Mini lift or mid facelift for my sagging cheeks, nasolabial lines, jowls and tear troughs? (Photo)

Question

I'm bothered by my sagging cheeks, depressions in the eye trough area, lines around the mouth, nasolabial lines and the beginnings of jowls along my jaw line. Due to Hashimoto's, fillers are not a recommended option for me. Which is my best option, a mid- facelift or a mini facelift to address my concerns? I've included photos in various lighting including natural sunlight, and the arrows indicate the areas I specifically want to correct.

Ronald J. Edelson, MD · Answer

I would recommend a standard facelift to address the neck and jowls. A mini facelift means different things to different people but usually involves cutting corners. Forget the mid face lift. Never been impressed that it did anything at all. You might benefit from lower lid eyelid surgery. Your kids look a little puffy. Personally I’ve never thought the tear trough was even a real thing or just something that plastic surgeons dreamed up. Also no fat injections. I’m trying to keep you away from junk procedures that surgeons will try to sell you. They’re entirely unnecessary. Keep things simple

Thomas A. Mustoe, MD, FACS · Answer

Most surgeons when performing what they define as a mini facelift involves some skin undermining and little or no undermining of the deeper tissues (SMAS) which has multiple fixation points ( retaining ligaments to deeper tissues.  The correction is obtained by sutures that pull on the tissues that have not been released. This gives a mid facelift that is subtle and not lasting because inevitably the tissues relax and pull through the sutures.  A properly done midface lift ( a variety of approaches) will release the deep plane tissues and reposition them in a new position giving lasting and natural results.  Consult with a surgeon who does extended SMAS or deep plane approaches.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may be a candidate for a traditional facelift to improve skin elasticity, lift fallen tissue, and define the overall face shape. Excess fat in the neck and jowls can be removed, along with any excess skin as necessary. Underlying tissue that has fallen over time can also be repositioned to achieve optimal results.
I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to conduct a thorough physical examination and determine the best option to address all of your concerns while helping you achieve your aesthetic goals.

Jason Emer, MD · Answer

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

John Michael Thomassen, MD · Answer

You have mild nasolabial and jowl lines.  A mini facelift would be ideal as this would lift your cheeks, and jowls and tighten your neck.  A midface lift alone may not improve the jowl area and definitely will not tighten the neck, even if it is not your main concern.

Trang Vo-Nguyen, MD · Answer

Thank you for providing photos of your face in multiple angles. Considering the areas that you would like to improve and given your facial shape, a mid-facelift would be a better option.

Darryl J. Blinski, MD · Answer

Based upon the excellent posted photos, I recommend mini FL/NL SMAS plication w nano fat graftig to tear troughs, naso labial folds, etc areas. Fee $15,000 ranges.  best to virtual consult.

Mini lift or mid facelift for my sagging cheeks, nasolabial lines, jowls and tear troughs? (Photo)

Answers (7)

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