I have some sagging on my lower face but I have a health issue that may make surgery unwise.

Question

I have sagging on my lower face, some jowling, and marionette lines along with some sagging on my upper neck. I have lost weight twice in the last five years and this hasn't helped. However I have Ehlers-Danlos syndrome - hypermobility type and my connective tissues are lax. I suffer easy bruising and tendon problems, and have very soft skin to the touch. Would I be a candidate for surgery? Or does my condition mean it's not a good idea? Thanks in advance for any answers!

Corey S. Maas, MD · Answer

Thank you for the question. Although surgery may not be the
best option, there are several wonderful nonsurgical options that provide
excellent results. Soft tissue fillers can be used for 2 main purposes: first,
to soften transitions between the cheek and lip (such as the nasolabial fold,
marionette lines, tear troughs), and improve depressions and irregularities;
and second, to provide volume such as in the midface, temples, and along the
jawline. The hyaluronic acid fillers (such as Restylane, Juvederm, Restylane
Lyft) are great for treating deep nasolabial folds or marionette lines.  Restylane Lyft can be injected just in front
of the jowl, thereby camouflaging the jowl, and creating a smooth and linear
jawline. Juvederm Voluma or Radiesse are great for improving the lost midfacial
(cheek and directly below the cheeks) volume that occurs with aging.  Another great “nonsurgical face lift” option
is Ultherapy, which is FDA approved for lifting and tightening the neck, face,
and brow. Ultherapy is intense focused ultrasound energy delivered through the
skin’s surface with selective creation of thermal injury zones into the deeper
connective tissues (called fascia) of the face and neck, heating this tissue in
a pinpoint way, resulting in contraction of the fascia. This results in lifting
and tightening of the skin on the neck, under the chin, along the jawline, and
on the brow. And for improvement of fat under the chin, a non-surgical option
is Kybella injections. Kybella causes destruction of the fat cells with release
of triglycerides leading to a local inflammatory response. As a result of this
inflammatory response, there is a lifting and tightening of the neck skin.
Kybella injections are performed every 1-2 months and require about 3-5
treatments, depending on the amount of fat that is present. Prior to any
intervention, however, a proper physical exam is necessary. I hope this information helps, and I wish you the best of
luck.

John Michael Thomassen, MD · Answer

This condition precludes you from having surgery unfortunately.  You may suffer severe wound healing complications.  I would not recommend you proceed.  A good option would be fat grafting to correct any deep wrinkles or volume loss.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

You will need your surgeon to optimize you if you are thinking of having surgery. As you are aware your condition involves multiple organs and cosmetic surgery would not be wise under GA.However some surgeons do perform face lifts under local anaesthetic such as my pioneering procedure Concept&trade; Facelift Surgery. This type of Rhytidectomy is unique as the face lift is performed under local anaesthetic, and is less invasive than traditional methods, meaning the cosmetic surgery has a significantly faster recovery time.This minimizes trauma of a GA to your heart and lungs and although the risk of infection of wound break down is slightly higher in you than general public, in discussion with your surgeon it can be achieved.

I have some sagging on my lower face but I have a health issue that may make surgery unwise.

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Everything you need to know about Lower Facelift

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I have some sagging on my lower face but I have a health issue that may make surgery unwise.

Answers (3)

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Everything you need to know about Lower Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.