Should Jaw & Lower Mouth Pull So Much That Talking and Eating is Difficult After SMAS Face? (Photos)

Facelift changed day of surgery from endotine to SMAS facelift. Hard jowls (swollen). Lower face (lip) and jaw is very stiff..hard to make "f" when talking and crumbly food falls out. Mouth looks like a frowning slash sort of. If I put pressure in front of the ear, its easier to talk. Surgery was 3 weeks ago. Right side had Bell's palsy so was expecting problem. Couple of indentations. Jaw/mouth area is kind of frozen, upper face is quite loose as well as neck. Browlift/subcutaneous done.

Doctor Answers 8

Face lift

Pictures posted are difficult to evaluate, because of animation and poses.

It seems you have major problems. Consult a BOARD CERTIFIED PLASTIC SURGEON(AMERICAN BOARD OF PLASTIC SURGERY) for thorough evaluation and recommendation. I think this is a very complex situation

After complete healing you may need revision face lift again

Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Tightness After SMAS Surgery

It is normal to have some tightness after SMAS lift surgery, although the tightness you have seems to be a bit different. The Bell's palsy may be contributing to your recovery. I would certainly suggest following up with your physician closely to ensure that you are healing as planned.

Carlo P. Honrado, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Should Jaw & Lower Mouth Pull So Much That Talking and Eating is Difficult After SMAS Face?

I have performed Face Lifts for over 20 years and the pleats and indentations are a bit odd.  You should ask your plastic and cosmetic surgeon these questions.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Facelift and asymmetry

Asymmetry after a facelift for the first few days is normal.  Around 2 weeks, most individuals begin to form collagen lumps in front of the ears, below the jaw, and below the chin.  These are normal and can persist for the first 6-8 weeks though they are usually felt and not seen.  The tightness generally subsides over the first 3 weeks after surgery and normal speech should be possible during the first day after surgery.  I would work closely with your plastic surgeon to make sure you are healing according to timeline he discussed with you prior to your surgery. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Should Jaw & Lower Mouth Pull So Much That Talking and Eating is Difficult After SMAS Face?

   In general, at 3 weeks following facelift, talking and eating should not be difficult.  However, method of fixation will influence this.  Hopefully, the pulled areas of the jowls will relax.  Dents at three weeks may well resolve as tissues relax and scar softens and swelling continues to decrease.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Temporary Discomfort and limited mouth movement common early on after SMAS Facelift

SMAS fixation near the temporalis fascia causes discomfort when eating or moving your lower jaw for up to a few weeks. This is normal and expected.

Here are some general comments that would include the rest of your concerns:

Everyone wants an immediate result - including surgeons! Unfortunately this just isn't how we heal.three weeks  is just too early to tell. There are many predictable portions of the healing process that ALL PATIENTS EXPERIENCE. Although both doctor and patients would like to not have this happen, it is part of the healing process.  Massage can some times be of benefit during this time period These Side effects refer to what you will be experiencing from the facelift healing process: Here are some of the common things you will experience. The common side effects include: swelling which is maximum 2-3 days later, bruising (highly variable), numbness which takes several months to resolve,  tightness takes several days to months to resolve, discomfort chewing (technique dependent), discomfort (generally mild with this surgery, nausea (variable) and in some patients emotional lability in some. Although most of the visible edema resolves in 2-3 weeks in mini-lifts and 3-4 weeks in traditional facelift approaches, residual firmness (edema you feel but don’t see) can linger for several months. Skin suppleness also takes a while to return as does scar maturation. I tell my patients it takes up to a year for final resolution of the healing process. In my experience, the above rough time table is usually delayed in smokers, when multiple procedures are performed together and when resurfacing procedures are done at the same time as the lift. The same is true if complications occur such as infection, hematoma, skin loss or compromise, etc.  Facelifts and all surgical procedures for that matter share several possible complications - such as excessive bruising or bleeding (e.g. hematoma), injury to deeper structures, anesthetic complications and so on

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

SMAS effect on muscles after surgery

Tightening the SMAS will at times cause some tight feelings that can take a few weeks to get better. In your case, there seems to be more going on. I think the prior Bell’s palsy is contributing to some of the problem along with the tightness. I think seeing your surgeon to make sure that no other nerves were injured during the surgery is crucial. If the nerves were just stretched out, they should return to function with time.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

SMAS lift pulling

Your pictures look a bit concerning. The folds that you have on either side of the chin are a bit unusual. It's difficult for me to conceptualize exactly what kind of procedure was performed. Make sure that you are treating the Bell's Palsy appropriately as well, keeping the eye adequately lubricated. A steroid taper may not be helpful as well. An opthamology consultation may not be a bad idea. I would follow up with your surgeon and if he or she is not helpful find another experience surgeon to make certain that you are being adequately cared for.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.