Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift? (Photo)

Question

I am 5 weeks post short scar lower face lift. I feel my jaw line is pulled too vertically and looks unnatural. I can actually see my lower jaw move when I talk. I also have noticeable pleats behind my ears. My surgeon says my jaw line looks great and the pleats will go away. Should I seek a revision and when?

Robert L. Steely, MD, FACS · Answer

good morning!looking at your photos it does appear that you are a bit tight in the posterior vector.  It is always difficult to comment on these without preoperative photos as well as more views but was liposuction performed along your jawline during the procedure?  That may be causing the asymmetry seen in these photos.Your best bet is to have an honest discussion about your concerns with your PS about these issues.  5 weeks seems like an eternity, but swelling can still be paying a part dependign upon what type of procedures your PS performed.I hope this helps

Edward J. Ricciardelli, MD · Answer

Given the limitations of forming an opinion without an exam or standardized photos, the problem with short scar lifts is that the skin is pulled tightly and no adjustment/addition of volume is performed.  As the previous consultant pointed out, that results in a flat cheek profile.  That being said, much of that tightness may resolve with time and 5 weeks is too soon to tell.  The pleats may go away but are easily taken care of in any case.  The bigger issue is adding volume to the cheek area which can be done with fat or fillers.  Most of the time I add fat as an adjunct to any mini or short scar lift.  Again, without the op notes, I am not sure what was done.  Good luck.

Keith Denkler, MD · Answer

Skin pleats behind the ear can be a problem with short scar facelift.  They can improve over time and some with massage. You could need a posterior skin pull/tuck in the next few months if they persist.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facelifts
over the past 30 years.  My goal with each and every facelift is to create a face that's more shapely, feminine (or masculine) and naturally beautiful or handsome.  Over-pulled, with or without pleats IMHO does not accomplish that goal.  From the attached photos, the cheeks are still flat
anteriorly (in the front), the posterior jaw line (close to the ear) is concave and the chin is weak.  The neck pleat can result from pulling excess neck skin through a small incision that creates tissue bunching or a pleat.

Following the beauty principles
outlined in my book on face and body beauty, women look the most feminine,
youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks
that are full and round in the front.  Cheek augmentation using a dermal filler
(I prefer Restylane Lyft) or with cheek implants for a permanent enhancement
will create full, round cheeks anteriorly that will feminize the entire face.

Jowls are sagging facial
tissues and an indication for some form of a SMAS facelift.  The
underlying SMAS layer, of the face, must be dissected, lifted, trimmed and
re-sutured.  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the
minimally invasive, short incision facelift that has all the benefits of more
invasive facelifts (traditional, mid-face, deep plane and subperiosteal
facelifts) but with these added benefits:

•very small incisions

•minimal tissue dissection = less
bruising and swelling = rapid recovery

•can be performed in 90 minutes or
less, with or without anesthesia

•no incisions within the hair = no
hair loss

•excess fat can be removed

•excess skin removed

•cheeks, chin and jaw line can be
augmented with dermal fillers (I prefer Restylane Lyft) or facial implants

•most patients fly back home to parts
all over the world in as little as 3 days post-opAt 5 weeks, post-op, it's probably best to see if the pleat relaxes over the next month or two and consider shaping the anterior cheeks and posterior jaw line, with a dermal filler, to soften and feminize the face.  This will reduce the "over-pulled" appearance again, IMVHO.Hope this helps.

Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift? (Photo)

Answers (4)

Answer: Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift?

Answer: Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift?

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Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift? (Photo)

Answers (4)

Answer: Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift?

Answer: Is jaw line pulled too vertically/sharply and are pleats behind ears normal after short scar lower face lift?

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Recommended reading

Everything you need to know about Lower Facelift

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