Recommendations for facial sagging? Lower bleph, Pinch under eyes, Or is facelift only worthwhile option? (photos)

Question

I'm 49 and starting to really notice my face aging. In first picture (not smiling) you can see tear trough deformity (heredity, always hated) and nasolabial folds that run parallel to each other and look terrible! What is difficult to see in first picture is loose skin under my eyes but that is easy to see in the second picture (smiling) as it crinkles up. What would you recommend to lift the sagging cheeks (nasolabial folds), fix loose skin under eyes? Lower bleph? Pinch? Facelift?

Suleyman Tas, MD, FEBOPRAS · Answer

Dear jim240,

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 mid-face lift combined with Lower blepharoplasty, the lift will eliminate the sagging cheeks/nasolabial folds and the lower blepharoplasty will remove the excess skin under the eyes and prevent your skin to collect under the eyes when smiling. Furthermore, I would also suggest you to get fat injections for your deep smile lines to fill in the lack of volume. For the midface lift and lower blepharoplasty i would strongly suggest to find a expert surgeon who does endoscopic scarlesss lift and follows the vertical lift technique in order to get a much natural lifted look.

Best Regards,
TAS TEAM

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You may benefit from a lower blepharoplasty to smooth the transition between the lower lid and the upper cheek area. During this procedure, loose muscles are tightened and fat below the eye is repositioned to add volume and create a firmer, more youthful appearance. 
Since the facial sagging you’re referring to appears minimal, you may want to consider RF microneedling treatments to tighten and contour sagging skin. This option can restore the skin’s elasticity by stimulating the body’s natural collagen and elastin production, producing smooth results that can last for up to five years or more. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can discuss your concerns with you and determine the best course of action.

Alan Gonzalez, MD, FACS · Answer

Hello Dear @jim24, thank you for your question and showing your picture. If you want a more definite solution suggest a facelift of the second and third thirds of the face and blepharoplasty. In this kind of interventions is important to have a surgical plan that takes into account the relationship the areas to be treated have with the other areas of the face to get an even, harmonious and long lasting result in the over all face. Best wishes! Alan Gonzalez MD, FACS.

David Nicholas Csikai, MD · Answer

There are  few options depending on what your expectations are and how aggressive you want to be.  Fillers such as restyle may be used for the tear trough and nasolabial folds and cheeks along with skin treatments such as lasers feels. Surgically a mini facelift with lower lid blepharoplasty may be performed.

Gurkan Kayabasoglu, MD · Answer

Hello. In order to understand whether you need a facelift surgery, we need to see photos from the side, from the three quarters and also leaning forward. I can see from the photo that you have a slight platysma ban on your neck, but the photos you sent are not enough to evaluate this. Therefore, looking at these photos, mid-facelift and lower eyelid surgery seems to be enough for you. It is possible to combine this with a single incision under your eyelid. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile. You can also book an online consultation and discuss your problems with me. With all respect.

Recommendations for facial sagging? Lower bleph, Pinch under eyes, Or is facelift only worthwhile option? (photos)

Answers (6)

Answer: Facial aging

Answer: Facial aging

Answer: Mid-face lift combination with a lower eyelid surgery!

Answer: Mid-face lift combination with a lower eyelid surgery!

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Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.

Recommendations for facial sagging? Lower bleph, Pinch under eyes, Or is facelift only worthwhile option? (photos)

Answers (6)

Answer: Facial aging

Answer: Facial aging

Answer: Mid-face lift combination with a lower eyelid surgery!

Answer: Mid-face lift combination with a lower eyelid surgery!

Browse related questions

Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.