Nasolabial and marionette lines after facelift, necklift and fat grafting. What can I do to improve my appearance? (Photo)

I am 54 years old. I looked younger than my age. I had facelift, necklift and fat grafting two months ago. Now my nasolabil lines and marionette lines are so deep and obvious. My chin looks weird. I look sad and older. I am depressed. What can I do to improve my appearance?

Doctor Answers 15

Swelling after a facelift can make the folds look deeper temporarily. Volume can be added to this area after swelling subsides

Face lifting surgery repositions sagging skin, improves jowls, softens marionette lines and the nasolabial folds. If you look at your pre-operative photos and compare it with you results, there may be some improvement. You must also recognize that at the two-month point, there will be some degree of swelling that may be present. With any surgical procedure, swelling can be a factor of how these areas look for six months to a year.

Nasolabial folds and marionette lines may look prominent because of the depth relative to the adjacent height. The two elements of facial aging: sagging where there is loosening of skin and support tissue, which was addressed with your facelift procedure; the other part of the equation is volume loss, where bone, muscle, fat, skin and soft tissue resorbs. I’ve always observed in women that the lower third of the face has a significant amount of volume loss resulting in loss of lip definition, vertical lines, and mesolabial or marionette lines become deeper. There is indentation of the mandibular notch which makes the jowls looks more prominent.

You can probably have a strategy with your doctor that could both address volume loss, but wait until swelling has resolved. In my practice, I let my patient understand volume loss after a facelift by having them hold the mirror and I lift the face. Then, I point out to the patient that the mesolabial folds are improved but there is still some depth. I tell them that we evaluate because when we change the whole architecture of the face, the perception of the face changes. I think that there will be options that will help you look even younger than your age as you already expressed. So talk to your doctor and express your concerns and I’ll think you’ll find solutions that will be satisfactory to you. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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New York Oculoplastic Surgeon
4.3 out of 5 stars 59 reviews

Facelift and still with aged look.

Facelift and still with aged look. You need to wait at least 6 months to let the swelling recede and in the mean time u can have fillers.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Nasolabial fold is generated by facial expression and is poorly treated long-term by a facelift.

A thorough facelift disassembles the nasolabial fold. However this is a feature that is generated by facial expression and will emerge as time passes. Postoperative recurrence is treated by fillers.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Swelling after face lift and fat injections

From the photo, you look still swollen but things look good.
See your plastic surgeon and compare your before photos with photos taken now -
you may see more improvement than you realize.
That and some more time for swelling may be all you need. Best wishes.

Nasolabial folds after facelift surgery

Thank you for the photo.  You do still look swollen but from what can be seen in the photo your results look good.  The folds look softened and natural and the fullness is a more youthful appearance.  Time will improve the result as the swelling goes down and it is hard to predict this early how it will look.  The face should have some contour and definition to it to produce a natural youthful look.  Overfilling or a flattened look gives the face an unnatural appearance.

Nasolabial folds after a facelift

I think your results are great, and it is still early. I would wait before trying to address those areas.  One of the most common misconceptions about face / neck lifting surgery that is that the nasolabial folds and marionette lines will disappear.  In most instances they get a little softer, but never fully disappear. In fact it is very natural to have them, and the dissection for a facelift usually doesn't extend that far towards the center of the face.   In my experience, the best and most consistent way to address them is by injectable fillers.

Samir Undavia, MD
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

The first thing you need to do is wait!

Hello topaz1991,

Thanks for your question.  The first thing that I would tell you is to wait.  The final results of your facelift, neck lift, and fat grafting are a few months away.  It takes up to 6 months for the face to settle in to it's new look.  You did not mention where you had your fat grafts placed.  If you didn't have the fat placed in your NLF and ML areas, then I would suggest that you speak to your surgeon about having fat placed in there at some point after 6 months.  If you don't want the downtime of additional fat grafting, you could consider using injectable filler in those areas to smooth them out some more.  You need to understand that your NLF and ML won't ever completely become smooth, even if you have a subcision procedure to cut under those areas prior to volume filling with fat or another substance.
My bigger concern is that it seems as if you don't have the support you need while you continue to improve after surgery.  I would strongly suggest that you speak to your surgeon and his/her staff regarding how you are feeling.  Don't try to recover alone.
Good luck,

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

Nasolabial fold after facelift

It is difficult to tell from your photo, but it appears that your nasolabial folds and marionette lines are very reasonable.  I realize that is easy to say, as I did not see them before the procedure.  However,  nasolabial lines occur in everyone, even babies have them.  A face without them often looks very unnatural.  It is important to communicate your concerns to you Plastic Surgeon.

Jarrod Little, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 17 reviews

Juvederm for nasolabial and marionette lines

You need a filler for these lines and the best filler is Juvederm Ultra Plus with xylocaine.   This is commonly a need because a faceift does not remove these lines.   The filler should solve your problems.   My Best,  Dr C

Residual folds after facial surgery.

Your photo doesn't give a full view but what I can see, it appears your skin quality is very good and your lines are not very deep .  Everyone, even after a facelift, will have nasolabial folds as they are caused by muscle insertions into the skin. As you are only 2 months after surgery and you still have several months to go to see the final result, ask your plastic surgeon whether some fillers would help add volume to the areas you are concerned about, and fill these lines.

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