Which would you recommend; Mini lift, Facelift or fillers? (photos)

Please advise whether I ready for facelift or might be able to address my issues with fillers. Can something be done for the Ptotic chin?

Doctor Answers 45

Facelift or Fillers?

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Your photos demonstrate many of the typical changes of aging with increased skin laxity, loss of facial volume of fat, descent of soft tissus of the mid-face and jowls, loose skin in your neck, and separation of the platysma muscle or platysma banding in your neck. So there are noticeable changes from your eye level into your neck, along with a ptotic chin. While fillers are useful for softening skin folds and replacing modest volume loss, they simply are not capable of, or appropriate for correcting all of these noticeable changes, and if overused will result in an unnatural or puffy sort of appearance.

A more natural and balanced approach involves lifting or repositioning the descended or sagging tissues, appropriately tightening loose or sagging skin, repairing the separated platysma muscle to correct the bands, and replacing the atrophied facial fat by autologous fat transfer. So this translates into a facelift with fat transfer to your cheeks and the area around your mouth. Fat transfer can also provide some increased projection to your chin, or you could consider a modest chin implant. Repairing the platysma muscle is accomplished through an incision under your chin which can also be used to correct your ptotic chin. The so called "mini" face lift produces mini results which are not long lasting, and cannot correct all of the changes that you see and give you a balanced result.


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I would recommend a full facelift for you.  This would best improve your midface, lower face, and neck.  A small chin implant can be done at the same time to improve projection in this area.  

I Recommend Facelift With Fat Transfer

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Thanks for your question and photos. You are showing the usual signs of aging, which are skin stretching from a loss of elasticity and loss of facial volume. Youthful faces are full and do not sag. So a facelift with fat transfer should be considered in order to return you to a more youthful appearance. The facelift will remove the excess skin, raise the jowls, and tighten the bands in the neck. The facial volume loss is addressed by adding filler. Although you can use fillers such as RADIESSE or JUVÉDERM VOLUMA XC, fat is your best choice. It is the longest-lasting option and can be done at the same time as the facelift. I would wait until after your facelift to address the chin. If it never bothered you before, addressing the sagging skin and bands in the neck may not direct your attention to the chin. It is easy to do at a later date if you so desire. Best wishes.

Facelift or fillers

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Thank you for your question and sharing your photos.  Based on your photos, your aging changes appear to be most pronounced in your lower face and neck which would make you a better candidate for a facelift in my opinion.  A chin implant could be performed at the same time to improve the balance in your profile.   I would recommend consultation with a facial plastic surgeon to discuss what option is best for you.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

The procedure depends on what you wish to improve...

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If you just want a little improvement in the jawline, a mini facelift would suffice. If you want your neck smoothed, then a facelift would do a great job of both improving the neck and jawline and improving the droopy chin. Fillers would be good for filling the smile and marionette lines. Ideally combination of these procedures would give the best and most long lasting results. Be sure to consult a facelift specialist to answer these questions for you in person.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Advice you against fillers

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Fillers can be grotesque, toxic or produce mid/long term serious hazards and deformities. From the pictures I think you need a neck lift with intensive platysma and SMAS work, aka platysmaplasty popularly. You will address your hanging jowls and the vertical neck bands.

Few surgeons have experience, do research well on this topic.

Alejandro Nogueira, MD
Spain Plastic Surgeon


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Thank you for your question and photos and given the amount of age related changes you would benefit from a full face and neck lift

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Best procedure for facial rejuvenation

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You are demonstrating significant volume loss, a weak chin and laxity of facial tissues and skin. Best results will be accomplished if all of these issues are addressed. We usually do this during one facial rejuvenation surgery in order to spare our patients multiple procedures and multiple recoveries.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Facelift Options +/-Fillers

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Although an exam is required for the best opinion, in my hands you should do well with a LiteLift
 procedure - a modified facelift that is less invasive and can even be performed in the office with local anesthesia and oral sedation. You age 3 main ways: skin laxity - hence the lift recommendation, loss of volume - so fillers or fat transfer helpful. The ptotic chin can also be corrected. 
I typically perform fat transfer as part of my facelift procedure whether traditional or a mini scar technique (most common). The reason is that part of the aging process is loss of fat in the temples and cheek regions which varies from person to person. There is a limit of how much fat can be safely injected into one area. The amount of fat that remains over time is variable from patient to patient. For some patients, more fat or other fillers may need to be transferred in a subsequent surgery to maintain or supplement the desired results.The survival of fat transfer (lipoinjection) is highly technique sensitive so choose the plastic surgeon with the most experience in this technique. See the below links for added details.

Best results from skin care, fillers and facelift

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Hi Agirl61. Thank you for sharing photos. You would benefit from professional skin care, fillers and a facelift. The changes with age in skin texture, pore size, pigmentation, elasticity, etc. respond to topicals (e.g. Retin A), chemical peels, laser resurfacing etc.  Fillers or fat transfer provide volume to key areas like tear troughs, around the nose and mouth, lips, and temples that aren't always included in facelifts.  The lift will reposition tissue (help ptotic chin, jowls, and neck bands) and remove excess tissue.  Your decision should be based upon what you are trying to achieve, your health, ability to have downtime, etc.  An in-person examination of your skin quality and how much improvement is achieved by manually pulling to simulate a mini vs full facelift is central to a recommendation.  Consult with an ABPS certified plastic surgeon, their medical aestheticians, and laser specialists before choosing. Good luck!

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.