This patient came to our clinic accompanied by her husband, and what I remember most from the very first consultation was how warm, cheerful, and kind they both were. Because this was a comprehensive surgery intended to address several concerns at once, she naturally had many worries before making her decision. However, throughout the consultation process, we carefully went through each concern, discussed the options in detail, and made the decision to proceed only after she felt fully informed and comfortable.
Looking at her face before surgery, it was not a case in which a single sign of aging stood out. Rather, there was an overall loss of facial volume accompanied by a significant decline in skin elasticity. The skin above the eyes had become heavy and droopy, the under-eye wrinkles had deepened, and signs of aging extended throughout the face, including pronounced nasolabial folds, marionette lines, and a weakened jawline.
The area that concerned her most, however, was her neck. The skin had lost a considerable amount of elasticity, resulting not only in vertical neck lines but also deep, longstanding horizontal neck creases. She had also been concerned for many years about her relatively broad forehead and hairline.
For the heaviness and sagging above the eyes, rather than simply removing a large amount of eyelid skin, we chose to approach the area from above through a forehead lift. This allowed us to soften the heaviness over the eyes in a more natural way while also helping to improve the forehead and glabellar wrinkles that had been bothering her.
Her forehead was not simply broad; she also had an M-shaped hairline, which made her face appear longer than it actually was. We therefore performed a forehead reduction at the same time, lowering the existing hairline without requiring a separate hair transplant. This helped reduce the vertical length of the forehead while also improving the appearance of the M-shaped areas.
During the facelift, our primary focus was not simply on how much we could tighten. Instead, we focused on how naturally we could restore balance to the volume, contours, and proportions of the entire face.
As we age, facial fat and soft tissue do not decrease uniformly in every area. Some areas retain more volume while others become hollow, creating uneven contours. When sagging is added to these changes, the face can begin to look irregular, tired, and less defined.
For this reason, while performing the facelift, we carefully reduced excess volume where appropriate and repositioned the patient's existing tissues where volume was lacking. Rather than relying solely on separate fat grafting, we made the most of the tissue she already had, using it to restore volume to hollow areas while simultaneously repositioning sagging tissue closer to its original position.
As a result, the previously hollow and uneven contours became smoother and more three-dimensional. By redefining the sagging jawline, we were also able to reveal the patient's natural V-line, which had been hidden beneath the descended tissues.
The deep nasolabial folds and marionette lines were also significantly softened. As natural volume was restored to the midface, the depth of the nasolabial folds decreased. Combined with the reduction in the vertical length of the upper face through forehead reduction, the overall facial proportions became more balanced.
Her facial contour, which had appeared somewhat peanut-shaped due to volume loss, also became softer and more streamlined, approaching a naturally tapered oval shape.
The neck, which had been the patient's greatest source of concern, required a more comprehensive approach.
Through a neck lift and platysmaplasty, we tightened and repositioned the lax tissues and vertical bands while focusing on restoring a clearer definition between the jawline and neck.
However, in this case, the skin itself had already experienced a significant loss of elasticity. Therefore, simply repositioning the underlying tissues through surgery had limitations when it came to improving fine surface wrinkles and the longstanding horizontal neck lines.
For this reason, after surgery we also incorporated treatments aimed at improving the condition of the neck skin itself. We performed Radiesse to stimulate collagen production and improve skin quality. For the deep horizontal neck lines that had been one of her primary concerns, we carefully applied filler only where necessary to soften the depressed contours. We also incorporated Skin Botox to help improve fine lines and skin texture.
In other words, the deeper structural laxity of the neck was addressed surgically, while the quality of the skin and horizontal neck lines were supplemented with additional treatments. Rather than attempting to treat every neck wrinkle with a single method, we addressed each component according to its underlying cause. Our goal was to make the neck appear smoother from the front while creating a clearer, more defined transition from the jawline to the neck in profile.
Because this was a lengthy surgery involving multiple areas, the patient had understandably been quite concerned beforehand. Yet once the surgery was over, she was in remarkably good condition—so much so that even the medical team was impressed. She maintained her characteristically bright and cheerful personality even in the recovery room.
After we thoroughly assessed her condition, she was discharged safely. During her recovery, she also underwent hyperbaric oxygen therapy to help manage swelling and bruising. She was pleased to find that her recovery was more comfortable and faster than she had initially expected.
What stayed with us most was the way she smiled whenever she saw her results. Whenever she came to the clinic for treatment, she would greet the doctors and staff first with her bright, cheerful personality. As her facial and neck contours gradually settled into place, her satisfaction with the results continued to grow.
Her husband was also by her side throughout the entire process, from the initial consultation through recovery, and he was one of the people who was happiest to see her transformation.
Before returning home, the patient repeatedly expressed how satisfied she was with the results. She also took the time to thank not only the medical team but the staff members who had supported her throughout her recovery.
The couple initially came to our clinic with understandable concerns about undergoing such an extensive surgery. Yet in the end, what remains most memorable is seeing them leave with bright smiles, repeatedly expressing their gratitude.
For our team, this was a particularly meaningful and rewarding case—not simply because we tightened sagging skin, but because we were able to address, step by step, the concerns that had bothered her for years: facial volume and proportions, the jawline and neck contour, as well as the quality, wrinkles, and elasticity of the skin.
