I'm a 57 year old female with wrinkles and loose skin. Should I do a SMAS Facelift or fillers? (photos)

The first photo at 50. The second At 52 still looked good. The last one now. :/ Had endoscopic mid face and brow done at 46. Was very happy. Now things look different and I don't like what I see when I look in the mirror anymore. Some say no facelift... Do fillers. Of course, those are the professionals that don't do surgery. The plastic surgeon thinks both. I would appreciate opinions from professional plastic surgeons with No Agenda.
 I am 57 now. Is it better to wait as long as possible or do it before more wrinkles and lots of loose skin? I really hate the volume loss I am seeing this past year, and the beginning of jowls and Turkey neck.

Thank you in advance!

Doctor Answers 5

Fellers versus face lift

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Fillers are  a temporizing way to augment an area of the face such as the cheeks, nasolabial folds, and lips.
A facelift involves tightening facial muscles, jowls and SMAS, tightening neck muscles, removal of fatty deposits in the neck that are present, and tightening loose facial and neck skin.
For many examples, please see the link below to our facelift  photo Gallery

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Liquid facelift for now

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As you say, loss of volume is very aging. Unless your neck skin is substantially lax and loose, I see no reason from the photos not to hold off on surgery for a while and do fillers. And this comes from a surgeon whose favorite surgery is doing a facelift.

Faial Rejuvenation with Lift or Fillers

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We lose facial volume as part of the aging process. Fillers or fat injections may help in some patients with this problem. Although these techniques will decrease wrinkles I would not recommend this approach; do you want to be heavier? - just gain weight !  If you have sagging of your skin and underlying muscle a lift would be the most appropriate choice. Injections don't lift. You have multiple choices; decide what you want to change and then consider all your alternatives.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rejuvenation options

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Dear Italian1,

There are often no right or wrong answers to facial rejuvenation options rather preferences based on recovery time, cost, and final outcome.  The best result will likely be provided by a short incision face/neck lift to lift and tighten the tissue that is causing jowling and cheek looseness.  I would also look into fat grafting at the same time since this will have the best impact on the midface area and also compliments the face lift portion of your rejuvenation procedure.  The before and after photo link below is a facelift/necklift and fat grafting patient of mine at 2 weeks following her surgery.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Facelift or fillers

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Dear Italian1,

  • You have beautiful skin with very pretty features
  • I don't think that you would need a facelift
  • Fillers can be placed in the temples, cheeks (to blend them), and maybe around the upper eyelid and under the brow (take a look at the fullness in your brow between the upper eyelid and eyebrow)
  • For the mild jowls, I have done a microliposuction in that area with very nice results (see B&A pic)
  • I think you would look too tight with a facelift
  • Alternatively, facial fat grafting would be great as well if you wanted something that would last longer than fillers

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 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.