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Dear Dr. Togba,

Q.  My girlfriends and I were having lunch and starting discussing the fact that as we are all entering our mid-40’s we are not at all happy with how our faces are aging. Each of us seems to be concerned with different areas – my eyes are tired and droopy looking, someone else doesn’t like the deep creases around her mouth, another complains about wrinkles. Can a facelift fix all of these problems or are there different types of facelifts for each type of problem?

 A. You are correct – there are different types of facelifts. In your case, tired looking, droopy eyes can be revived with an upper facelift which is a combination of a browlift and eyelid surgery. The browlift involves tightening the skin on the forehead, which smoothes out the brow and opens the eyes. If you have hooded upper eyelids or bags under your eyes, the eyelid surgery or blepharoplasty could be performed at the same time.

It sounds like your friend with the deep creases around her mouth could benefit from a mid-facelift. The lines that run from your nose to the sides of your mouth are called nasolabial folds. The muscles holding up our cheeks, or buccal fat pads, begin to stretch as we age. Combine this with stretching with sagging skin, and the buccal fat pads begin to descend towards the nose and create deep lines around the mouth. A mid-facelift elevates the cheeks and addresses these creases.

A full facelift is a good option for your friend concerned with a heavily wrinkled face that is the result of sagging skin and facial muscles. The full facelift procedure consists of tightening the underlying musculature of the face and removing the excess skin. This procedure is very effective at removing heavy lines and jowls and most beneficial in improving the jawline and neck areas.

Dr. T