Will Muscles That Have Been Shortened in a Facelift Thin out and Weaken in Time?

I am considering a lower face lift. I am 62 years old. I am told muscles will be shortened. I am thinking that might be compared to an elastic band and wonder if they could eventually snap.

Doctor Answers 6


Good question. The short answer is "No". The muscle function is not altered unless there is damage to the nerves that send messages to the muscles. That is an infrequent complication and usually resolves over a few months. The long answer is that we really dont do much to the muscles although some surgeons use that term because patients understand the word muscle. In fact, the muscles don't sag at all. It is the layer of tissue that holds the fat pads that sags along with the skin. The muscles are tiny thin structures and when we lift the deep tissues the muscles just go along for the ride. But it is important to lift the deep tissues and let them lift the skin. If we only tighten the skin you look tight, not youthful, and we do not want that look.

Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Condition of muscles after a facelift

The muscles are not shortened during a lower face/neck lift.  The platysmal muscle is tightened through a platysmaplasty in the front portion of the neck by placing permanent sutures between the left and the right anterior platysmal bands.  Further tightening is performed in the posterior portion of the neck of the platysma along the angle of the jaw line that creates a new jaw/neck line.  Liposuction in the neck removes fat and redefines the jaw and neckline.  Excess skin is removed.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Muscles in a Facelift are not technically shortened

Facelift surgery involves multiple techniques depending on each facial patients needs. Perhaps you are discussing the SMAS procedure which I perform on the majority of all my facelifts for a better longer lasting more youthful appearance. In the SMAS technique you are dissecting, lifting and trimming and suturing between the subcutaneous fat layer and the functioning facial muscles. On some patients the platysma muscles under the neck are plicated to provide less sagging. I know it is complicated and difficult to understand all of these terms. I would suggest consulting a good surgeon in your area and he/she can show you anatomically exactly what these procedures involve and if you are a candidate for these procedures. Best regards and I hope this is helpful to you.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Will Muscles That Have Been Shortened in a Facelift Thin out and Weaken in Time?

 The muscle layer that is lifted and trimmed, during a Face Lift is called the SMAS layer and this is not part of the muscles that animate or move the face.  The SMAS is a thin layer just below the subcutaneous fat of the face but above the facial muscles themselves.

 The SMAS is dissected, elevated, trimmed and sutured together during a Face Lift and would not have any impact on the facial muscles themselves.  Be sure the Face Lift Surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.

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

Do Muscles Thin out and Weaken After a Facelift

Facelifts do not weaken your facial muscles. The way most surgeons perform a lower facelift does not involve "shortening" of the muscles. In order to improve the area under the chin and in the neck, the muscles that have separated over time are sutured back together. This is called a platysma plication (platysma being the muscle that separates). The platysma plication creates a sling under the chin and is an important part in getting a good contour under the chin into the neck.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

SMAS and platysmal plication in Facelift

   SMAS and platysmal plication are attempts to resuspend or reapproximate tissues for a more youthful look.  No muscles are involved.  Kenneth Hughes, MD facelift Los Angeles, CA

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