Best Way to Treat Jowls, Nasal Labial Folds, Festoons? (photo)

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.However, if you learn that you are a candidate, this may be helpful. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.The best candidates for #LiteLift are patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

In our office, we review with you both surgical and non-surgical alternatives on every patient.  At 44, despite not seeing every view I need to see for a facial consult, I doubt those are your only alternatives.  A significant amount of rejuvenation can occur with skin care, photofacial & laser treatments, Ulthera for lifting and tightening, combined with botox and fillers.  Surgical facial options include laser liposuction of your neck and jowls and fat grafting before a mid-face lift. 


Best wishes!!

You will get various opinions. Surgeons will typically recommend surgery, while non-surgeons will recommend non-surgical techniques to improve the jowls, folds, and wrinkles. You may get great results with either approach.

 

You are still young and appear to have good skin quality and bone structure. Based on the information provided, you may consider a lower facelift, cheek lift, neck liposuction, and facial fat grafting (injection). Typically, I avoid liposuctioning fat from the face. Lastly, if you haven't already, you should consider non-surgical options such as facial fillers or other non-surgical facelift options to rejuvenate the face without surgery. Without a comprehensive evaluation, it would be difficult to provide more specifics.

 

Your photos  show evidence of looseness and sagging of the cheek soft tissues, creating deepened nasolabial folds, marionette folds, and jowling.  I also notice fullness under your chin in the front of your neck.  Although filler injection in the nasolabial and marionette folds can soften and camouflage these grooves as a temporary measure, the best approach is surgical with a short scar face lift focusing on elevating fat and skin upward in the cheek and reducing the fullness under the chin with liposuction and muscle tightening.  A chin implant could be considered if you are bothered by your slightly small chin.  I often use conservative liposuction in the jowl area to reduce the fullness there,  but never over the cheekbone area.  This combined approach should freshen the appearance of your cheeks and neck.

After examining your profile, you certainly would benefit from a neck lift, chin enhancement and probably some fat grafting.

Personally, I would not recommend liposuction from the cheek areas.

If you are unsure about the proposed plan, visit another face specialist to obtain a second opinion.

Facial rejuvination surgery can address the concerns you listed. Each surgeon has their preference for which procedures they feel are most appropriate. In my opinion a short scar facelift and Platysmaplasty (probably what your surgeon is referring to as an "anterior neck lift") would be and excellent way to achieve long lasting and substantial improvement in your lower facial features. The attached video explains the different incisions types that are used with lower facial rejuvenation surgery.

The picture demonstrates symmetrical aging from the eyelids to the clavicles. Full facelift will collect all aesthetic problems observed. A mid face lift will do nothing to improve the neck.

Basically, you are in the early stages of needing a face lift done. You will get different opinions depending on different surgeons' preferences. You can go with a lesser procedure, but if you really want a nice result that will last, have a facelift done.

A frontal photo could have added more information to this discussion, however it appears you have some standard concerns.  A facelift ( there are several types which would do an excellent job, but all should involve vertical lifting of the SMAS) combined with some judicious neck liposuction, should give you a thinner neck contour, a smoother jawline, help lessen your nasolabial folds and accentuate your cheek bones.  As loss of volume in patients faces makes them look older, I would not do liposuction in your face!  If you have any concerns, meet with a board certified plastic surgeon and discuss your concerns.

A lower facelift would be a great way to treat your jowls, nasolabial folds, and sagging neck skin.  Also, instead of liposuction of the neck I would recommend direct excision of the fat if you're getting the facelift as this would provide excellent access to and visualization of the excess fat.  The entire procedure is very well tolerated and usually takes 3-5 hours.  The recovery is about a week with any discomfort well treated with oral pain medications.  Having done many facial cosmetic procedures, it appears as though you can get an exellent result!  Thanks for your question...Dr. Schreiber.