Q: Dr. Eppley, I am interested in getting a facelift. I always thought that it would never come to this desire but it has. My goals are to lift my sagging cheeks, reduce the marionette lines some and hopefully ease few wrinkles out of chin. I’m not wanting to look 30… but 55-60 would be nice. I’m going to be making a series of videos of me for my work and the producer wants me to look like a grandma. I would rather look like the kids’ dear auntie. Vanity, vanity….I’ve always known that so I’m good with it.

A: In looking at your three facial rejuvenation goals, they are all exactly what a facelift does NOT improve. A facelift is largely a neck and jowl improving procedure for the lower face. It has not effect at all on the chin, mouth or marionette liens of any significance. It has does not lift the cheeks. Each of your three facial concerns have to be treated by different procedures. Chin skin wrinkles can only be reduced by laser resurfacing, there is no lifting procedure for them. The cheek can be lifted but that has to be done with a cheeklift or midface lift. This is done through the lower eyelid approach so the cheek an be lifted vertically. In some cases, submalar cheek implant can lift sagging cheeks. Your type of deep inverted marionette lines are the most challenging since any type of injectable filler or fat injections will barely make an improvement in them because the line is inverted like a V…this makes it very hard to push out. The best treatment is to excise them and trade-off into a fine smooth line. That would remove them completely but is really done except in older marionette lines that are very deep.

All three of these facial procedures could be performed together and are a lot easier to got through than a traditional facelift.

Dr. Barry Eppley
Indianapolis, Indiana