Need work - what should be done? (Photo)

Ok.. want a mini facelift to correct skin laxity, but not sure what to do with the lines going down my mouth and nose, and missing fat in the middle of forehead and under eyes.. Hot mess please help! What will improve my face to turn back the way I was once was I have to loose weight and never smoked nor drank, not too much of sun person, but did tan, how does this happen ? Will a mini facelift fix those lines near my mouth?

Doctor Answers 8

Consult Needed

Hi there, 
It is not ideal to recommend surgical procedures with a picture alone. I recommend booking an in-person consultation with a board certified facial cosmetic surgeon. When you are exploring the options of a facial surgical procedure, make sure that you also explore the right type of cosmetic surgeon to perform your plastic surgery. A facial plastic surgeon is a cosmetic doctor that is an expert strictly in the head and neck. Focusing on the head and neck area means that the specialty area is concentrated and the surgeon is extremely familiar with facelift procedures (one of the most popular and common facial cosmetic surgeries).


Toronto Facial Plastic Surgeon
4.8 out of 5 stars 112 reviews

Possible Candidate for Facial Rejuvenation with Lite-lift™

A person’s age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.
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. If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

However, if you learn that you are a candidate, this may be helpful. Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.

The best candidates for #LiteLift are patients 35-60 years old with early changes of the lower face and the neck. Older patients who cannot or do not wish to have a longer operation or general anesthetic can be improved with a Lite Lift™.
Lite Lift™ surgery is individualized for each patient. The best candidates for Lite Lift™ surgery have a face and neck line beginning to sag, but whose skin has elasticity and whose bone structure is well defined and do not smoke.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Don't we all

Hi Help me Plzzz

Thanks for your post and photo. Great stars!

Our Concept Facelift is less invasive than a traditional facelift and there is less scarring, bruising and swelling for a significantly quicker recovery period. 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 is a combination of a SMAS lift and skin tightening that allows the procedure to have it's longevity without the trauma and invasiveness of a traditional facelift. You should find that the lines around your mouth have a better appearance.

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

Mini Facelift will not fix Lines around the Mouth

A mini facelift will not change the lines around the mouth.  These lines are best treated by skin procedures such as:

1)  Chemical Peel
2)  Laser Resurfacing
3)  Dermabrasion
4)  Microneedling

These procedures could be completed at the same time as your mini lift procedure.  Each has advantages and disadvantages, and surgeons will have their preferences.  I would discuss these options during your consultations. 

I hope this helps.  

Want a mini facelift to correct skin laxity, but not sure what to do

  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 had pre-mature "jowl" formation.  "Jowls" are the folds between the lips and the jaw line that create the lines which are called "Marionette lines".  From the photos your cheeks are flat anteriorly (in the front), jowls are present and there is excess fat in front of the cheeks and below the chin.   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.  Despite its recent popularity, fat transfer (injections) are far less reliable at creating facial shape and volume than an "off the shelf" dermal filler or cheek implants.  For that reason, I don't use fat to shape or contour the face.

  "Jowls" represent sagging facial tissues and are 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 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 whatever facial shaping necessary 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.  The lines in the Glabella (area of forehead, between the eyebrows) can be softened using Botox injections.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

'Hot Mess'

Thanks for your pictures and I would like to start by saying that you are definitely NOT a 'hot mess'. 

You have the typical signs of aging that include volume loss in your cheeks and extra skin laxity in your jowls and neck causing a change in overall shape from a heart shape to a more square appearance. 

You have many options, depending on how far you would like to take this- facial fillers such as voluma/radiesse/judeverm will correct the volume loss and lift the mid face area improving the lines around your mouth, jawline and contouring your cheeks- these last anywhere from 6m to a year or two depending on the amount of filler being done. Other filler options include facial fat transfer which is a more 'invasive' procedure, but does last longer. 

A minilift or some type of lift would also be an option to improve your neck and jawline, and combing that with a filler would be the best, longest term solution- the type of lift will depend on your examination. 

Good luck!

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 78 reviews

Mini-Facelift

It sounds like you are a candidate for a Mini-Facelift. My favorite technique is the MACS short scar Mini-Facelift. Developed in Europe, it is the ideal approach for the younger patient, not ready for a full facelift, or patients who desire a less invasive procedure with a shorter recovery time. Check out the link below to an article I wrote about the subject. Good luck.

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

Mini-Facelift and marionette line filler

Hi and thanks for the question and photo.  You would do very well with a mini-facelift and some filler such as Restylane for the corners of your mouth (marionette area)  I believe that the nasolabial folds would respond very well to a mini facelift along with your jowls and neck. It is hard to tell what is going on with your under eyes from the photo. Botox and filler would take care of the central forehead crease. I would be happy to see you for a consultation.  Good luck.

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 101 reviews

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.