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Should I have a facelift or try a different laser?

Q:

I am 60 years old. I have had a lot of sun damage, wrinkles more around my chin, vertical lip lines, wrinkles around my eyes. From the nose out, not so much. I had upper and lower eyelids done in my early 30's. I had 3 FX laser, deep FX for the chin, forehead, and lip lines. It didn't help much. I'm considering a facelift, eye upper and lower redo and nose surgery. Should I have a facelift or try a different laser?

A:

A facelift will improve on the sagging tissue, deep naso-labial fold, jowls, and neck. Facelift will not improve the fine lines of the lip and the lids, only the CO2 laser can smooth fine lines, this should be full ablation not fractional. Fractional CO2 requires multiple sessions and has some limitation. Full ablation is much more effective. So you may consider both a facelift and CO2 laser resurfacing.

A:

Definitely you are a candidate to a full Facelift including your eyelids, to reposition all the deep planes. This surgical procedure will define you facial contour, bringing the fat compartments to their original position obtaining a best projection in you profile. For the wrinkles you can try a new laser session at the surgical room combined with the facial rejuvenation surgery, or maybe a dermabrasion.

A:

From your description of the result you have obtained from the FX laser, it does not make sense to repeat this as the results are not likely to change.  To truly rejuvenate your face, you should have a facelift combined with upper and lower blepharoplasty.  This will reposition the deeper tissues to the correct location so the skin can be smoothed over this new sculpted facial contour.  If your skin needs further rejuvenation a laser which does more ablation than the FX laser would be in order or a chemical peel.  The facelift would be the best starting point and most likely to get you to the results you wish.  

A:

Perhaps a resurfacing laser treatment would be more effective for you that fractionated lasers. A facelift will elevate and reshape the face in ways that skin tightening procedures do not, so your best answer might be both. The laser peel could be done around the mouth and eyes at the same time as the facelift.

Richard A. Baxter, M.D. - View Other Answers by this Doctor
Mountlake Terrace, WA

A:

Perhaps a resurfacing laser treatment would be more effective for you that fractionated lasers. A facelift will elevate and reshape the face in ways that skin tightening procedures do not, so your best answer might be both. The laser peel could be done around the mouth and eyes at the same time as the facelift.

Richard A. Baxter, M.D. - View Other Answers by this Doctor
Mountlake Terrace, WA

A:

A facelift is the best procedure to correct the loose lax skin, sagging of the cheek, jowls and neck laxity.

If however your primary concerned is skin wrinkles than laser resurfacing is a better option than a facelift for wrinkle removal.

A:

Laser Versus Facelift- These are completely different operations. A facelift allows for shaping, lifting, and filling  of the central and lateral face. The laser does not do either one of those, but it helps to smooth out any deep wrinkles around the face and perioral area. If you have both facial sagging and fat loss in the face one can consider doing both simultaneously.This should be done in the hands of a Board Certified Plastic Surgeon with expertise in Facial Rejuvenation.

 

A:

There are no noninvasive procedures, including lasers,  that will produce the results of a natural appearing facelift in patients with laxity of the tissue at the jaw and neckline. While there may be some improvement of skin complexion and very fine lines, you need to be very realistic about what  anything short of a facelift will and will not achieve.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

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