Pouches below jawline after lower facelift - would revision be a better option than Botox? (Photos)

Question

I had lower facelift surgery a few months ago. As the swelling subsided, I am left with these pouches below my jawline on both sides, more prominent on my right side. My surgeon said it is muscle and glands. He says botox might help. Would a revision be the better option?

Jacob Tower, MD · Answer

Hello, hope you are well. Your photo shows the muscles underneath the chin have become skeletonized and now protrude creating the appearance of 'pouches'. It could be platysma, but more likely to be the digastric muscle bellies. (It would be helpful to see your operative report to see what was done in that area). In any case, botulinum toxin can only selective weaken / soften muscle for a few months at a time. Even if it diminishes the prominence of those muscles, it would in all likelihood be a temporary fix. Revision surgery can offer the option of directly reducing the muscle there.
Best,Dr. Tower

Ronald J. Edelson, MD · Answer

Those are the edges of the platysma muscle which have separated. They can be seen to each other through a small incision under your chin. This may have been fine at your previous surgery but sometimes these platysma bands can separate and a revision is needed

Andrew Kornstein, MD, FACS · Answer

Based on your photos, these appear to be your anterior digastric muscles
Once all swelling has resolved(roughly six months) a decision can be made between surgically reducing them(without compromised function) or using permanent fat grafting to camouflage them
Hope this helps

Pouches below jawline after lower facelift - would revision be a better option than Botox? (Photos)

Answers (3)

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