I Had a Facelift 2 Months Ago and Have a Lateral Sweep on the Right Side of my Face? (photo)

Hello. It is hard to evaluate your result based on this picture alone. However, it appears that you do have a lateral sweep deformity. This usually occurs when a facelift is done without addressing the underlying SMAS or by directing tissue vectors in a totally vertical direction. At two months from surgery, it would be difficult to imagine this problem would correct itself. I would recommend you talk to your original plastic surgeon and discuss the possibility of reoperation. If he disagrees, I would then consider a second opinion. Hope that helps.

  These folds can be improved with time.  If after 6 months or so they are still bothersome, a revisionary facelift may be possible to help realign the skin and resuspend the deeper tissues.   Find the plastic surgeon with ELITE credentials who performs hundreds of facelifts each year.  Kenneth Hughes, MD Los Angeles, CA

A lateral sweep or "Nike swoosh" occurs due to inappropriate elevation of the lower face/jowl, without repositioning of the SMAS in the malar region/cheek.  As previously mentioned, Restylane won't help very much with this condition.  I would suggest waiting at least 6 months for potential resolution.  In my experience, this condition is unlikely to resolve spontaneously and will probably require a revision.

I am sorry for your experience.  It is best to wait at about 6 months.  Seek other opinions concerning a secondary facelift.  Restylane injections are a waste of your time.

Dr. ES

 

The difference between this facelift and one with less sweep (and necessarily less pull) is judgement.  There is a limit to tightening that is different for every face.  It is determined in part by skin quality, bone projection, and facial fullness.  Facelifting is an art of limitations.  It is essential to make the most of what one has without over doing it.  Can your lateral sweep be improved?  Well, time will help this certainly.  However you may also benefit from fat transfer and chemical peeling.  Your current surgeon is likely to be the most motivated individual to help you with this situation.

Facelifting requires deep understanding of vectors of pull. Unfortunately, if the side is pulled to tight in a lateral vector, without supporting it with an upward vector, a lateral swoop deformity can occur. No amount of filler can correct this. It is possible that it improves over time, but this takes many years and basically means that you are waiting for the results from your facelift to go away.  The only way to correct this is to redo the facelift. you will need to wait about 6 months before having another surgery. Sorry.

The lateral swoop problem results, quite simply, from the side of the face being lifted up and the center of the face not being lifted.  This creates a "hanging curtain" appearance.

No amount of injections can overcome the lateral sweep problem:  the simple physics still apply of something being lifted on the side, and not in the center still applies, even after fillers.

Often the lateral swoop deformity goes hand in hand with loss of the sideburn (or excess elevation of the sideburn), and problems with the ear configuration and the posterior hairline.

It is possible to correct or reduce this problem with two maneuvers:  first, redoing the facelift with a technique that does not pull primarily up at the temple.  Second, performing a cheek lift.

Patients never like to hear that they may have to undergo another facelift to fix or reduce this problem, and they should certainly weigh whether it is worth it to incur considerable expense with a new doctor when their neck might look quite good.  Patients may perceive their results of a complex revisional surgery as subtle given the money they have spent.  So it is a highly personal decision.

For some patients, it is preferable to wait 5 - 10 years or so when some looseness starts to recur and then redo the facelift with an eye to correcting the lateral sweep effect.

Lateral sweep after facelift is treated after 6-12 months by redoing your facelift. Injections probably will not do much.

Firstly I have not seen your preops and am not sure whether you have irregularities beforehand.I am not sure what type of facelift you have had - where are your scars? and how much undermining of the face and neck skin was done. It would appear that there is skin tethering and a tunnel effect that has been created. This may be tethering due to stitches - did your surgeon use barbs or threads? Barbs and threads can lead to irregularities like this and is common when the face/neck skin has not been lifted fully off the underlying layers where stitches etc are placed.I am unclear why your PS is using filler - I am concerned that the filler could be making things worse.I would get a copy of the operative note, your photos and ask for a second opinion. 

First off, thank you for providing photos. It is likely that this will improve over time but it's unclear how much improvement you can expect. Time will definitely tell. I would recommend against fillers to camouflage this while you heal. You would require enough volume of filler that it would make your lower face look heavier and unnatural. Massage will likely be beneficial as well and should not interfere with the lift itself. I hope this continues to improve for you over time. I would discuss with your surgeon the possibility of revising this result if it does not resolve on its own. If they do not acknowledge your concerns, I would recommend seeking a second opinion.Stephen Weber MD, FACS