Facelift or sculpting? (photos)

my in my mid 30's my cheeks have dropped causing jowels. I work in media and being under the spotlight has knocked my confidence. Asked atleast 5 surgeons if I will be a suitable candidate for a short scar lift but all say no. I'm really confused as I want the bottom cheek lifting and neck defining will liposuction work? I already have fillers which have lifted my upper cheek causing less jowls but the problem is still there. Is there anyone that can help? My eyes have dropped too

Doctor Answers 19

Determining the Facial Procedures Best For You

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. It is possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result. The best procedure approach will be discussed in greater detail during your one-on-one #consultation. I invite you to visit PacificCenterPlasticSurgery.com to view a complete list of surgeries commonly performed. 

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives. It is extremely important to seek a board certified plastic surgeon highly trained with your desired procedures. I also encourage you to look at before and after photos of the surgeons actual patients. Also, reading patient reviews of those who have had combined surgeries will be beneficial. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Lowerface-neck lift, possibly chin implant

It would be very difficult to give you good advice based on these photos. It appears that combination of neck/lower face lift to tighten you neck and clean your jawline would be working for your. I do not see your chin clearly to suggest chin implant? Liposuction of neck, jowls and jaw line plus chin implant may be an option? Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Surgery should focus on your lower face

Dear Ms. Zara,
While your photos are difficult to interpret, it's clear to me that your problem is facial proportion: your lower face is smaller than your more youthful appearing upper face. Your cheeks (mid-face) have beautiful volume and contour because of your ample cheekbones which provide support to the cheek tissues. However, your lower face is much smaller because your jaw is small and your is chin set back. With such little bone support, your lower face tissues appear to slide down and fold over - this manifests as jowls, a double-chin and extra neck skin. Removing volume through liposuction alone is not the answer - this will worsen facial imbalance. I also recommend against more mid-face filler. Instead, augmenting your jaw and chin will balance your upper face and also provide bone support, and *possibly* a neck lift with sub-mental liposuction will restore beautiful proportion.
All the best,
Dr. Rad

Ariel N. Rad, MD, PhD
Washington DC Plastic Surgeon
5.0 out of 5 stars 51 reviews


Better photographs are the key to the answer.  For a better chance of a useful answer, have someone take photos of you directly from the side with your head facing forward and resubmit the question.  Or better, visit a qualified surgeon for evaluation.
That being said, it does appear that liposuction of your neck along with a neck and jowl lift would help you significantly.  That is a procedure I perform on a lot of younger patients with limited mid face issues. The recovery is much shorter than a "facelift" and the results can be spectacular.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 39 reviews

Facelift or Sculpting?

Hello.  Thank you for your question.  It is really difficult to make any accurate assessment of your neck and jawline with the pictures that you provided.  Your chin is tucked down in all of the pictures which will make the neck skin and soft tissues appear lax, even in someone with a perfect neck and jawline.  Pictures with your head in a neutral position would provide much more useful information.  You are very young at this point to consider a facelift.  Often, less invasive or nonsurgical options can be considered for women in your age group who likely still have pretty good skin elasticity.  Nonsurgical options, such as fillers or fat injections to restore midface volume, Kybella injections to reduce fat under the jawline and chin, and non-ablative laser treatments or radio-frequency treatments to provide skin tightening may be a consideration.  For individuals with more fat in the neck, liposuction with, or without, a platysmaplasty may be a consideration to improve the neck and jawline without the need for a facelift.  I would advise you to seek a consultation with a board certified Facial Plastic Surgeon who specializes in facial rejuvenation and allow them to assess your anatomy, concerns, and goals in order to determine the best treatment plan for you.  Best of luck to you in achieving your aesthetic goals.

Michael Boggess, MD
Nashville Facial Plastic Surgeon
4.9 out of 5 stars 41 reviews


I suspect that because you need work in your cheek jowls and neck that surgeons feel that a short scar will not solve your problems.
The addition of incisions behind your ears (that are hidden) would be more likely to get the result you desire.

Michael J. Yaremchuk, MD
Boston Plastic Surgeon
3.7 out of 5 stars 24 reviews

Explore Facial shaping/sculpting options

You've made a partial diagnosis: Media & HD in particular is extremely unforgiving as the #perception of youth, beauty and attractiveness are valuable commodities, which can be spuriously equated with ability and worth.  So what's a 30-something woman to do?  Investigate nonsurgical options such as Ultherapy for the lower face & submental area +/- Kybella (Deoxycholic acid) for nonsurgical fat dissolution may be viable both from recovery time as well as the fact that your mandibular jowls aren't extremely pronounced.  Your young age, darker complexion are compatible with non-surgical modalities.  If the cost is excessive, try facial contouring, the "Nefertiti" neck lift, which is a combination of Botox and Hyaluronic acid fillers (to address the marionette's lines).  Your lateral orbital rim is remarkable for what is known in L.A. as the "Charlie Brown" eye, i.e. loss of overlying fat, leading to a "skeletal" appearance.  Belotero is a smooth HA, which is suitable for this area.  Take a breath, investigate and realize that there are many nonsurgical options, which will produce attractive results, which can be "tweaked" as you age.  

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Mid 30's my cheeks have dropped causing jowels.

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that developed early, jowl formation. From the photos your cheeks are flat anteriorly (in the front), jowls are present and the chin is weak. These factors combine to create a rectangular shaped face.

Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

A weak chin 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 and highly effective.

"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
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • 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

Facelift or sculpting?

A facelift with Platysmaplasty or neck muscle tightening through an incision underneath the chin as well as around the ear is the only effective method to tighten and correct the neck.  Do not consider liposuction as the skin will likely sag more and you may have irregularities in the skin.

The Concept Facelift Under Local Anaesthetic

Thank you for your question Zara, I have pioneered my Concept Facelift, performed under local anaesthetic this innovative procedure combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days.  This procedure is very suited to patients who concerns are jowls and neck line, wanting the restored contour.

The Concept™ facelift is suitable for men and women who wish to reduce sagging in the lower face and neck and regain a more natural, rejuvenated appearance. The procedure is less invasive than a traditional facelift and there is less scarring, bruising and swelling for a significantly quicker recovery period.

What are the benefits of The Concept Facelift:

  • Minimally invasive as it is a short scar facelift
  • There is minimal bruising and swelling, especially when compared to traditional facelifts
  • As the procedure is performed under local anaesthetic, you can go straight home following the procedure
  • Full recovery in a matter of days rather than months
  • Significantly less risk than Facelifts performed under general anaesthetic
  • Fresh, youthful and long lasting results
Zara from your pictures it is hard to assess your skin laxity, so I would advise you to come for a private consultation.

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.