Charles W. Guy II, DO, FAOCO

Great question!   A facelift can "set the clock back" but it does not stop the aging process.  There are few things that happen with aging that can affect your results.   Your skin will loose elastin and collagen which can cause wrinkles or sagging.   Using sunscreen and avoiding the sun can help protect the collagen and elastin in your skin and protect your investment.  Using a daily facial moisturizer, drinking plenty of water and healthy diets can help.   This will not necessarily stop the aging of the deeper fascial layers or the volume loss.  You may need occasional filler or fat transfer to replace volume or a device that delivers a deeper energy to help tighten the skin.   It is not uncommon to need a touch up or revision facelift in another 10-15 years.   I hope this helps

It is difficult to tell if there is still swelling without comparing it to the pre-operative photos.   It looks as if you have thick skin to the nasal tip which can limit the amount of tip refinement that you can achieve with rhinoplasty.  I would continue to follow up with your surgeon for his/her recommendations.   As far as the steroids go in a Type II diabetic, I would not be worried about it having a significant affect on your blood sugar.  It is used in small amounts when injected.   However, it may not have a large impact either if you have thick tissues.   I hope this helps

A facelift does not freeze the face in time.  I do not know if those were present originally or if they developed afterwards and would have developed over time naturally.  The good news is that they can be treated through a small incision just under the chin.   This can be done in the office or the operating room, depending on surgeon and patient comfort levels.   Botox or Radiofrequency treatments will probably not get you the results you are looking for.

From the photos, it looks like the tissues did not hold as expected.   Performing a revision SMAS facelift could potentially get you the results you are looking for.   I don't believe more fat will get you the results of a more smooth and continuous jawline.  I hope this helps.

If the pain is located just to that spot, there may be some chronic irritation that could cause some pain.   It is not uncommon to have pain just under the earlobe.  There is a nerve that runs up toward the ear there and with the sutures from the facelift it can pinch the nerve and would be unrelated to the sutures shown in the photo.   Your surgeon should be able to remove the possible piece of suture shown in the second photo.  Otherwise a small dose of steroid injected into a tender spot below the earlobe can help with the other possibility.  I hope this helps.