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.

I mentioned in my book, “The Fine Art of Looking Younger,” is that if you are around the fourth decade, you start to manifest some of volume loss and facial descent changes. Basically, there are two parts of facial aging that people are becoming aware of: one is that there is loss of bone, muscle and fat and the skin gets thinner which is called volume loss with the face collapsing a little bit and the lines become little deeper; secondly, there’s looseness of skin and of the supporting tissue.

A nasolabial fold is an area that is often referred to as a parenthesis. Very often, the solution by a lot of surgical colleagues is try to do a mid-facelift. This means to lift the mid-face and the cheek area and go vertically upward to try to soften the nasolabial fold. This will create higher cheek fullness.

From my experience and in the past 20 years of different mid-facelifting procedures, I have found that some procedures tend to push the mid-face too wide. Others also look very good in the beginning where everything is high, but then eventually tends to descend. So you have to ask yourself also about how much this area bothers you.  

The one thing that I can’t determine from your photos is of course how the skin feels. When I evaluate a patient, I look at them and I move the skin to see how much movement there is. Basically, in lifting procedures there has to be something loose to lift. If something is not that loose, then I will not be able to move it very much. So you may wanna consider more conservative options related to the nasolabial fold.

On the other hand, I think the best procedure when it comes to jowls is some type of face lifting procedure especially when someone has very loose skin in the jawline. As the face descends and sags, we are able to successfully redefine the jawline by lifting the skin and soft tissue underneath called the SMAS. The SMAS is often referred to as a muscle by a lot of people who research face lifting, but it’s actually the tissue that supports the skin and has to be tightened. When you look at the mirror and you lift your skin in an upward and back direction, you can get an assessment of how loose and tight your skin is.

So before you proceed with a surgical procedure with a combination of other procedures, see if your surgeon really understands what your expectations are. Sometimes there’s a miscommunication where surgeons are happy with some type of improvement but the patient wanted something a bit more dramatic or didn’t want something so dramatic. So it’s critically important that you communicate with your surgeon and get more than one opinion before you commit to any extensive surgical procedure.  i hope this was helpful, and thanks for your question.

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!!