Norman Leaf, MD (in memoriam)

Temporary numbness is not a complication of facelift. That has been well addressed by the other doctors responding to your questions. 11 Weeks without any resolution is a little longer than usual, but I am confident that the feeling in your cheeks and neck will come back eventually. Patience is a virtue here. The ears may be a different issue...sometimes the greater auricular nerve (provides sensation to the outer ear) can be injured, stitched or even severed during the dissection on the sides of the neck. This might take a great deal longer to return...and some parts of the ear might remain permanently numb.  This will not affect hearing, but simply remain as a bit of a nuisance if it persists. Ask you surgeon about that.

If you choose to roll the dice and  travel to Mexico for this extensive and intricate procedure, you obviously have plenty of confidence in the surgeon you have chosen. He or she should be able to answer this question more reliably than those of us board-certified American surgeons who have no clue what his or her level of skill is and who have not been able to examine you.  Ask him (or her).

I don't blame you for feeling dissatisfied. It's a shame to have gone through an extensive (and expensive) procedure and end up with your neck, which shows some improvement but does not show an excellent result. It appears to be more than just loose skin. It is true that a neck which had such a significant amount of fullness and laxity, such as yours, is more difficult to repair than a minimally sagging neck, but I think you are right to have expected a more satisfactory result. It's hard to tell from your after picture, but I'm afraid another lower face and neck lift is in order.  I wouldn't waste time and/or money on Ulthera...it's a reasonably good treatment for very mild sagging, but it wouldn't give you enough of an improvement to warrant the time, the cost (if any) or the discomfort. Talk to your surgeon about a complete redo.

Facelifts, including secondary neck lifts, must have all the tension of the lift taken up by the deep layer repair before the skin is trimmed from around the earlobe. There should be absolutely no tension on the skin closure. It's important for the surgeon to make sure the first side is not pulled too tightly, which can create a situation in which there's not enough laxity to close the second side without  tension, creating a pixie ear on that side only. This is extra important in a secondary procedure, such as the revision facelift you experienced. The good news is that a mild pixie ear is usually fixable with a minor local anesthetic procedure. It would be best to discuss this with your plastic surgeon.

This is truly every patient's worst nightmare. It's obviously a problem with the administration of local anesthetic. The only thing more nightmarish is being aware of everything but being unable to talk or move...I've never seen this happen, but patients ask about it often. There just isn't an excuse for either scenario in contemporary plastic surgery. Therapy may be a good idea.  I presume you've spoken to your surgeon about it.

If I didn't operate on patients who smoked the occasional joint, my practice here in Beverly Hills would diminish significantly.  Although it is true that smoking cigarette tobacco substantially increases the risk of post-operative complications and is a significant cause of many diseases, including lung cancer and heart disease, the toke or two you've been taking should not impair your health, nor your recovery and result. There is quite a large body of data indicating that marijuana  may have positive effects on health in general, but you should fess up to your surgeon and anesthetist about it before your surgery. No one will condemn you for it. I don't know the legality of weed in Arkansas so my comments might have to be filtered through that aspect. 

By now, I'm guessing most of the puckering has gone away. It should continue to improve. But looking at your 5 days post-op picture, it looked like there might have been a wound infection. Happily, the 11 day post-op picture looks much better. The pocket on the left is possibly swelling, but might be a bit of retained fat.  Swelling will go away, but retained fat might require a small revision.

Best way for you to evaluate this is to see if the skin glides over the muscle when you move it with your hand. If it moves easily, I would just use some Botox injections into the cords. If not, I'm thinking that even without liposuction in the neck area, you probably had a good deal of undermining to lift the skin off the platysma muscle, which is commonly performed. In that case there may be some residual inflammatory scar contracting of the skin to the muscle. I would recommend some very dilute Kenalog mixed with Hyaluronidase (to help spreading the Kenalog along the under-skin space) injections to the area. Then have some Botox injected directly into the bands. It will improve, I'm fairly certain.

It looks like you've had a good deal of fat removal during your procedure, which is not uncommon. This can sometimes cause the undersurface of the skin to attach to the platysma muscle in a corrugated pattern as it heals.  I've found that an injection of dilute Kenalog with some Hyaluronidase, fanned out under the skin, goes a long way to resolving this issue.  The enzyme helps the Kenalog spread along the under-skin space. Ask your surgeon.