Should I have a facelift or try a different laser?

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.

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.

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.

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.

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.

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