1.5 years post op - what could have caused issues with my facelift and what can I do to correct the falling? (photos)

Thank you for your question and for providing photos. You appear to have developed hypertrophic scarring, which is the result of an overly zealous healing process. When the body’s cells produce too much scar tissue, this causes the scar to raise from the skin. At this stage, it is possible to surgically remove the scar tissue while also addressing the double chin and jowl formation you’re referring to with a revision facelift. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your surgical history, conduct a thorough physical examination, and determine the best approach to help you achieve your aesthetic goals.

Unfortunately you have developed some widened scars around the ears. This is a common complication of a face and neck lift resulting likely from the excess tension around the ear closure, which holds the highest tension in a face and neck lift. This can be corrected typically with a steroid injection or scar revision which can be done under local anesthesia or in the operating room. As far as the jowling and your new chin issue goes, it would take an in person examination to determine exactly what is going on there and what, if anything, can be done.

Generally, the two most common causes for thickened, hypertrophic scars are the patient's innate tendency to form such bad scars and too much tension (tightness) on the skin closure. Other than repeated steroid injections into the scars, which works best within the first year after surgery, I would consider surgical removal of the offending scars without any further skin tightening and precise skin closure. However, if you have shown a tendency to form such thick scars in the past, it could always happen again. Good luck.

Your pain along the incision lines is due to hypertrophic scarring. If you go back to your surgeon, he would likely be able to inject Kenalog into the scars to decrease scarring and reduce pain. I can't comment on your outcome because there are no pre-op photos but I'm sure you could mention that to your surgeon.

It seem that you are dealing with large, hypertrophic, possibly keloid scars. There are different approaches how to treat these problematic scars, mostly based on use of corticosteroid injection or topical application. You should discuss this issue with your surgeon or seek a second opinion consultation with another, board certified plastic surgeon with known expertise in facial rejuvenation. Good luck.