How Can I Avoid This? (Facelift Gone Wrong) (photo)

Question

I'm wondering if a plastic surgeon can offer an expert opinion on what cosmetic procedures were likely performed on this actress that resulted in her recent facial appearance? It is said around Hollywood that she got a facelift/bleph, which did not turn out well. How does this happen & why the lumpiness/weird contour & immobility? Possible nerve damage? I am around her age & am having a subperiosteal MFL through the temples/mouth to raise the cheeks, is this aesthetically an outcome I risk?

John Alexander II, MD · Answer

I think most would agree that this woman looks better before than after. For someone this young and pretty I would have recommended waiting or doing something less invasive. I am not sure what she had done, but here are the things I see different. It does not look like she had a severe brow lift, but the angle of the eyes looks more slanted, suggesting a canthopexy. Something is different with the mouth. The lips have probably been augmented and the corners of the mouth are a straight line with the center of the lip, whereas before the corners of the mouth are lower than the center of the lip when smiling. This creates a more attractive smile. Most people think the upper mouth turns up with a smile, but if you study many pictures of beautiful smiles, you will note that the upper lip creates an upside down smile, while the lower lip curves up with an upright smile. She also looks like the cheeks are fuller and this may be due to fat or filler.

	A subperiosteal MFL is often recommended in younger patients with some early midface change, who may not be candidates for facelift surgery. In my opinion, the midface is a tricky, difficult area, and the two most common outcomes are no change vs. bad change. In my opinion, too many beautiful 35-45 year old women submit to early plastic surgery because they hate the early changes of aging, and in a short time they destroy their faces. Just look at Real HW of BH and you see these faces everywhere.

	Be very careful. Make sure to ask a lot of questions, look at pictures, talk to patients who have had the same thing done and look at their pictures. Show these pics to your doc and see what he/she has to say about them.

	Good luck.

Kenneth Hughes, MD · Answer

Midface lifts have a laundry list of problems even in the hands of experts.  If you do not need it or can avoid it with other measures, that would be best.   Kenneth Hughes, MD Los Angeles, CA

Stephen Prendiville, MD · Answer

I agree that this person looks worse after surgery, which begs the question:why did she have surgery anyway? Surgery as a tool in facial rejuvenation is only useful when it is actually indicated. In this person, I just don't see any real reason to have had a procedure. I agree with other posts that this patient most likely underwent a superiosteal mid face lift. This procedure tends to be transformational rather than rejuvenative. Youths person has clearly been "transformed" but hardly in a good way

Larry S. Nichter, MD, MS, FACS · Answer

Choosing the right surgeon for you is extremely important: 

	1. Seek a board-certified plastic surgeon by the American Board of Plastic Surgery

	2. Look for a surgeon who produces natural-looking results &ndash; look at before and after photos

	3. Consult with  different qualified surgeons to find the right doctor for you. Ask how many of these surgeries they have done and if they have had complications.

Sam Naficy, MD, FACS · Answer

The most common cause of unnatural results in facial plastic surgery have to do with poor midface and lower eyelid work or excessive brow lifting. Find a surgeon with a proven record of producing natural results

J. Jason Wendel, MD, FACS · Answer

Thank you for your question and the photos.  From those pictures, it looks like she has been overdone with Botox and dermal fillers of some variety.  When overdone, they give a very unnatural look and in my opinion, can make someone look older and worse than they did before. Also, specifically the cant of her eyelids is different, so she may have had at minimum a canthopexy or perhaps a MFL.

	When you see your surgeon, ask not to be overcranked, and yes, unfortunately poor cosmetic result is a risk of most procedures, especially if there happens to be a complication.

	Best wishes you a safe and full recovery.

How Can I Avoid This? (Facelift Gone Wrong) (photo)

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