Lateral Sweep on 1 side of face 8 years after SMAS Imbrication. How can I fix it?

Question

It protrudes somewhat on the right side, making the face look out of balance. Like it should be higher up on the face instead of where it is. It is not that bad on the left side. What would be the best way to fix something like this?

Konstantin Vasyukevich, MD · Answer

There are two possible treatments for a lateral sweep.  One would involve re-doing the facelift and re-positioning the sagging tissue to improve the appearance of the face.  Another possibility is to use fat grafting procedure to restore facial volume and to elevate the skin of the lateral cheek.  Occasionally, to achieve the best result it becomes necessary to do both of these procedures together.Best wishes!Dr. Konstantin

Marc DuPéré, MD · Answer

Thank you for your question.Pictures would be very useful to us if you have a chance.It is unlikely that your "lateral sweep deformity" improves now after 8 years post facelift surgery.The ideal solution would be to redo the #Facelift and SMAS (deeper layer), reposition the soft tissues, suspend and re-anchor the SMAS and close the skin with no tension.Adding fat is also a common adjuvant procedure in most of my facelifts and it would also likely help correcting your lateral sweep deformity.Revision #Facelift requires an added experience so find a qualified plastic surgeon and try to bring your old surgical note to your chosen plastic surgeon.  Those surgical notes are very useful.All the best,DrMarcDuPere, Toronto Royal College Board-Certified
plastic surgeon

Paul Lanfranchi, DO, FAOCOO · Answer

Everyone's face is asymmetrical naturally.  For some, surgical procedures of the face can make this asymmetry worse, or create a new asymmetry.  The good news is that 8 years have passed since your first procedure and a second procedure should be able to address (to some extent, at least) your concerns.  What is equally important is that you have reasonable expectations for your next procedure.  If you are "uneven" before the procedure (whether it be from surgery or just naturally), it is important to expect that you will still possibly have some asymmetry after the procedure (although usually less).  Depending on the extent of the "sweeping" or wrinkling of your skin, it may be advisable to add a fractional laser treatment to your skin at the same time as your relift.  The laser can help decrease the wrinkles and sweeping effect that is troubling you.  Hope this helps.  Best of luck to you!

John A. Standefer Jr., MD, FACS · Answer

Lateral sweep after facelift can often be improved with repositioning the tissues in a natural position and redraping the skin in a smoother position. This may require a little more anterior dissection than was done before to release the tissues from the underlying muscles and tissues that are causing the abnormal "sweep".This would require another facelift and or fat transfer to the skin to replace any volume loss. In my experience, patients that get the "sweep" have a little thinner skin and have less elasticity of the skin than patients that have thicker, more elastic skin. Care must be taken to fully release this skin from the deeper tissues as mentioned above, and reposition the skin carefully to prevent the "sweep".Photos would help visualize if there are any other issues.John Standefer MD

Lateral Sweep on 1 side of face 8 years after SMAS Imbrication. How can I fix it?

Answers (4)

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