Facelift did not address jowls - are there any recommended procedures? (Photo)

Question

I had a facelift about a year ago, but it did not address my main concern: jowls. I don't see any change in my face shape. Is there any other, non-surgical way to do anything about it?

Frank Agullo, MD · Answer

Your jowl did not move and the shape did not change, so the first lift therefore tightened only the skin layer without moving the deep SMAS layer. A jowl only lifts when you pull the SMAS, the deep layer, and release the ligaments that hold the soft tissue down along the jawline. A skin only lift lets go quickly and your jowl drops right back down to where it was before. Fillers simply add volume to create an illusion but remove nothing. Adding some filler to your prejowl depression, the hollow just anterior to the jowl, will straighten out the jawline as judged visually and therefore make your jowl less apparent. Microfocused ultrasound or RF microneedling can tighten mild skin laxity. Both are mild procedures and both will reverse, but neither one will lift a true jowl.

Your picture is cropped closely so I get your lower face and jawline but not the neck or any kind of profile shot. In case jowls were your main complaint and your procedure somehow missed them, the real correction is revision surgery to go deep.

Review your operative notes to find out what you actually got done the first time around.

#StayBeautiful,

@RealDrWorldWide

Your picture is cropped closely so I get your lower face and jawline but not the neck or any kind of profile shot. In case jowls were your main complaint and your procedure somehow missed them, the real correction is revision surgery to go deep.

Review your operative notes to find out what you actually got done the first time around.

#StayBeautiful,

@RealDrWorldWide

David Hill, MD · Answer

While difficult to assess in the single photo of just part of the face, there are lots of options, including either fat grafting or filler to the pre-jowl sulcus, adding volume in the same way to the chin or mandible, or doing external procedures to improve skin laxity such as resurfacing lasers.

Ronald J. Edelson, MD · Answer

I’m afraid a major surgical revision would be necessary in order to properly tailor the skin and that should alleviate that problem

Mike Majmundar, MD · Answer

It’s difficult to tell from this one zoomed in photo but it seems there are other items that need to be addressed based on these photos.  Issue one is a weak chin and jaw that doesn’t provide adequate jawline support so this limits your lift result.  Second issue seems to be a prominent buccal fat pad that is weighing down the corner of mouth and marionette fold limiting the effect of the facelift.  Based on the photo, adding chin projection using a chin implant and removing your buccal fat pad with a revision facelift (you’re a good candidate for a deep plane facelift) would be the best option.  I can’t tell if you also have a small mandible which may cause extra shadowing around the mouth which may also require fat grafting with the chin implant to get you the best improvement that will make you happy.

Facelift did not address jowls - are there any recommended procedures? (Photo)

Answers (4)

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