Joseph T. Cruise, M.D.


(949) 446-1421 

Lower Face Lift

The CustomLift® approach to the problem areas of the Mid Face.

Region of the lower face

1. Jowls, Jaw line, and Marionette Lines

Jowls, marionette lines, and poor jaw line definition are routinely treated by a face lift. Let's go over the causes of these problems so we can better understand the treatment.

Marionette lines

Marionette lines are the lines that form at the corner of the mouth and go downward.

Marionette face They may look like an extension of the naso-labial folds but they are treated differently. The root cause of jowling, marionette lines, and poor jaw line definition is the same. It is a combination of saggy facial skin, descended facial fat, and loss of facial fat.

Lifestyle Lift™ performs a basic face lift under local anesthesia correcting the skin excess. CustomLift® custom face lift offers this one dimensional procedure as well to select patients who do not need much fat elevation and replacement. This is rare. In addition, Lifestyle Lift™ does not routinely directly address the neck problems which is often the biggest problem. Still, in the right patient, the Lifestyle Lift™ can obtain good results but it is limited.

If all you need is skin tightening than a mini face lift under local anesthesia may be a good option. This is the least invasive of the options offered by CustomLift®. As mentioned above, facial aging is rarely just a skin problem.

Animated correction of lower face lines

Animated Correction of Lower Face

Scroll over the images to see the effects of face lift on the jaw line, marionette lines and down turned corners of the mouth.


Animated lower face correction - male

The CustomLift® is not a procedure. It is a plan to identify all the aspects of facial aging and choose which procedure(s) is/are necessary to obtain the result you are looking for.

Correction of jowls, marionette lines and poor jaw line definition with face lift. Notice the youthful triangular appearance of the lower face.

Fat elevation and fat transfer is an integral part of the CustomLift® when there is jowling and hollow cheeks. Fat suspension will elevate the jowl fat so that it is repositioned back into the cheek where it belongs. Then additional fat is added to fill in for the fat that has melted away with time.

This provides the optimal rejuvenation as it defines the jaw line, eliminates the marionette lines and recreates fuller, more youthful cheeks.

A critical component of the CustomLift® is the addition of the temple lift which Dr. Cruise includes in all of his face lifts. This is because it adds such a dramatic improvement over conventional face lifts. The temple lift is explained above .It outlines why it is so important.

Facial Aging in Men

There is very little difference anatomically in facial aging between men and women. There is however a significant difference in treatment and expectations. Men are much less tolerant of an operated, surgical appearance. It is therefore critical to make sure that their result is completely natural.

They key to male face lift is to maintain a natural appearance.


In summary, the CustomLift® custom face lift is, at a minimum, a conventional face lift performed by an experienced plastic surgeon. Routinely, it also includes fat elevation, fat transfer, and a temple lift.

2. Weak Chin

The goal of facial rejuvenation is to create a more attractive, rejuvenated facial shape. Adding a chin implant greatly enhances the result if it is needed. In fact, it is not uncommon for the chin to sag and recess with age.

Chin Augmentation effects on recessed chin

Animated Chin Augmentation

Scroll over the image to see the effects of chin implant on recessed chin.


Animated chin implant - male

The implant will plump the chin out and fill in the area in front of the jowls.

Improvement of facial aesthetics with chin implant in conjunction with neck lift (no face lift was performed).

As with any component of the Custom Lift® it requires evaluation to determine if it would be helpful. The surgeon will assess not only if it is needed but the relative importance of adding a chin implant. This allows you to make an educated decision.


What does a chin implant do?

In women, a chin implant will create a more defined jaw line as well as a more triangular face.

With men, it will not only define the jaw line but will create a more powerful, masculine appearance to the entire face.

3. Upper Lip Wrinkles

Wrinkles around the lip (they can occur below the lip too) are caused by a combination of factors. The most significant are loss of collagen, loss of fat, and the constant motion of the underlying muscles.

The most effective way to improve these wrinkles is dermabrasion with a tiny bit of Botox®. The dermabrasion will smooth and thicken the underlying dermis. Then a very small amount of Botox® will be injected just under the skin to flatten the muscle. This will not affect lip motion but will do a great job of diminishing or eliminating the wrinkles.

Correction of fine wrinkles around the lips with dermabrasion and soft tissue filler.

Animation of thin lips and upper lip wrinkles

Thin Lips and Upper Lip Wrinkles

Scroll over the image to see the correction of Thin Lips with Soft Tissue Fillers and Upper Lip Wrinkles with Dermabrasion

4. Thin Lips

The gold standard for obtaining predictably larger lips with very little down time is Hyaluronic Acid. Hyaluronic Acid soft tissue fillers are marketed as Juvéderm™ , Restylane®, Perlane, etc. These are a significant improvement over the previous gold standard - collagen. They are touted to last anywhere between 6 to 18 months. In reality, predictable enlargement lasts 6-8 months in the lips.

Correction of thin lips with Juvéderm™ .

Injection techniques have improved considerably. Routinely, Dr. Cruise will numb up both lips. This ensures that the procedure is done pain free. In addition, Dr. Cruise uses needles that are half the size normally used. This allows for more accurate placement. In addition, bruising almost never occurs and swelling is minimal. Returning to work the next day is typical.

5. Down Turned Corners of the Mouth

Often, patients complain that they look sad or upset because they have a permanent frown. This is because the corners of their mouth have become down turned with aging. This is most effectively corrected with a face lift. However, there is often a simpler answer - Botox®.

By selectively relaxing the muscles that cause frowning, the corners of the mouth will elevate about 3-4 mm. This simple maneuver, when properly performed, can eliminate the frown and give a happier, more pleasant facial expression. The lips will still work normally and no one will ever know.


Thank you everyone especially Dr. Cruise. I am extremely pleased with my results. I feel like I am brand new. I have been telling everyone that my wonderful doctor and staff created this miracle. Many are asking who did this fantastic job. I have referred all who ask and some who didn't ask.
Thank you, thank you, thank you

Face Rejuvenation