My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help? (Photo)

Question

I had a facelift 2 years ago and it was beautiful until about 14 months postoperative and the left side near my mouth started bulging. My Doc said he wanted to do buccal fat pad removal after much research I asked him not to remove buccal fat, but to slightly tighten area that was bulging. He removed large amount of subcutaneous fat during the surgery!!! My perioral mounds are very prominent now, marionette lines very deep and face is very thin!. What can be done???

Vincent N. Zubowicz, MD · Answer

If I were you I would be dissatisfied with the aesthetic result of the facelift based on the photograph provided. A revisional procedure will be necessary that will address the deeper structures and removed tension from the skin.

J. Kevin Duplechain, MD, FACS · Answer

Your early results really looked very nice and so one question is have you had any weight loss or was fat injected in some areas that may have not survived the transfer long term.  The left cheek seems to demonstrate some fullness almost like a herniation of fat in the buccal area and the right side looks a little thin.  I agree that it is difficult to judge everything on line, but suspect some volume addition to areas of the face and perhaps addressing the bulge in the left cheek might be helpful. A secondary facelift to address some of this may not be out of the question

Curtis Wong, MD · Answer

as your thinner, more angular face looks pretty good as well.  If you are desiring going back to what you were, it will take fillers or fat grafting.  Resurfacing (if you are accepting of the risks) can also help smooth skin and diminish lines.  Or as everyone else has mentioned, you can have another facelift but I prefer the more conservative approaches at this point.  You can discuss your concerns with your surgeon as your surgeon will ultimately be the one doing this.

Barry L. Eppley, MD, DMD · Answer

It would be helpful to know exactly what was done in these two facelift procedures. But now there appears to a volume-skin excess mismatch. Based on your description in your inquiry was buccal fat removed during the revision or was it the perioral mound area? You mentioned subcutaneous fat but it is not clear where that was done exactly. Most likely volume addition is needed by fat grafting to restore some facial fullness but there is not enough known information about your prior procedures to give any specific recommendations just yet.

Darryl J. Blinski, MD · Answer

Very hard to advise in great detail via the internet. Appears as a mid face lift plus Voluma fillers are needed. Or fat grating. Best to seek a few IN PERSON opinions.

My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help? (Photo)

Answers (8)

Answer: Facial Thinning after Facelifts

Answer: Facial Thinning after Facelifts

Answer: My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help?

Answer: My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help?

Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.

My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help? (Photo)

Answers (8)

Answer: Facial Thinning after Facelifts

Answer: Facial Thinning after Facelifts

Answer: My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help?

Answer: My perioral mounds are very prominent, marionette lines very deep, and my face is very thin. What can be done to help?

Browse related questions

Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.