SMAS Facelift: Q&A
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Where Do Jowls Go when SMAS Muscle is Lifted and Tightened?
Do they move outward or up next to the sides of the mouth and just hang? Would lifting that muscle cause the lower face to appear heavier?
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18 Doctor Answers |
Asked by
hellofromteresa
in Sacramento, CA
+3
Depends on technique used
Hello Teresa,
Jowls are composed of 3 main components:
1. Muscle / Fascia (SMAS)
2. Fat
3. Skin & it's attachements to the underlying tissues
There is also the pre-jowl sulcus (this is the crease that is present at the front of the jowls).
Depending on your anatomy, desired goals, desired degree of surgical invasiveness, time available for recovery, overall health, etc., your Surgeon should be able to offer you a technique that is best for you.
As a general overview here is what happens...
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+2
The jowls disappear!
The jowls are composed of skin, fatty tissue and muscle. Typically in a facelift, some fat is removed, and as the muscular layer and skin are pulled up, back and tightened, the jowls flatten. Some of the tissue (fat) is removed, while some is tucked flat against the underside of the chin and the rest up. This allows for better definition of the jawline but does not add bulk to the lower face. In contrast, the lower face becomes more defined and youthful.
+2
SMAS Facelift Elevates Jowl Fat to Cheeks and Cheekbones
The SMAS Facelift uses the deep tissues to move facial fat to its original youthful positions providing volume and highlights to the face. When properly performed by a very experienced facelift surgeon, the SMAS is used to carry jowl fat superiorly to the midface and cheekbones recreating the "heart" shaped youthful configuration that you had when you were younger, as evidenced in your old photographs. This recreates the high voluptuous contours of youth....
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+2
Jowls and Facelifts
Jowls are deposits of fat, muscle, and skin which descend below the jawline with age. Appropriate treatment of jowls depends on the anatomy of the patient. Typically, jowls are contoured and repositioned creating an improved jawline and facial appearance.
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+2
Facelift, jowls
Jowls are generally made up of fat and lax skin. During a facelift, I sculpt out the fat in the jowl area so that the fullness is diminished to the proper degree. I then re-drape the connective tissue known as the SMAS to flatten and smooth the remainder of the jawline. The skin is then re-postioned in a backward direction, never upward, so that a natural, non-stretched appearance is obtained.
+2
Vertical SMAS Lift is best!
In my mind, the jowl is soft tissue that used to be part of the cheek and the hollow underneath the cheek. Many SMAS lifts pull this tissue to the side (toward the ear). I call this the Nike Swoop look. Try pulling your jowls to the side and look in the mirror. Not Good!
But, if you smile and place your fingers at the top of the cheek to hold the tissue in place. Voila! The jowls are gone, you look smooth and natural. Hence the Vertical Lift!
+2
The SMAS gets pulled into the face to where it was originally
Jowling is essentially tissue that has descended from the face to sit beyond the lower border of the jawline. When you do a SMAS facelift, this tissue is pulled up over the jaw and into the area where it used to be. Your face won't necessarily be fatter, it will have more of the youthful volume it use to have when you were young. Adding tissue into the buccal lower face area tends to make you look younger in fact.
This area can tolerate a lot of tissue without making you look fatter in the...
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+2
It depends on what you are calling jowls.
Normally, surgeons call jowls the fatty masses on the lower jaw and below it. These are repositioned in the cheek where they used to be.
Having said that, your fat is higher than that and may only require liposuction at the time of facelifting.
Tightening the muscle will not cause the lower face to look heavier; it should do just the opposite if done properly.
+1
The Jowls are returned into the Cheeks
The use of the SMAS and the release of the mandibular ligaments allows for the repositioning of facial fat and the jowls are returned into the cheeks. The jowls are returned vertically and posteriorly into the cheeks. They do not move to the sides of the mouth. Mobilization of the SMAS also allows for some correction of downturned corners of the mouth that is seen with aging. The lower face does not appear heavier because elevation of the SMAS also lifts facial fat...
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+1
Jowls and facelift
The goal of a lower facelift is to reposition the jowls (composed of skin, fat, and muscle) in a more natural, youthful position. This involves elevating the jowls in an upward direction so that they are positioned above the jawline. This creates a defined, youthful looking jawline. If the jowls are especially heave conservative lipocontouring can be performed in order to remove some of the fat.
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