Thomas Tzikas, MD

Excessive straining—such as heavy weight training, running, or other high-impact activities—too soon after surgery can place stress on the healing tissues and potentially stretch the face and neck, which may compromise the longevity of your results. This risk is greatest during the first three months of recovery, when the tissues are still settling and healing. After this period, the tissues are typically well-adhered, and returning to strenuous exercise should not negatively affect your long-term outcome. It’s always best to follow your surgeon’s post-operative guidelines to ensure optimal healing and results.

In most cases, a facelift will not affect the results of a prior otoplasty. Although facelift incisions are often placed behind the ear, near the area used for otoplasty, the ear cartilage and surrounding tissues are typically well-healed and stable. As long as your surgeon is aware of your previous otoplasty and plans accordingly, there should be no impact on your results. It’s always important to choose a board-certified plastic surgeon who can evaluate your anatomy and surgical history to ensure the safest and most optimal outcome.

It is difficult to fully evaluate your case without an in-person examination. Correcting the pixie ear deformity, tragus distortion, and associated scarring typically requires a surgical lift to release tension, excise scar tissue, and reconstruct a natural, rounded earlobe. Without sufficient skin laxity, this is not feasible. I do not utilize tissue expanders in my practice, as they are generally reserved for major reconstruction and can be disfiguring during the expansion process.A comprehensive deep-plane facelift revision would be the most effective long-term solution once adequate skin laxity develops. I recommend scheduling an in-person consultation for a detailed assessment and personalized recommendations.

I definitely recommend fat grafting around your eyes, as well as to the mid and upper face extending into the temples. This will restore volume and create a softer, more natural appearance in these areas. Your mid and upper face are noticeably sunken due to volume loss from your prior blepharoplasty.You would also benefit from fractional CO2 laser resurfacing of the periorbital area combined with a deep plane lower face and neck lift.

Did you have a chin or jaw implant? Most likely, it was a chin implant. Increasing the size could provide additional projection, which would help create better balance in the lower face. A cheek and jawline lift would be the most effective approach to address the drooping of the lower cheeks and the development of jowls. Unfortunately, this appears to be an early hereditary characteristic.

The neck would require revision, as the underlying muscle does not appear to have been adequately addressed. This may involve the platysma or another underlying muscle group. To achieve a smooth and natural result, the structural defect would need to be corrected surgically, as non-surgical treatments would not adequately resolve the issue.

A CO₂ laser will not address under-eye bags or hollowing. The appearance you’re describing is due to fat pseudoherniation of the eyelids, which requires a blepharoplasty to properly contour the area. Non-surgical treatments like lasers or polynucleotides may improve skin texture or fine lines but will not correct the underlying fat protrusion.

Unfortunately, the spots are areas of hypopigmentation, which cannot be corrected with topical treatments or standard procedures. However, a deep laser resurfacing treatment may help create a more uniform appearance by lightening the overall lip color

Based on what you’re describing, it appears there may be some localized fat accumulation under the chin. In cases like this, neck liposuction is often an excellent solution. It effectively removes the excess fat and enhances the jawline and neck contour, providing a more defined and streamlined profile.

For patients in their 20s who want a more defined or tighter-appearing jawline, non-surgical contouring can be a great starting point. Carefully placed filler along the chin and lateral jawline can help camouflage mild softness and create the appearance of a sharper contour. However, results with filler are subtle and temporary. For patients seeking a more significant or longer-lasting improvement, a surgical jawline lift provides a more definitive enhancement by addressing deeper structural support.