Q: I am a 55-year-old women who is a little overweight. At 5’4” and 190 pounds, I wouldn’t call myself fat just above my ideal body weight. The reality is that this weight is very stable, and I have been relatively the same weight for almost 20 years. I exercise and eat reasonably and this is just the way it is. I am fine with that as I am otherwise healthy. My face has always been al little plump but otherwise firm until the past few years. I have noticed that there is some jowling that has appeared along the jawline but the real problem is my neck. It has gotten so droopy and saggy that I know it is time for some type of necklift. Am I too fat to get a facelift?
A: Your question is a good one and would be a lot more relevant if you were younger. But as you have gotten older, regardless of your weight, the skin in the neck has begun to sag. This sagging is the result of the skin stretching and loosening, no longer being able to support the weight of the fat it contains. Many men and women with similar situations and face shapes actually get great benefit from neck reduction/tightening. Until proven otherwise, it may be that you may get a greater benefit from a necklift than someone who is thinner with less loose skin. Delaying a necklift may make sense if you are planning to lose more than a few pounds of weight but that clearly is not the case.
Q: I would like a facelift to remove my jowls and improve my droopy neck. I also would like my nose done as the tip seems to keep getting lower as I age. The question I have is the timing of the nose surgery and the facelift. Should they be done separately or together?
A: You are correct in your impression that the nose is getting longer. It does not grow, but the tip of the nose does fall as the ligaments weaken. As the tip falls downward, the nasal length increases. This means that a very simple tip rhinoplasty to elevate the tip and open up the nasolabial angle can make an older nose look younger.
It is not necessary to look at the ‘new’ face afterward to figure out how to change the nose. I have found it best to combine the procedures for the benefits of one single surgery and recovery and lower costs. One does not really impact the other when it comes to facial appearance changes or swelling and bruising.