Q: Dr. Eppley, I have been considering facelift surgery for two years. I have done extensive research and have had consultations with local doctors. While I think I need both a mini facelift and neck lift, I am very uncomfortable/scared to do both at one time. I am a 57 year old female and honestly believe that I look 65 due to a lifetime of sun exposure. My thought of starting with a neck lift is that it will give me an introduction to facial surgery and help to relieve my angst of cosmetic surgery. I would love to have your thoughts. (is the neck lift the right procedure for me)? Thank you.

A: I believe you are confusing several ‘facelift’ terms and procedures. Technically a traditional facelift affects the lower face and neck and is best known as a jowl-neck lift. (this is what you are calling a ‘necklift’) This is the foundational procedure in the treatment of facial aging/facial sagging and is absolutely what you should do as the first and most basic procedure. This will help immensely by cleaning up the neck sagging as well as the jowls along the jawline.

FYI a minifacelift is a watered down limited form of a lower facelift that is not appropriate for you. It is indicated for younger patients with more limited facial aging issues or as a secondary procedure years after a primary facelift

Because you also have some midface sag (and central facial hollowing/gauntness) I believe term you are referring to is a midface lift…not a mini facelift. You have multiple options here as this requires some additional work from that of the lower facelift. You could defer it to later you or you could treat it at the same time with either a midface lift or more simple malar-submalar implants. (which create the same effect as a more extended midface lift) The timing and technique to treat it can be debated and each approach and technique as their own advantages and disadvantages.

Dr. Barry Eppley

Indianapolis, Indiana