I have been given 3 different suggestions from 3 different surgeons as to what procedure to use. What do you suggest? (Photo)

I have had 3 consultations with facial plastic surgeons. I have gotten 3 different suggestions. One suggested liposuction to the cheeks with a lower lift, one suggested a MAC lift with a Co2 laser to the chin and one suggested a SMAS lift with a chin implant. I would appreciate another opinion at this point. I have attached front and side pictures. I am 50 years old. Thank you.

Doctor Answers 5

Different Recommendations for Facial Rejuvenation.

Different Recommendations for Facial Rejuvenation.
It sounds as if the advice you have been given is simply variations of a similar theme.First, there is no doubt you need a full face and neck lift.Whether this is done with a MACS Lift or a SMAS Lift is surgeon preference.I, personally, prefer the MACS Lift, as I think it provides a more natural result and a better improvement of the neck.You do appear to have some excess fat under your chin.If this is so, removal of this is necessary for an optimal improvement.Using the MACS technique, this is generally done with liposuction.Many SMAS techniques will open the area under the chin and remove the fat manually.You also, definitely have a recessive chin.Augmenting this will provide a more marked improvement of your neck.However, this is not absolutely necessary and is a personal choice you can make.The 2 things I do not believe you need and would recommend against are liposuction of the cheek and CO2 laser of the chin.The latter will not significantly improve your appearance.The former, cheek liposuction, can actually make your appearance worse, as you need fat added to the cheek, not removed.

Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Chin implant/ face neck lift candidate

The photograph shows a significant weak chin profile, jowls and neck skin laxity. A chin implant would give added projection to the chin and more structural support to the neck area. A comprehensive lower face and neck lift will address  tightening the jowls, removal of fatty deposits in the neck, tighten the neck muscles in 3 locations, tighten that SMAS layer in the face and tighten excess facial and neck skin. For many examples of this combination, please see the link below to our facelift/ chin implant photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

I Would Recommend a Lift and a Chin Implant

To be able to accurately answer your questions, I would need to know your goals.  I am going to assume your goals are:

1)  Create an Elegant and Defined Jawline
2)  Improve the Angulation Between the Chin and Neck from Profile View.

In order to understand the any facial plastic surgeons recommendations, you must first understand the cause of your concerns.  In your case, your issues are:

A)  Loose skin of the neck
B)  Jowls
C)  Excess fat in the neck region
D)  Small Chin

You must address each one of these issues.  In my practice I would recommend:

1)  SMAS Lift with a vertical pull in the cheek and a lateral pull in the neck
2)  Medium extended anatomical silicone chin implant.  I believe is silicone are the safest implant material in the chin
3)  Open liposuction of the jowls
4)  Though the same incision for the chin implant, I would remove the excess fat in the midline of the neck.  I would also tighten in the middle of the neck by performing a platysmaplasty.

You have a heavy neck in the midline.  I would highly recommend direct liposuction in the region and a platysmaplasty to create definition of the neck from the profile.  

I hope this helps.  

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews

Facial rejuvination


Thanks for posting.  Reviewing your photos, I would agree with the chin implant and facelift.  These are likely to give you the most bang for your buck.  (SMAS, deep plane, or MACS will give you a good result with the right surgeon).  Best of luck!

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Facelift with chin implant

Looking at your photos, you would probably get the best result with a facelift and chin implant.  If you do just the facelift, you will get improvement, but is you also do a chin implant you will have a much sharper jawline/profile and the neck will look much better.  Laser is great for fine lines and wrinkles, but you need something more than that.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 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.