Why the "ugly smile" after facelift?

Question

Thinking of getting a face lift. Looking at Christy Brinkley, Meg Ryan, Olivia Newton John. They look fine without smiling - why is the result an ugly, joker smile. Susan Sarandon had a facelift, her smile is fine. What is going on with the procedure to make an unsightly smile? Thanks

Franklin D. Richards, MD · Answer

A facelift should look natural without any "surgical" signs that you have had a procedure performed. This is especially true for the area around the mouth. A overtightened lip stretching result is not natural. Additionally, the look you are seeing in those mentioned may have had procedures done directly around the mouth. These procedures that lift the corners of the mouth can give a joker look. Stay away from them. A well done facelift should not result in the look you are trying to avoid. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. This is often the result of overly aggressive tightening and should be avoided.  If good technique is used,
a facelift can be done with minimal scarring and can result in a natural look, not
over-done look, with rejuvenation of your face.  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

Dilip D. Madnani, MD, FACS · Answer

There are so many factors that its hard to say why some appear this way. It may not even be from the facelift, but from placement of fillers and botox after the facelift. You really have to critically examine a before smiling picture with an after smiling picture to see if there are any specific differences. Suffice to say that newer techniques do not suggest such aggressive pulls or manipulation of all the deep structures so these 'problems' are easily avoided in experienced hands. Make sure to examine your surgeons befores and afters and if you are concerned about appearances on smiling, then ask to see a few patients he/she has operated on to get fully comfortable with what the possible outcomes can look like.

Robert M. Tornambe, MD · Answer

Suzanne.    I know what you mean, and you are correctly describing the "Joker's Smile", seen sometimes after facelift surgery.  Techniques differ regarding this operation, as do surgeons' philosophy.  I try to achieve a less dramatic affect after facelift, allowing significant Rejuvination, but still keeping the face looking natural, and more importantly, recognizable to friends and family!  For this reason, my go to technique is the MACS facelift technique, which allows re-draping of the skin in an upward fashion, avoiding the lateral pull, which can create the Joker's Smile. Be sure to consult with a board certified plastic surgeon . Good Luck!

Philip Solomon, MD, FRCS · Answer

A Facelift is a great procedure for improving an aging  neck and lower face.  Like every plastic surgery procedure there is variability amongst patients and difference in surgical techniques.  The best results are ones that create improvement without tell tale signs of surgery.

Kouros Azar, MD · Answer

That weird look around the mouth when someone smiles is the result of a poorly done facelift. A facelift needs to address the underlying structure of the face. It's not just about pulling/tightening the top layer of the skin. This is why I use the SMAS technique. It delivers a youthful, but natural looking result because it focuses on the underlying structure.

Robert L. Kraft, MD, FACS · Answer

That taut, ear to ear look is the result of too aggressive a procedure rather than a more natural facelift or it reflects repeated surgical intervention.  It can also indicate fillers and Botox.  This should not be the ideal although, obviously, people in the public eye may focus on perceived goals that differ from real world sensibilities.

Steven Wallach, MD · Answer

There are many different reasons why some may have smile issues after facelift. My goal is to give patients a very natural result so that they look like a more youthful natural version of themselves.

Martin Yanez, MD - Account Suspended · Answer

It is all in the hands of the plastic surgeon. If the skin is pulled too tight, one can have unexpected results....

Juris Bunkis, MD, FACS - Account Suspended · Answer

Christy Brinkley, Meg Ryan, Olivia Newton John were not overdone, did not have their skin pulled too tightly!    What sags with aging is the muscle under the skin.   During a facelift procedure, the muscles have to be returned to where they were in your youth.............but even in youth, skin was not pulled tight.  Why do that now?

Why the "ugly smile" after facelift?

Answers (14)

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