I am trying to decide whether to have these procedures (see below) ? What should I consider for best result?

I am a 58 year old male. Have moderate fat under chin (between neck and chin), some loose skin on the lower neck, and a slightly drooping jawline or jowels. Neck liposuction for fat under the chin and "thermi tight" for loose skin around neck have been recommended for me. Nothing was being done for the jowels, as I did not want a face-lift because of the scar that would be left. What else should be considered and what else can be done for jowels with no scar?

Doctor Answers 4

50-year-old male facial rejuvenation and neck recontouring. Best advice?

Without seeing you face-to-face and without the benefit of a series of photographs I can only generalize by saying that you will probably be disappointed by a nonsurgical treatment.  Females can contract the submental skin dramatically but this rarely occurs in males leaving empty sagging skin that may be more bothersome to you.  Modern facelift surgery allows for camouflaging of incisions in ways that make them minimally if at all visible and rarely detectable by others.  In my opinion you should reconsider to avoid possible disappointment.  Best wishes and good luck with your decision,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Trying to decide whether to have these procedures (see below) ? What should I consider for best result?

 Hi, I have performed many facial shaping procedures over the past 30 years using dermal fillers, facial implants (cheek implants, chin implants), liposuction and/or facelifts.  Non smiling photos of your face from the front and side would help with the evaluation.  Following the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.   The following procedures would create a more ruggedly handsome face.

  • Cheek augmentation with cheek implants to add angularity to the cheeks and mid face.  This would be combined with liposuction to reduce the any excess facial fat to further define the cheek shape.
  • Chin augmentation, using a chin implant, to add projection to the chin creating harmony and balance to the lower face.  I have performed many Chin Augmentations using chin implants for over 30 years.  If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone. 
  • Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.

 I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

 My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions and no incisions extend or are placed within the hair.
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Male Facelift vesus Thermitight

at age 58, your skin elasticity is most likely suboptimal for the liposuction and thermi treatment.   The scars associated with a facelift heal well and are rarely a problem.  You should reconsider a facelift.  See a plastic surgeon who has experience with male facelifts.  There are subtle technical differences that will give you a good result.

face and neck lift candidate at age 58

At age 58, a face and neck lift procedure is usually required to lift the jowls and tighten skin and remove the fatty deposits in the neck. In our practice, we perform a high-SMAS lower face and neck lift which accomplishes tightening loose facial and neck skin, tightening loose facial and neck muscles, lifting the jowls, and removing the fatty deposits underneath the neck in addition to a platysma plasty. Placement of the incisions can make them minimally detectable when properly performed. For more information and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 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.