Part3: Can a joker smile EVER be corrected after a facelift?

Question

Thank you all for your answers. So my next question is basically around the "end result" if the smile is a joker smile? Will removal of juvederm or any other procedures, correct the smile? Thanks again!

John Michael Thomassen, MD · Answer

The use of fat grafting in the submalar space prior to the lift can correct this.  In addition to avoiding a lateral sweep of the SMAS tissues when performing the lift.

Philip Solomon, MD, FRCS · Answer

This can  be difficult to correct.  With time it may settle on its own.  In certain cases facial filler can be helpful.   In very specific cases revision surgery could be considered involving revision redoing the facelift and reoriented the vectors of pull.

Robert M. Tornambe, MD · Answer

Suzanne.   The best way to correct the Joker's Smile is to avoid it, facelift technique does play a role. However if present, fillers like fat or Juvederm can soften it. Regards

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It really depends on how tight the tension lines are and how recently surgery was performed.  It may be possible to rearrange skin tension lines to improve this.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Trevor M. Born, MD · Answer

Dear SuzzanConnThank you for your question!  The shape change may be help with fillers or fat grafting to correct for volume loss.  The relaxation of the tension and or the vector of the facelift is more difficult to correct and it may be a function of time, tissue relaxation and reshaping of the face with surgery.With Warm RegardsTrevor M Born MD

William Portuese, MD · Answer

It really depends on what procedures were performed and what the results look like both in a static and dynamic state. A full set of facial photographs in repose and smiling are going to be required to make a determination about whether or not anything can be performed for improvement

Kouros Azar, MD · Answer

Without photos, it's hard to say. Fillers may help but the issue it typically due to the skin being "over-pulled". So sorry that you are experiencing this. Best of luck.

Ludwig A. Allegra, MD · Answer

It is in fact difficult to correct as the initial cause is related to an over-pulling of skin in an unnatural vector instead of focusing on the underlying tissue support without "pulling" the skin. It is difficult to recommend other options without some images-non smiling.
It may be possible to reduce some of the appearance with filler or possibly "neo threads".

Barry L. Eppley, MD, DMD · Answer

The upturned and elongate mouth corners can be corrected by a reverse corner of the mouth lift. Non-smiling pictures would be needed to determine of this approach would be successful.

Steven Wallach, MD · Answer

Often the illusion of the joker smile is seen preop especially when photos are reviewed after surgery in a patient that has it.  Sometimes fat grafting can soften the look.

Part3: Can a joker smile EVER be corrected after a facelift?

Answers (14)

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