In our weekly Post Your Face column, Dr. Robert Freund answers readers' cosmetic surgery questions, and shows them how they'd look if they underwent the enhancement. To post your own face, visit

The Patient's Question: I want a cheek lift, neck lift, fix my nose tip/cartilage, fat injection and repair previous blepharoplasty (upper/lower).

The patient before and after the suggested cosmetic surgery procedures. Photos courtesy of Dr. Robert M. Freund

Dr. Freund's Answer: You have voiced many concerns about different parts of your face and I will start by saying, "slow down!" You are an attractive woman who has several mild concerns. If you have read this column before, you can see that there are people with far greater concerns and aging related issues. Perhaps most concerning are the risks of further surgery, especially since you have some untoward effects of your previous surgery.

If we look at your before picture from the front, the "A" shows a bowing or pulling down of your lower eyelid. This suggests scarring or too much tissue was removed. From the side view, the "C" shows a visible scar that is likely from your previous blepharoplasty. Other issues to notice are the hollowed tear trough (B) and mild marionette lines (D).

As for my suggestions, I would start with a good, basic skin regimen. Daily skin care should include:
1. A non-foaming cleanser – Cetaphil is an inexpensive ideal way to clean your skin with less dryness.
2. Zinc oxide sun block – regardless of the season, a zinc oxide sun lock is a must, especially if you are concerned about those blotches. My favorite is EltaMD.
3. Retin-A or Renova – this is a prescription medication that will exfoliate, even out your skin color, thicken you skin and slow the outward signs of age. See your dermatologist or plastic surgeon to get started on this medication.

For my surgical suggestions, I would start by saying that "less is more." An easy starting point would be to correct the tear troughs or hollows under your eyes (B) with fat grafting. When done well, we can really make a person look younger with minimal risk or downtime. Fat grafting performed under local anesthesia can cost about $2500.

The patient before and after the suggested cosmetic surgery procedures. Photos courtesy of Dr. Robert M. Freund

For the marionette lines, I would start with filler like Restylane or Juvederm. These are temporary treatments but will perhaps delay the need for a cheek lift or mid face lift.

Your lower eyelids are a little bowed; I would need to examine them to determine the cause of the problem. In any case there is surgery that can correct this issue. Usually a lateral canthoplasty will correct the problem and this treatment typically costs about $4000, with a short recovery.

Finally, the cheek lift or mid face lift may be in your future, but because you have had some prior issues with surgery, I would probably wait and let the lesser treatments have a shot first. Save the big guns for last!

I hope this helps a little. If you would like further information on any of these subjects, please refer to my new book, "A More Beautiful You – Reverse Aging Through Skin Care, Plastic Surgery and Lifestyle Solutions."

Respectfully submitted,

Robert M. Freund, MD, FACS

The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.

Read about common cosmetic surgery and procedures on AOL Health.

And click here for 10 reasons cosmetic surgery may not be right for you.