How Long Should It Take to Witness the Final Results of a True Facelift

Swelling after a facelift should be nearly fully resolved within about 4-6 months.  This makes it unlikely that you will be seeing any additional improvement in your results.  The area you are concerned about is due to ptotic or hanging salivary glands, which are usually tucked up behind your jawbone and hidden.  As our tissues age, the glands descend and sit below the lower border of the jaw.  Patients may not notice them prior to surgery as the loose skin of the neck is covering them.  However when the skin of the neck is tightened and smoothed the rounded contour of the glands is seen.  To correct this problem is difficult.  Some surgeons resect part of the glands and other advocate sutures to resuspend the glands.  Great care must be excersized in doing either as prominent blood vessels and nerves run through the gland and can be injured during the surgery.  Don't be shy about consulting with other board certified plastic surgeons to see what might benefit you most.

Facelift
recovery varies from patient to patient and depends on a large number of
variables. Just as every patient is unique, the chosen procedure is unique as
well. The differences in wound healing characteristics and the types of
procedure performed account for variations in facelift recovery.Most patients feel pretty good in
about four to five days, but their primary concern is when they will look good
enough to go out in public. Recovery following facelift surgery may last for
months, but most patients feel they can go out in public in about two weeks. At
this point, most of the swelling and bruising have resolved. Many patients
adjust their hair style to hide their incisions and use make up as well. It’s
important to emphasize that recovery periods are variable and depend not only
on the patients wound healing characteristics and the surgical technique
utilized, but also on the patients tolerance for changes that may occur
following the facelift surgery. The drooping glandular tissue that
seems to be your primary concern won’t get better with the passage of time.
This condition is probably related to the sag of the glands that produce
saliva. Over the course of time these glands tend to drop because of gravity
and loss of soft tissue support. When loose facial skin is present these glands
are well hidden. Following facelift surgery the skin is tightened and the
glands become more apparent.This is a very difficult problem to
treat. In some cases surgeons have resected these glands, while in other cases
they have re-suspended them. If you’re concerned about these glands, it may be
appropriate to re-discuss the issue with your plastic surgeon. Your surgeon
should be able to formulate an appropriate treatment plan.

This is a great question and brings up an interesting but difficult point. After 12 months, you should be seeing pretty much a final result. In some cases, particularly in older patients, the submandibular glands (salivary glands) are very low in the neck.  Elevating the skin, muscle, and soft tissues of the neck will not lift these glands... and in some cases, it can make them seem more prominent.  There are some suture suspension techniques that can be used during a facelift to help lift the glands, but that is not possible at this point in your case. It is possible to use Botox or other neurotoxin treatment to reduce the size of these glands, but there are risks -- including weakness of one of the muscle used in moving the lower lip.
 

It is very difficult to answer your question without seeing your pictures or examining you – consider posting images showing your areas of concern. Typically by 1 year the healing is complete

In general, most patients feel they look their best around the 3-4 month mark so having subtle swelling until this point is not unusual.  You seem to be describing either a prominent submandibular gland or a ptotic submandibular gland.  This gland is one of our spit glands and is held in place by ligments and muscle.  The gland descends with time and after a facelift the glands can become a bit more visible as they descend with time or if you had ptotic glands to begin with.  Eighteen months after surgery, this is probably the most likely reason.

Facelift results do not change much after one year; you will normally see a very close approximation of your final result in 6months. However, there are some subtle changes that occur over the next six months that are visible. The problem you are describing is probably ptotic sub-mandibular glands which, as you have read from the other comments, can be a difficult issue to handle but will require a re-operation to fix.

Dear Johnadler from San Clemente, CA
In my opinion what you are dealing with is called a ptotic or droopy submandibular gland (salivary gland) which were not noticeable prior to surgery since loose neck tissue was covering it. Once you had your face and neck lift then skin became smooth and that gland appeared more prominent. Prominent submandibular glands are difficult problem to treat. Some surgeons partially remove them, but that involves major risk such as nerve injury to dry mouth. I do not believe that you should be experiencing any swelling by now. Please do not Inject Botox into it that is a waste of money. If you would like, I will be happy to evaluate you since you are in my area. best of healing for you.

In my hands the results are noticeable early and become much clearer to the patient after the majority of the swelling has resolved in about 10-14 days.  If you are failing to see results after 13 months then it is unlikely that your situation will improve. 

Dr. ES

We say that normally it takes 12 months for the facelift to be healed. You may want to get a second opinion from an experienced facelift surgeon.

In an individual who is thin, prominent submandibular glands may be a difficult problem to treat. Some bold surgeons advocate partial removal but this is not without significant risk and my comment is "be careful what you ask for". Suspension of the gland is also a difficult undertaking and sometimes difficult to achieve reliably.