78, 25 years post facelift. What would you recommend for the cheek, mouth and neck areas? (Photo)

Question

Hello, I am 78 years old and have developed a lot of wrinkles since having a facelift 25 years ago. I’m happy with the eye area, but I would like the cheek and mouth areas, as well as my neck, to be smoother. What would you recommend?

Julian De Silva, MD · Answer

Hi annkstr, thank you for your question, and it is lovely to hear you are still happy with your eye area 25 years on.

From your description and photo, the changes you describe are usually a combination of three different processes rather than one: some renewed descent of the deeper tissues, some loss of facial volume in the cheek and around the mouth, and changes in the skin quality itself, which is where fine wrinkling and smoothness really live. Each of these is treated differently. Lifting procedures address descent, particularly in the neck and jawline, but they do not smooth the skin around the mouth, where skin-quality treatments or volume restoration often matter more.

At 78 many patients remain good candidates, but a careful in-person examination and a full review of your general health and medications is the essential first step before anyone recommends a specific procedure. I would encourage you to see a facial specialist who can examine your skin quality and tissue laxity together and talk you through the options honestly, including the gentler non-surgical ones.

78, 25 years post facelift. What would you recommend for the cheek, mouth and neck areas? (Photo)

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