Thank you for your question.
You're 34-years-old and you state that you're not overweight, you weigh 115 pounds, but
you feel like you have sagging, and jowls, and a double chin.
You state that it's a family trait, and you want to know what kind of facelift you should
have.
Well, I can certainly guide you based on my experience as a cosmetic surgeon as to how
I would approach someone like yourself in our practice.
A little bit about my background, I'm a Board-certified cosmetic surgeon, certified by the American
Board of Cosmetic Surgery, and a Fellowship-trained oculofacial plastic surgeon, through the American
Society of Ophthalmic Plastic and Reconstructive Surgery.
I've been practicing in Manhattan and Long Island for over 20 years, and facial aging
is one of the areas that I have focused a lot on in my practice.
In fact, I wrote a book several years ago to help people understand better how to approach
facial aging.
So, when it comes to facelifts, it's very important to make a determination as to whether
or not you're a candidate, based on the degree of laxity.
You see, facial aging is two things—its volumetric loss (loss of bone, muscle, fat,
and soft tissue), and descent, or sagging or loosening of the structure under the skin
called SMAS (superficial musculoaponeurotic system), the platysma muscle, and the skin
and soft tissue overlying it.
Now, in my practice of over 20 years, the youngest patient I ever did a facelift for
was 37-years-old.
But it was a different situation—this woman happened to be a physician, had very thin
skin, and really did have laxity, and so a limited lift did help improve that area.
In your situation, I would say that you are probably not a good candidate for a facelift.
When you look at your profile, and in your front view, yes, we can say that there is
some volumetric loss, or there's some accentuation of the nasolabial folds, or sometimes referred
to as the marionette lines.
And at the same time, looking at the side view, you can see maybe a rounding or a relative
roundness, but certainly not a loss of the definition of the jaw line.
When we do facelifts, we're doing this to improve the neck, to improve the definition
of the jawline, to lift the sagging cheek.
Now, something to consider, and it's very important that you do this strategically,
is something that we call structural volumizing.
Now there's a difference between structural volumizing versus the use of traditional dermal
fillers such as hyaluronic acid fillers.
Because I think you might find yourself frustrated by going to people who are trying to keep
adding volume in areas in a way that's more superficial.
So let me just make that distinction.
We perform the procedure in our practice called the Y Lift.
And although I'm not suggesting that this is right for you, to describe what we do will
probably help you understand how this method may be of value, although you probably won't
need that kind of volume that we typically do in someone who has more advanced aging
changes.
With the Y Lift, what we're doing is injecting filler at a deeper level, at the structural
level of the bone, and using these filters in a very specific method to create definition
of the jawline, definition of the entire mandible or the jaw bone, definition of the cheeks,
definition of the chin.
So there can be an application of this method potentially for your situation.
Again, one can also argue that you're being over critical, and accepting that this may
be just a genetic family trait, and not focusing on it is also reasonable.
There's plenty of time to consider facial aging interventions as you approach your 40s.
During the 40s, this is when people really do a lot of the correction with volume and
fillers, etc.
But as an option for yourself, I would say structural volumizing may have a role.
Now, in order to find a person who does the Y Lift, we are part of a network of Y Lift
trained providers, and it's a very distinctive method that is different from the traditional
use of fillers such as Juvederm, Voluma, etc. that's routinely performed by a lot of different
doctors.
Now, there may be value to the combination of the two methods also, but I think the take
home message for you is you are not ready, in my opinion, based on your photos, for a
facelift.
So think structural volumizing rather than lifting.
I hope that was helpful I wish you the best of luck and thank you for your question.