Well...what's next? Jowls, mouth laxity, issues related to gravity. (photos)

MIMomBA  Hello Neighbor A complete consultation is necessary in order to determine your best route. Regardless of the route you choose, surgical or non-surgical, you have lost volume.  Being in great shape from your exercise is terrific for your overall body but starts to show faster in your face over time. Together we could choose the best course of action from short term to longer lasting fillers like Artefill or Fat transfer.In order to obtain tightening you could go non-invasive like Exilis.  this is a radiofrequency treatment to tighten the skin.  You could also have a Quicklift facelift which would give the best tightening and longest lasting of the procedures.  Lastly I have been very successful with a minimally invasive procedure called my lazerlift.  This procedure has minimum downtime and addresses all of your concerns.I have been rejuvenating women and men of Southeastern Michigan for the past 20 years.  Come cross Woodward to my beautiful office in Sterling heights, Accents Cosmetic Surgery and I would be happy to discuss your best course of action. Please call Laney 5862547692

A facelift may help you to improve your jowls and sagging skin, however I would need to see you in person to determine the best course of action.

The pointed chin is effecting the facial aesthetics. The easiest and quickest treatment is a filler (my choice would be Radiesse) in MCTs (Marionette Chin Triangles) also called Prejowl Sulci. RegardsDr. J

From the photograph it looks like pruning of the buccal fat pad might improve the sculpting when accompanied with the facelift. You should be an excellent candidate for facelift in that you have attractive features, what appears to be good quality skin, and aging changes that facelifts generally do a good job with.

Facelift
before 50

You are an excellent candidate for a
well performed lower facelift. Facial aging varies from patient to patient, it
is imperative that the surgeon carefully examine your face to individualize your
surgery. A well executing facelift can produce a dramatically rejuvenating, and
yet very natural result. In my practice I routinely perform facelift in
patients in their 40’s. The results of a facelift in this age group lasts for
many years. Interview a few surgeons with reputation for excellence in facial
surgery. The office should be able to provide a large number of before and
after photos of patients with similar facial aging as you have.

The lower face would benefit greatly from a deep plane facelift with platysmaplasty, some liposuction of the jowls, and a pre-jowl sulcus implant or at least fat grafting in this area to improve the mandibular rim.  I would strongly conside a lower eyelid blepharoplasty to tighten the lid, elevate the muscle slightly, and remove a small amount of skin.  Laser resurfacing would improve the overall skin envelope  which has aged due to environmental and lifestyle stresses.  Although this may seem like more surgery than you currently think you need, this procedure has significant longevity ( 10 years) and will significantly rejuvenate your face.Younger patients like yourself benefit greatly from traditional facelift surgery and should consider this as an alternative to mini facelift procedures.

Facelift for the sagging face with jowls and pre jowl depressions filled with implant or tissue is what you need. See a very experienced facelift surgeon who does natural looking faces.

Hello MIMomBA,Thanks for your question.  Looking at your pictures and by your description above, you seem real fit.  That probably means that you don't have much in the way of extra fat on your face.  As we age, the size of our skull starts to shrink in volume.  The skin and other structures tend to deflate creating the lax and hollowed look you are complaining about.  While your neck looks tight, the rest of the face has not had the same aggressive treatment.  When I look at the area around your mouth, I see the volume loss related to changes in your teeth.  This gives what we call the "parentheses deformity."  There are some minimally invasive ways to improve your concerns like Ultherapy to reduce the fat in your jowls and possible heat tighten the loose skin.  Facial fat grafting can improve volume related issues.  Use of injectible filler can improve fine lines and wrinkle.  Ablative and non-ablative light therapies and lasers can improve the collagen in the skin around the mouth and jowls.More aggressive procedures such as a facelift with jowl liposuction and fat grafting can create a more extensive improvement in your areas of concern.  I will often add facial implants to improve volume relationships.Whichever road you choose make sure you have realistic expectations because we all keep aging.Finally, I recommend that all my patients who complain about facial aging and are past the age of 40 consider getting a bone scan to assess overall bone health.  Osteopenic and osteoporotic patients seem to age faster as the bone loss in their skulls is more extensive.  You can supplement with bone building minerals to at least try to slow things down.  This, and the use of bone building medications, like Fosamax or Boniva, might help.I hope this helps.Warmest regards,Dr. Shah

Hello, your question is a good one and very common!  There are options to address your concerns. Some are more involved and some are less as you can imagine.  From what I can tell, you have a very good bone structure to the face, including, chin, cheeks, jawline and position of the hyoid bone (in the neck).  Depending on skin type, thickness, degree of laxity etc a more classic and time-honored procedure would in my opinion give you the best result for the longer term.  It is difficult to give a more accurate opinion without an actual evaluation however. 

Thanks for sharing your photos.  You appear to be an excellent candidate for facial rejuvenation. Signs of facial aging varies from patient to patient, and it is very important that your plastic surgeon carefully examine your face to individualize your surgery. A very significant improvement in facial shape and transitions is possible to give a youthful and natural result. In my practice I am now frequently seeing patients with some jowls and loss of midface volume and projection seeking facelift in their 40’s. I think as we have learned about facial aging and its signs we now recognize these issues sooner and patients are more comfortable with the treatments.The results of a facelift in this age group lasts for many years. I recommend a consult with a board certified plastic surgeon with experience and dedicated interest in facelift surgery.