To remove lax skin and folds from the neck and jowls of the face, a face lifting procedure will give you the best result. Thermage and the Thread Lift are only partial, temporary fixes for a problem that will reveal itself again very soon. Many patients are seeking the face lifting procedure in their late 40's and early 50's. Most patients ask "am I too young for a face lift?" This answer depends on your genetic makeup, and possibly weight loss. The best way for you to know if you are a good candidate for the face lift is to consult with a board certified plastic surgeon. Ask to see before and after photos of the surgeon’s work, and if possible speak to one of his patients that have had the procedure you are seeking.

The search continues for maximum result with minimal invasion. The jowl results from the changes in contour in the bone, muscle, fat and skin. The changes in the jowl vary widely and the treatment selected depends on the amount of change. For minimal changes, a surface treatment may tighten the area enough to yield improvement. For changes that are more significant, injections and/or implants will improve the area. For the most significant changes, a face-lift is the only way to correct the problem. A consultation with a surgeon certified by the American Board of Plastic Surgery is the only way to answer your question for you specifically.

It may be safe to do a minor procedure on a 90 year old person, in relatively good health, under local anesthesia, if careful evaluation reveals no contra-indications. A clearance from her family physician would be preferable. It is actually a case by case situation and not for everyone.

I generally try to avoid absolute terms like “all”……..

You need to be examined, and there are a variety of options depending on the severity of your problem, your overall health history, and how much correction you are trying to achieve.



The following options may be appropriate in certain circumstances, depending on the quality of your tissues, the experience of the surgeon and the desired goals:

- liposuction of the excess tissue/jowl

- addition of your own fat (or another material) to the low points around the jowl to fill it in.

- an extended chin/jowl implant to smooth the transition along the jowl

- a "short scar" facelift

- a traditional incision lift

- a combination of the above procedures.

Be sure to clearly state your goals and your plastic surgeon will examine you and make a recommendation that is appropriate.

It is difficult to pinpoint a "best age" for having a facelift, since people of the same chronological age may present very different appearances depending on such factors as heredity and exposure to the sun. Aesthetic plastic surgeons very often recommend a first facelift for women in their mid-forties or early fifties, because at this age the skin still has sufficient elasticity to achieve the best possible results. Excellent results can still be obtained, however, for women in their sixties, seventies or older who have maintained good health and overall fitness. Men rarely seek advice on facelifts before their fifties or early sixties. Normally, results of a facelift will last eight to ten years. Most people who have had one facelift will, at the appropriate time, want another. Patients are pleased to find that the results of a second facelift are usually as good, and often better, than the first.

Since we now know that all the layers of the face gradually droop with aging, most facelift techniques are designed to restore all these layers -- the skin, muscle, and fatty tissue -- to a more youthful position. The deep plane facelift refers to the lifting of the various layers of the
face as a single unit rather than separating and lifting them individually. Many surgeons prefer the deep plane approach when performing a secondary facelift (a facelift on a patient who has had a lift in the past) in order to avoid the scar tissue from the previous operation. In the right hands, most facelift techniques give excellent and long-lasting results with low complication rates. The deep plane facelift is probably less common than some of the other methods, but those surgeons who use it often advocate its use for all facial rejuvenation candidates.

It is possible to lift the neck if you only have excess skin below your jaw line. If your facial skin is also lax, doing a neck lift only (without an incision behind the ears) can cause pleating or bunching of the skin just in front of the earlobe. You may also get a non-harmonious appearance if your neck appears youthful and your face looks old & tired. The overall outcome should be the most important factor when making your decision about facial rejuvenation.

There are no nonsurgical ways to tighten the skin under the chin. In some cases, liposuction (lipoplasty) and other corrections made through a submental incision (a small incision underneath the chin) may help. However, in other instances, lateral tightening may be needed; it is possible to do so with a partial, or "mini", facelift.