Facelift on thin weak skin - what procedures would be suitable for very wrinkled under eye area & lower face? (Photo)

Question

Facelift on thin weak skin I would like to have a facelift to improve my appearance. My skin is very thin and is starting to get quite slack especially my jawline and under eyes. I have had prednisone in the past which I am sure has contributed to my thin skin but am ok at the moment. What procedures would be suitable for the very wrinkled under eye area and lower face given my skin type?

Robert M. Wald, Jr., MD · Answer

With age, our skin falls, jowls develop, and our skin thins. Prednisone also contributes to this process. You are a candidate for a face neck lift and laser therapy to the eyelids. Non invasive techniques such as laser or micro needling would give minimal improvement. I would consult with a plastic surgeon and discuss these options.

Michael Zacharia, MBBS, FRACS, FAAFPS · Answer

We can perform collagen stimulating procedures to thicken the skin first before the facelift. There are a number of energy-based devices or biostimulating injectables available to address this concern. A thorough assessment including medical history review should be considered first. Regarding the under eye skin laxity and thinning, we can perform energy-based devices during the facelift surgery to tighten the skin and promote collagen synthesis. However, if the skin laxity is severe or with accompanying lower-eyelid sagging or laxity, a lower blepharoplasty with cantopexy or canthoplasty might be considered.

Jeffrey M. Darrow, MD · Answer

You are noting 2 separate issue.  One is your lined skin and the other is the loose skin in your lower face and jawline.  A facelift would best improve your skin looseness by gentle traction and smoothing.  However, a facelift doesn’t change the quality of your skin.  Some form of skin resurfacing would be needed, such as chemical peel, laser, radio frequency, etc.  A detail consultation with your plastic surgeon would help you understand your best options and expected results.  Best wishes.

Arif Eroglu, MD · Answer

Hello; Your cheeks sag. The Jowl and Marionette lines are very distinct. Malar field has flattened; eyebrows drooped. In terms of age; you look over 50 years. My suggestion is to you; Endoscopic Deep Plane Facelift, Temporal Lift to the lower eyelid; Pinch Blepharoplasty and Endoscopic lower face-neck lift.

Marguerite E. Aitken, MD, FACS · Answer

Surgical options are the best results for these areas. A in person consultation would help to explain the procedures that would most benefit your concerns.

Jacob Tower, MD · Answer

Hello, hope you are well. Based on the information and partial photo that you provided, you would be a great candidate for a deep plane facelift. Unfortunately the photo here does not provide a good view of your lower eyelids, but a lower blepharoplasty is typically the preferred method of treating a very wrinkled under eye area. These procedures can be done at the same time under general anesthesia. Good luck!

Cheers,
Dr. Tower

Cheers,
Dr. Tower

Ryan Rebowe, MD · Answer

I would consider a face and neck lift with fat injection to the face. Although your chin can't be seen clearly in this picture a chin implant is an excellent way to enhance your profile. The fat grafting will help to fill in the areas of volume loss from the prednisone.

Carmina Cardenas, MD · Answer

Based on the very few features we can see on your photo, you have developed different features to improve:
Very thin and wrinkly skin which surgery will do nothing. So you will need to improve importantly your 1)nutritional status, you just do exercise, have balance on your hormones (estrogens, testosterone, thyroid, etc) and levels of vitamins. 
2) improve your sleeping habits. 
3)exercise every day. 
4) improve your levels of stress (meditation and yoga)
5) Imrove your skin care. 
6)try the Injections of your own cultured Fibroblast every year to improve the thickness, elasticity and in general your quality of skin. 
After that, you may have a surgery which will have higher chance of being successful. 
You will be candidate for Deep planeMid Facelift, facial fat grafting and possibly Deep plane neck lift. 
Hopefully you understand my point. 
Be encouraged!!
Dr. Cardenas

Ronald J. Edelson, MD · Answer

Definitely a facelift. What needs to be done with the eyelids is hard to tell from the photos. However loose skin on the eyelids can be dealt with at the same time

Zeshaan Maan, MD · Answer

Your best bet is to have in person consultation with a plastic surgeon so that they can throughly evaluate your face and discuss the various age related changes that have occurred in terms of volume, tissue laxity, and skin changes. 
In terms of the under eye, assessing your tear troughs, the presence of fat herniation and excess skin will inform an appropriate plan. For your lower face, a thorough assessment of the neck will also be helpful but a facelift & necklift may be helpful.