I had a lower lift done recently. I still have the jowl and a loose neck. Doctor says that is all that can be done. It was a SMAS lift. Does the SMAS lift just need to farther in the face? Can every jowl be lifted?
SMAS Facelift to Improve Jowls?
Doctor Answers (22)
Mini SMAS lift?
Since I cannot see your preoperative photographs, it is difficult to make a complete judgment. However, I feel it is safe to say that you had a very "conservative" procedure. In certain circumstances, conservative or mini- is good, in yours it may have been less appropriate.
As others have stated, one surgeon's "SMAS" Facelift may be entirely different and less substantial than that of another surgeon. I would venture to guess that your SMAS procedure probably involved plication of the SMAS, a less effective maneuver than SMAS elevation and imbrication. Likewise, there is persistent jowling present and poor definition of the jawline which could be improved upon by more aggressive liposuction. Lastly the definition in your neck could very likely be improved by liposuction and platysmaplasty.
I would recommend a return visit to your surgeon for starters, and other opinions if you are not satisfied.
Facelift to improve jowling and neck fullness
You do appear to have quite a bit of residual fullness in your jowl area. This could be due to inadequate tightening during the facelift or may be from excess fatty deposits that could be improved with liposuction.
As some of the others have mentioned, you may also have persistent fullness in the neck from your submandibular glands. An examination would help determine if this is contributing to your findings at all.
"Branded" lifts and minilifts
There has been a big move toward 'mini-lifts' and 'lifestyle this or that' and other named lifts. For some, this is the answer. Usually, this works best for someone who does not really need a facelift. However, the result you have is inadequate. Need to go back and get those jowls moving. Or see someone else for a second opinion.
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Residual jowls after SMAS facelift
Unhappy After Facelift
Facelift techniques are confusing but the results should speak for themselves. Your photograph demonstrates a full face, persistent jowls plus or minus prominent salivary glands, and an ill-defined jawline and neck. Most of these problems can be dealt with with some form of SMAS manipulation along with minute amounts of liposuction. Your skin tone appears to be excellent, and should help you in the end. It appears that more aggressive techniques need to be employed; I would suggest a small amount of liposuction of the jowl area and neck/submental area along with a technique to remove some of the bulkiness of your face. A Lateral SMASectomy whereby a strip of tissue containing the SMAS layer and fat is removed and the edges are approximated, increasing the contour of the area while simultaneously lifting facial fat to a more youthful position. I would get a few more opinions from experienced Board Certified Plastic Surgeons. Good Luck.
From the picture you still have major jowls, but an exam is needed to rule out a prominent submaxillary gland. You still have los of neck fat also.
ALL JOWLS CAN BE LIFTED WITH A SMAS face lift, in the habds of an experienced Board Certified PLASTIC SURGEON.
Find another Plastic Surgeon.
It is difficult to tell from this picture especially without viewing your preoperative pictures but I will assume you went to a qualified surgeon. There are many other things that could explain your findings and difficulty in obtaining an optimal result. A prominent submandiblular gland could partially be responsible. Sub-platysmal fat is another possible explanation for the poorly defined neck angle. I would consider a chin implant as this can enhance the projection of the jawline.
SMAS face lift to lift the jowls
Revision facelift with liposuction may help you
With only one picture to look at and no physical exam it's pretty hard to evaluate your case but certainly I have some initial thoughts.
1. Not sure what type of face lift you had, but in looking at your anatomy you would benefit from a sub-SMAS approach. This is a deeper facelift that helps lift your jowls as a whole instead of relying on sutures from above to lift them.
2. Liposuction under your chin and along your jawline would give you more satisfying definition.
3. There is some fullness along your jaw that could be related to your salivary gland there. In most cases it is best to leave alone although if desired a portion of the gland could be removed to provide more definition there.
Best you sit down with your surgeon and discuss your concerns.
All the best,
SMAS Face Lift and Jowls
It is not clear at all what was done, but it is not the result that I would expect from a SMAS face lift. It is not just a question of whether the SMAS was "lifted" though. The mandibular ligaments and submental crease do not appear to have been released and the area under the chin is still full (probably with subplatysmal fat). If these elements had been incorporated with an adequate SMAS release and the use of a SMAS flap transposed to the mastoid area to provide hammock support for the neck, I think that you could still get some significant improvement.
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.
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