Surgeons seen to have their out buzz words for facials. Deep plane, refresher face lift. Are they really different? (Photo)

Patient like you may require set of different procedures/treatments, surgical and non-surgical, to achieve good improvement. In your case, based on these photos, procedures like face/neck lift, upper and lower eyelid surgery as well as brow lift, possibly fat grafting, should be considered. Botox, soft tissue fillers, skin treatment like laser or chemical peels, radiofrequency, J plasma, would address skin part. Of course, you do not have to do all of these, but there is no one single procedure that will do all the job. As long as you are confused, before doing any of these treatments, keep asking and define your priorities. Face and neck lift may be something too start with. Hope this helps. Good luck.

All facelifts are variations on a theme. The goal is always to restore the soft tissues and skin of the face back to their natural positions. The extent of the facelift operation is tailored to each patient's needs.

• A mini lift: This uses a small skin excision from in-front of the ear to just behind the ear that tightens the skin along the jaw line in young patients with minimal aging and good skin quality.

• A lower face and neck lift: The most common type of lift targeted towards middle age and older patients with moderate skin excess and facial decent. The incision is extended higher in front of the ear into the sideburn and further back behind the ear into the hairline. During a lower face and neck lift, often the deeper tissues (deep plane) of the neck and face (platysma muscle and SMAS) are also tightened. Overall, this surgery typically tightens the neck and repositions the deeper soft tissues of the face to efface neck bands, lift the jowls, and add volume back to the cheeks.

• An upper and lower face and neck lift: a further extension of the incision higher in-front of the sideburn to allow tightening of the upper face — addressing the crow’s feet and upper cheek skin. In some cases this can encompass a lateral eyebrow (forehead) lift to lift the brows.

Your pictures demonstrate a degree of skin laxity of the face and neck, facial decent, and fullness of the neck that cannot be significantly improved with a mini-lift alone. In addition, the pictures show significant creasing of the surface of the skin – especially around mouth. For optimal treatment, a full face and neck lift with liposuction of the neck, deep plane tightening, and laser resurfacing of the skin would give you a nice improvement. Typically, we do those procedures as part of our Wide-Awake-Surgery program – surgery done under local anesthesia in the office. The same surgery is also available in the OR under anesthesia.

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Many words are used for marketing and trying to stand out from the crowd. Read to see what is being discussed. There are lots of treatments available and many noninvasive and minimally invasive treatments work very well. There are now good alternatives to surgery.