Lower Face Rejuvenation

Lower Face Rejuvenation

The CustomLift® approach to the Lower Face


Joseph T Cruise, MD takes a customized approach to addressing facial rejuvenation. In this section, you will find information about the areas of the lower face which be improved with facial surgery. As shown in the diagram above, the lower face is considered from the area just above the lip running horizontally to the ear down to the chin/jawline.

Nasolabial Folds, Marionette Lines, Jowling

All of the areas shown below are routinely treated with a lower facelift with very good results.


The cause of nasolabial folds, marionette lines, and jowling is the same. It is a combination of saggy facial skin, descended facial fat, and loss of facial fat.

The once widely popular Lifestyle Lift™ was a very basic facelift performed under local anesthesia that corrected skin excess. Joseph T Cruise, MD's CustomLift® facelift offers this one-dimensional procedure to patients who do not need much fat elevation and replacement, which is rare. The Lifestyle Lift™ did not routinely directly address the neck problems which is often one of the biggest issue, however for the right patient this type of facelift can obtain good results, but it is limited.

If only skin tightening is needed, then a mini facelift under local anesthesia may be a good option. This is the least invasive of the possibilities offered by CustomLift®. As mentioned above, facial aging is rarely just a skin problem.





Joseph T Cruise, MD correction this patient's jowls, marionette lines, and poor jawline definition with his Custom Facelift. 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 over time. This provides the optimal rejuvenation as it defines the jaw line, eliminates the marionette lines and recreates fuller, more youthful cheeks.

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.The key to male facelift is to maintain a natural appearance.





Weak Chin

The goal of facial rejuvenation is to create a more attractive, rejuvenated and proportionate facial shape. It is not uncommon for the chin to sag and recess with age. When necessary, adding a chin implant greatly enhances the result.


As with any component of the Custom Lift® it requires evaluation to determine if it would be helpful. Joseph T Cruise, MD 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.

Chin implant w/ neck lift





Joseph T Cruise, MD performed a neck lift with chin implant on the above shown above. This result was achieved without the need for a facelift. The implant will plump the chin out and fill in the area in front of the jowls.

So what does a chin implant do?

In women, a chin implant will create a more defined jawline 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.









Thin Lips, Lip Lines, Down Turned Corners

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.

Thin Lips

The gold standard for obtaining predictably larger lips with very little downtime 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.

Injection techniques have improved considerably. Routinely, Joseph T Cruise, MD will numb up both lips. This ensures that the procedure is done pain-free. In addition, Joseph T Cruise, MD 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.





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.