, MD · Answer

I would recommend a lower lid blepharoplasty, mini facelift, and fat grafting.  This would address the loss of volume around the eyes and the deep wrinkles.

Anil R. Shah, MD · Answer

Assessing candidacy for a facelift is best done in person rather than from photos. Volume restoration appears to be a key concern, and addressing volume loss can significantly improve your appearance. In the lower eye area, removing minimal fat can often yield better results. Additionally, focusing on improving skin quality and addressing laxity can enhance overall complexion and facial aesthetics.

Carmina Cardenas, MD · Answer

You have developed several features: lines as result of muscle activity (forehead lines, frown and crossfeet) which will need botox. 
You have developed sunken areas which will need volume: temples, lower eyelid crease (lower eyelid fat transposition), mid central cheeks, nasolabial folds and jawline which will need fat grafting. 
And lastly saggy deep tissues: mid face and neck. 
So you are candidate as well to Deep plane Facelift which means small skin delamination and extensive deep plane dissection to lift the natural fat volume to its correct position. Also  deep plane neck lift which means Reduction of submandibular glands, reduction of digastric muscle, reduction of subplatisma fat and tightening of the platisma muscle. All with the purpose to create a nice neck angle and better definition of the jawline. 
Be encouraged!!!! After the correct procedures you will look astonishing, fresher, natural and still yourself!!
Dr. Cardenas

Gary M. Horndeski, MD · Answer

You would benefit from a facelift, browlift and lower blepharoplasty. The browlift will improve the wrinkles/lines of the forehead and the eyebrows will be elevated at the orbital rim. The facelift will pull up the nasolabial folds and the neck. The lower blepharoplasty will need to transpose fat to minimize the tear trough deformity.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Stephen Prendiville, MD · Answer

The 3 basic criteria needed for a surgical solution are as follows: 1) aging face indications, 2) a healthy patient, 3) a desire to address these aging indications.
Although an examination is necessary to finalize any preliminary suggestions, I feel that a deep plane facelift will address the cheek, neck and jawline; the nasolabial folds are usually softened by this approach and the midface is self-volumized.  I perform a deep necklift to remove subplatysmal fat and shave down the anterior bellies of the digastric, usually preserving the submandibular glands, followed by a corset platysmaplasty and posterior platysmal sling.  An upper and lower lid blepharoplasty will address the upper third of your face.  I prefer to avoid browlifts in most men and would suggest Botox.  
Whether or not you are actually an appropriate candidate would require a consultation and physical examination.

Barry M. Weintraub, MD, FACS · Answer

You have excellent bone structure. Unfortunately, your skin is beginning to show the signs of aging as evidenced by the normal gravitational descent of soft-tissue structures. This happens to us all. Starting from the top -- and only having the opportunity to judge from your photos -- because of your recessive hair line, I would not advise upper-third or temporal surgery. Your vertical and horizontal furrows of your forehead would best be treated with Botox approximately 3-4 times per year. For the deeper creases, I would augment with two sessions of filler to help restore volume. Your lower eyelids are puffy, which is a result of herniated suborbital fat, easily removed from the conjunctiva with corneal guard in place. Your NL folds and hanging cheeks could be addressed with a midface and lower-midface suspension. I employ a hybrid lift, which is a combination of  Deep Plane, SMAS, and Subcuticular. I am not in favor of the submandibular-gland resection or digastric-muscle resection, since the former can potentially lead to your inability to salivate and therefore lubricate your food, and the later can affect the ability to make fine movements with respect to turning your head. Regarding your sun-damaged skin, lasers can work wonders. Facelift surgery in men must be done very carefully to ensure that the result is extremely natural looking, without any telltale signs of surgery. Incisions should be hidden and sewn with the finest suture material in order to produce a very sophisticated result.

Camille Cash, MD · Answer

You do appear to be a good candidate for a facelift.  This would address the skin laxity and lift the sagging tissues.  Fat grafting can be considered for further contouring.  The best place to begin is a consultation with a board certified plastic surgeon near you.

Mats Hagstrom, MD (license on probation) · Answer

It sounds like you already have a pretty good assessment in regards to what you need.
It sounds like a facelift brow, lift and facial volume restoration is what you’re looking for.
Volume restoration especially of the midface can be accomplished with multiple treatment options.
Fillers in the right hands is probably the best Facial restoration treatment available.
The drawback is obviously the lack of longevity.
Still, fillers, have the advantage of being precise, predictable and forgiving if patience don’t like the outcome.
Check out the work done by David Mabrie MD in San Francisco.
I can’t put a link to a website on this site so you’ll have to look up his website. he does only facial fillers, and his work is some of the best I’ve ever seen.
This in combination with the standard skim surgery would be an ideal outcome.
I’m not suggesting everybody fly to San Francisco to get fillers, but understanding what this treatment can accomplish is helpful when comparing results by other providers.
His work is what I consider the gold standard for facial volume restoration using filler pad
Best,
Mats Hagstrom, MD

Full Facial Rejuvenation - Am I a Good Candidate for a Facelift? (photos)

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