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why does my facelift hardly look any different? (photos)

I am 55 years of age, 7 weeks ago had a full facelift, i am dissappointed that there is hardly any change. I wanted the facelift as i am getting married in March and wanted back my confidence. when i took these photos i was convinced that the jowl lines were tighter but this week the numbness has started to dissappear and the jowl line has started to drop. i do not see my surgeon for another 6 weeks. Not one person has noticed any difference. Can anyone advice me on what to do.

Doctor Answers (13)

Was a Necklift performed with the facelift?

+1
Hi foxden,

In general, facelifts clean up the neck and jawline.  In your before photo, your jawline has some squaring from the jowls.  In the after photo, it appears more heart shaped.  Your neck does not appear to be improved in the after photo.  I feel that the necklift is the foundation for the facelift.  If the neck is untouched, meaning no liposuction and no muscle tightening (platysmaplasty) then the neck will want to return to its original shape, since nothing was surgically changed.  Usually the necklift portion of the facelift is the "dramatic" part of the result.  Since the neck appears slimmer, and the sagging of the skin under the chin is smoothed out, usually the patients will get comments that they look good, or did they lose any weight, but really they don't really know what was done.  

The problem with performing a facelift without a necklift, is that the facelift ends around the jawline area, and the under chin/neck area is not changed.  This creates a "tug of war" effect, where the surgeon lifted up the sides, but the neck is trying to pull back down to it's original shape.  The lifting of the jowls are being offset by the pulling down of the weight of the neck which will want to pull the jowls back down.

If a structurally sound necklift is performed, then the loose skin under the chin can freely slide upwards along the sides of the face and actually support the facelift/jowl lift, instead of fight against it.

At 7 weeks, you are still swollen.  In your before photo, your lower eyelid area blends seamlessly to the cheek and on the after photo, your cheek area, appears swollen and puffier than the lower eyelid area.  This should resolve and end up looking more like your pre-surgery photo, where it is seamless.  Your upper eyelids appear puffier than your pre-surgery photos, but this may also be temporary swelling.  Your upper eyelids most likely have not changed much in appearance since you were younger (Diane Lane type of eyelid).

If you are not happy with your results, you should keep the lines of communication open so that your surgeon knows how you feel.  There is no reason to keep these feelings held in for 6 weeks, and I'm sure the surgeon would want to know sooner, than later, so he or she can reassure you or offer you some advice for swelling and perhaps some other treatments in the meantime.

Best,

Dr. Yang

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New York Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Not much improvement after a facelift...

+1
You are still relatively early in the healing process and it could take 6-12 months for the final result to reveal itself. I know this doesn't help regarding your wedding. Sometimes, a supplemental procedure such as a filler like Juvederm or Restylane in the tear trough and cheek region can provide a nice balance to the face lift. Try and talk with your surgeon and see if there are little things that can be done to get you a little more improvement before your wedding.

Todd C. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Give It Some Time

+1
During the first several weeks after a facelift the swelling resolves, and there is some relaxation of the tissues, which is noticeable. In general, it takes 6 months to see a final result, (after that the normal aging process continues but is very gradual). The amount of improvement seen with a facelift varies with the patient and the surgical technique used. However, with a very natural result as you have, it is not surprising that other people do not notice. That is far preferable to an "operated on" look, in which the patient may look younger but also looks different. With that being said, some improvement should be evident on before-and-after pictures, which from the limitations of your supplied photos, I think I see.
There are a number of "mini lift" procedures that offer the promise of quick recovery, but they come with more subtle results. I am not sure what procedure you had, but I would give it more time. I also cannot see your neck from the photos, which is an important part of the overall result.
I would also suggest that you discuss your concerns with your surgeon, and ask for before-and-after pictures taken by the physician with standardized lighting and camera for an objective view of the amount of improvement you have gained. Best wishes.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 22 reviews

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Seven weeks after a facelift is too early to pass judgment.

+1
Your concerns are best addressed by your own surgeon. Seven weeks is too early to make a final pronouncement about the operation but your surgeon should be willing to see you at your request to address your concerns.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 10 reviews

Why does my facelift hardly look any different?

+1
Hello foxden.

Nothing can be said about the final result yet, just 7 weeks after a full facelift. There could still be some slight swelling present and this must first disappear completely. It would be good if you could wait at least 3 months or better 6 months, and then post new before and after photos.

Waldemar Merck, MD
Germany Plastic Surgeon

Facelift

+1
I understand that it can be frustrating when you do not see the immediate results that you were looking for. I see some improvement with your jowling of your face, it is hard to tell for sure without a lateral or oblique view.  I would discuss your concerns with your surgeon and I am sure that he or she would be happy to sit down and talk with you. Let them know your concerns.  Sometimes it takes a while for the swelling after a facelift to go down.  I think you still have time before your wedding to see improvement. 
All the best,
Arun Rao Plastic Surgeon Tucson, Arizona

Arun Rao, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 5 reviews

Little Change after Facelift

+1
A simple test of how much improvement you can expect from a facelift is to gently pull on each cheek in the mirror. If there is hardly any movement, then probably not much will change with a standard facelift alone. At this point, follow up with your surgeon to see if there are other options to refresh your look to your satisfaction. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Revisit the situation soon.

+1
It really depends on what type of facelift was done to determine the problem of inadequate improvement.  Hopefully, you have already looked into revision in light of the important March date.  However, ideally we would want the tissues to heal longer before considering revision.  Consider other alternatives for now as well:  laser resurfacing, skin tightening procedures (e.g. radiofrequency, ultrasonic therapies), and fillers.  Good luck!

John Frodel, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 1 review

No Change After Facelift Surgery

+1

There are numerous reasons why there may not be a substantative change in your facial appearance after a facelift including the facelift technique used, the degree of the original problem and your expectations of what you thought a facelift could achieve. Now is the time to go back and talk to your surgeon before you get too close to your wedding date.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 32 reviews

Why does my facelift hardly look any different?

+1
It's hard to tell based upon this one photo, but it does appear you do have some improvement in your jawline; nonetheless, you should express your concerns to your surgeon and see if there is something he or she might be able to do for you prior to your wedding.  Best of luck.

A. Joshua Zimm, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.