Would release of the ligaments, during a Deep Plane Facelift, have any possible negative impact on my jaw/TMJ?

Question

I am in my late 40s and am considering a deep plane facelift. I have a history of hemifacial microsomia (not noticeable to most people unless told/shown), partial right condyle and likely flattened discs on both sides. I do not have tmj pain issues as long as I avoid excessively chewing gum, jaw breakers etc. Would release of the ligaments, during a deep plane face lift, have any possible negative impact on my jaw/tmj? Thanks in advance for your response.

Jigar Sitapara, MD · Answer

Hello from Washington DC,Great question! Quick anatomy review, the SMAS is the connective tissue/muscular sheet that is released during deep plane lifts. The layers of the face from superficial to deep go skin, superficial fat, SMAS, deep facial musculature/fat compartments, bone. The ligaments that are released include the following:- zygomaticocutaneous- parotidocutaneous- masseteric-cutaneous- cervicocutaneous- mandibulocutaneous (some do, some don't)All of these ligaments are released just under the SMAS or just under the skin. Therefore, the ligamentous release during a deep plane lift does not affect the underlying muscles or bone. You should not have a negative impact on your jaw or TMJ with a deep plane lower face/neck lift. I hope that helps!Jigar Sitapara, MDChevy Chase Facial Plastic Surgery

Brian M. Harmych, MD, FACS · Answer

Releasing the ligaments should not have any effect on the jaw joint. However, keep in mind that it is somewhat common to have some degree of jaw muscle soreness after both deep plane facelift and traditional SMAS facelift techniques. A soft diet is recommended for all patients for 7-10 days.

Gianfranco Frojo, MD · Answer

Releasing of the osteocutaneous ligaments that are part of a "deep plane" facelift should not have any impact on your temporomandibular joint. The ligament release may cause adjacent facial nerve injury if performed my someone without adequate experience in this type of surgery; I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Dilip D. Madnani, MD, FACS · Answer

I have never had anyone with TMJ pain after facelift surgery. Patients do complain of tightness that resolves. The ligaments you refer to are also not related or connected to the TMJ joint. 
Your surgeon will evaluate the hemafacial microsomia and make adjustments as needed.

William C. Harris, MD · Answer

The deep plane facelift releases ligaments that adhere the skin and muscular layer (SMAS) down to bone in order to naturally reposition these tissues and restore a more youthful appearance. There is no effect on the TMJ or the muscles involved in closing or opening the jaw during this type of facelift or any other type commonly performed. The masseter muscle, which helps with jaw closure may become temporarily inflamed or swollen from the surgery, but this shouldn’t effect your TM joint other than some soreness with chewing for a short period of time. It is important, however, for your surgeon to know about your hemifacial microsomia prior to surgery. I hope this helps and make sure to find a reputable, board-certified plastic surgeon prior to undergoing your facelift.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! The ligaments released are near the cheek and along the jawline. These help to support the deeper layers to the skin. The TMJ is deep and in front of the ear as you may know. The lift isn't done that deeply and I don't know of an instance where TMJ disorders would be exacerbated. Hope this is useful!

Would release of the ligaments, during a Deep Plane Facelift, have any possible negative impact on my jaw/TMJ?

Answers (6)

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