Should I have facelift? Necklift? or just Blephoplasty? (Photo)

So I am considering surgery... I have had plastics in the past but have been afraid to consider anything around my face. Now my eyelids are getting in my way LOL so since I have to be able to see in the future, I am going to take of this now. And while I am taking care of this area my daughter has suggested I do something about my 'gobbler', so now I am thinking about the whole shebang... what is your opinion? I know the pictures are not the greatest...

Doctor Answers 22

Prioritizing cosmetic procedures according to visual impact and your priorities. You can set the clock back 10 years or more.

The photos you submitted demonstrate some particular issues with the upper and lower eyelids such as dermatochalasis which means extra skin. You also have fat prolapse of the upper eyelid and lower eyelids. From the side and bottom view, I clearly see extra skin under the neck. There are also two bands in the neck area called platysmal bands. I would say that you are a candidate for blepharoplasty, face and neck lift surgery. The question is, are you ready for all these procedures?

I spend a lot of time talking to my patients. I feel that communication is very important. Many people go to plastic or cosmetic surgeons and their consultations are very short and they get pushed to doing something that they would have done otherwise. They feel that they are pushed without getting proper information. All surgeries have risks and benefits. A detailed discussion of what’s involved, how the procedure is done, where the incisions are placed, why the incisions are placed and what to expect are important things to discuss. Very often, it is the combination of a good discussion, physical examination and review of the doctor’s previous patients to get an idea of what their personal style is. These are the things that are important so that you can make an informed decision.

You could find many doctors who have overlapping concepts in their minds of what a facelift and a necklift are. But in our practice, we define a facelift from the cheek to the jawline and the necklift from the jawline then into the neck. Most of our facial rejuvenation surgeries for people at your stage would be a face and necklift, which can be explained through where the location of the incisions are and the vectors in how things are lifted.

Although it’s your daughter that mentioned the little excess skin at the neck, it’s your personal preference that's important. In our practice, there are patients who are very focused on their eyes. I always say, if someone’s going to do anything on their face in their lifetime related to facial aging, it will be their eyes. The eyes make a very big impact on the facial appearance. That said, when you do the eyes, face and neck lift together, you literally bring back 10 years if not more. You will look really great, but it’s a very subjective thing. You should always think what you want to see change and how motivated you are. You should be ready to make an investment on money, time and the whole process.

In our practice, we have made it a mission to avoid general anesthesia. We feel that people do much better with local anesthesia with LITE™ IV sedation . Our patients recover faster and I feel that I do my surgery better. Again, this is my opinion and this is my experience as a doctor. This is something that our patients have found tremendous appreciation and value. I hope that was helpful, I wish you the best of luck, and thank you for your question.

New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

Facelift or Eyelift

You appear to be a good candidate for facial rejuvenation and eyelid rejuvenation surgery. Take some time looking for the best board-certified plastic surgeon for you. Start by looking at many, many before and after images with natural looking results. I've posted a link to my facial rejuvenation photo gallery below. When you find a plastic surgeon who has demonstrated through photographs the ability to provide beautiful, natural results, look at the training of any plastic surgeon you are considering. Did they attend a top ranked medical school and graduate at the top of their class? Did they receive formal surgical training from prestigious university medical centers? Are they certified by the American Board of Plastic Surgery and members of both ASPS and ASAPS?
Remember that this is your face. Take your time searching for the right plastic surgeon for you

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Facelift, necklift or blepharoplasty

Hello and thank you for your question.
Your pictures are a bit limited, but likely you would benefit from all the procedures you mentioned. If you treat one area of the face it makes sense to treat the others that need rejuvenation as well so that everything stays in harmony. I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.
Best of luck to you!

David L. Cangello, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 14 reviews

Facelift with blepharoplasty

From your pictures, it looks like you would benefit from several procedures.  You have significant neck laxity which can be tightened to improve the jawline and excess skin.  A lower facelift will also help with the jowls.  You also need a blepharoplasty to remove the excess skin.  Probably a lower bleph too to smooth out the lid/cheek junction.  Get a few opinions to see what the surgeons recommend after a real consultation.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Excellent candidate for facelift in blepharoplasty.

A properly executed full facelift will take care of all aging issues from the lower lids down to the clavicles. Commonly this is done with upper and lower eyelid surgery which I think would be an aesthetic benefit to you.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

A combination approach could make a big difference.

If your lids are starting to bother your vision, you could benefit from an upper eyelid lift. And a lower eyelid lift will give you a smoother, more refreshed look below the eye as well. Many patients these days prefer to combine procedures, which helps achieve a more even rejuvenation throughout the face for very nice results. Looking at your photos, face and neck lift could help you look younger, possibly in combination with eyelids as well, although an in-person examination would be necessary to say for sure. Definitely do find a board certified plastic surgeon for an accurate assessment and the best results.

Glenn M. Davis, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 68 reviews

Should I have facelift? Necklift? or just Blephoplasty?

Yes, the photos are not standardized and an in-office consultation is always the best way to accurately assess your features and concerns, but some recommendations can be considered.

All the procedures you mentioned would benefit your appearance, but also consider a treatment to improve the quality of your skin.  However, there are many factors to consider before moving forward with one or all four.  How much or how little to do is dependent on your health, downtime limitations, what you want to experience, the results you are seeking as well as cost.  All issues that can be discussed during a consultation with your surgeon.

I hope this helps.

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Great candidate for facial rejuvenation

Thank you for sharing your photographs. From reviewing your photos, you would be a great candidate for comprehensive facial rejuvenation. This would include a lower face and neck lift to address the loose neck skin and jowls, as well as an upper eyelid blepharoplasty to remove excess upper eyelid skin. You would also benefit from fractionated CO2 laser resurfacing which would improve the tone and quality of the skin texture.

Many patients choose to complete these procedures at the same time to reduce cost and have only one down time. These procedures can be safely done together to give a very nice outcome while still keeping a very natural, rejuvenated look.

Andrew M. Ress, MD
Palm Beach Plastic Surgeon
4.1 out of 5 stars 10 reviews

What Facial Cosmetic Procedure Should I Have?

Thank you for the pictures.  I would suggest that you could benefit from all procedures you discussed.  A lower facelift/neck lift will help to tighten your jawline, and improve the laxity in your neck.  An upper blepharoplasty, will also provide you with rejuvenation of the sagging skin in your upper lids.  I would also suggest a fractionated CO2 Laser Resurfacing to improve skin tone and complexion, tighten your skin, and reduce fine lines and wrinkles.  Good Luck

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 34 reviews


After reviewing your photos it is apparent you have both upper and lower face aging changes. It would be most natural do address both at the same time. The lower face would be best addressed with an endoscopic composite facelift, lower lid fat removal and Sciton laser for lower lid lines. The upper face with an endoscopic browlift and upper eyelid surgery. You have very good bone structure and should expect an excellent result.

Mark Prysi, MD
Naples Plastic Surgeon
4.4 out of 5 stars 8 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.