Is it common to still need filler in your nasolabial folds after SMAS or Deep Plane Facelift?

Question

Hello! It's been 18 months since my surgery and my neck is already falling. My nasolabial folds are coming back as well. I know that I am continuing to age, but I feel like it's too soon after surgery to see these changes and need filler? Would a deep plane facelift correct these issues longer? What are realistic expectations? Any feedback would be greatly appreciated!

Kaveh Alizadeh, MD, MSc, FACS · Answer

Hi TriciaMc,
I would love to see your photos to be able to better answer your question but suffice it to say that a face lift alone does not address every issue in the face. We now know that an aging face also loses soft tissue in many dimensions and therefore it is important to administer fat grafting during the face lift to help replenish these areas. Please also remember that that not all face lift are created equal and just as you have wondered, deep plane face lifts are able to better address the nasolabial folds as long as the SMAS is also lifted as part of the procedure. We use a multi-planar, multi-vector approach in my face lift technique that address all the major areas of the face and incorporates fat grafting to help with the soft tissue replenishment of the face.

Lucian Ion, FRCS · Answer

Thank you for your inquiry.

Nasolabial folds tend to be relatively strong in some people with more activity in the muscles around the mouth. The nasolabial folds are not usually fully corrected by any form of facelift intervention, although they can be softened by treatments, either with a SMAS facelift or a deep plane facelift.

In general, injectable fillers can complement the impact of the facelift surgery and soften the nasolabial folds. The alternative is represented by subcision, which also attenuates the visibility of the nasolabial folds, or fat transfer done in moderation.

Jonathan Kulbersh, MD · Answer

Thank you for your question, sorry to hear that you’re concerned about your facelift results. While a facelift procedure is an excellent choice for reversing many signs of aging, they don't always create the desired effect on nasolabial folds.
You may benefit from a non-surgical treatment to further optimize the results of your facelift. Filler injections are great for nasolabial folds, while chemical peels, and laser resurfacing are valuable approaches for diminishing fine facial lines. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They’ll be able to review your surgical history and your concerns to determine the best treatment option for you.

Martin Jugenburg, MD · Answer

Nasolabial folds are often corrected with filler injections.  A facelift does not correct this properly because when enough traction in applied to the face to pull on the nasolabial folds, the excessive pull can create a wind-swept look.

Michael P. Morrissette, DDS, FACS · Answer

Both deep plane and SMAS tightening techniques are effective treatments for facial aging. The best results are dependent more on the surgeon than on the specific technique. It's unfortunate that you are experiencing some relapse. Perhaps you can return to your surgeon to relay your concerns. In general, the nasolabial fold area is minimally affected by a facelift procedure though many surgeons no longer advocate placing filler in the nasolabial folds. Facelift surgery primarily changes jowling and facial heaviness.

Connie Hiers, MD, FACS · Answer

No surgery will stop the aging process, especially if you deal with much stress, have poor eating and sleep habits, smoke, or change weight. However, folds are one of the things that can come back fairly soon. Try fillers to fill the folds or fat transfer.  Many surgeons do add fat transfers to the lifts for better long term results.

Barry M. Weintraub, MD, FACS · Answer

I’m sorry to hear that you feel like the facelift your surgeon performed did not last, but many factors come into play about how effective and long-lasting a facelift will be. Age of patient, fluctuations in weight, environmental factors such as smoking, sunshine – all influence the longevity of facelifting surgery. Without a physical examination, it would be difficult to make a sound assessment. There are certainly cosmetic “fixes” that can possibly help you, but without seeing you in person, it would be improper to make suggestion

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem but everyone ages differently but if you have concerns see your surgeon as he knows what he did and where you should be in the healing process

Dr Corbin

Is it common to still need filler in your nasolabial folds after SMAS or Deep Plane Facelift?

Answers (8)

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