Question About Lipo to Tighten the Jowls and Neck After a Facelift

I recently had a facelift and everything is coming back. I am really concerned with my jowls and my skin from my neck and that's the reason I had this done and I used a great surgeon. I was told that having lipo to tighten my jowls and my neck would be the best solution.

My question is would that only be a band aid for a short time and then come back again and was also told that I can't have anything done for 6 months from the surgery date. I'm just trying to understand all of this.

Doctor Answers 42

Liposuction will not tighten skin of jowls and neck after Facelift Surgery

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If you have excess fat and NO LOOSE SKIN in your neck after Facelift then Liposuction may help. New laser Liposuction may also help tighten the skin a small amount.

However if you truly have jowls and neck folds caused by skin laxity Liposuction will not adequately tighten neck and jowl skin.

In fact using Liposuction near the angle of the lips can cause serious irreversible nerve injury and a crooked mouth.

If you have significant jowls and neck laxity after a Facelift it is very likely you will need a revision Facelift with emphasis on the lower face and neck. This likely needs to include an incision under the chin and a Platysmaplasty-a procedure to suture tighten the neck muscles under the chin. This procedure should give you a nice tight neck and jaw line

Lipo for jowls

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As we age, certain areas of our face lose volume selectively more than others. This may accentuate the jowl. One key aspect of a youthful appearance is maintaining facial volume. Sometimes adding volume to other areas will create a youthful look and diminish the jowl. 

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.6 out of 5 stars 28 reviews

Great Question

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Hi Mia 229

With regards to the face - the skin looses elasticity over time. The tissues under the skin tend to drop due to gravity and there is a degree of loss of volume of the face. It is important to address each of these issues that are present in any individual to achieve a desirable and long lasting outcome. The skin needs to be lifted and tightened as does the muscle layer underneath, called the SMAS and this gives it the longevity of a facelift that should last 7-10 years.

Some surgeons perform a skin only tightening without tightening the SMAS which has a good outcome immediately after surgery but has very little longevity and lasts only a few months.

With lipo, this reduces the volume under the jowls and its good for contouring of the jaw line but does nothing to make the procedure to last longer. Commonly face and neck tightening are performed together and in the neck typically, the skin, the fat under the skin and the muscle called the platysma, are addressed to different degrees on any individual. The lipo to the neck and skin tightening improves the contour but if there is laxity of platysma underneath then tightening the muscle will give the contour of the neck a longer lasting result. It is important to ask your surgeon whether he has performed skin only or he has tightened the underlying muscle for your facelift.

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Liposuction to Tighten Jowls and Neck

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Liposuction will remove bulk but will not, as an isolated procedure, tighten the jowl and neck skin in a revision of your previous facelift. It is best to wait at least 6 months after the first operation. Make sure you and your surgeon agree on the goals of any future work.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Tighteting jowls and neck

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You will get some relaxation of the face after the swelling resolves.  Unless you had a lot of fat I wouldn't liposuction your face.  It can tend to leave some irregularities. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 73 reviews

Lipo after a Facelift

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Whether or not liposuction may help after a facelift really depends on the individual and his/her neck features. If there is a significant degree of fat, then liposuction will improve the neck and jawline. However, the problem of excess skin remains. After about 30 years of age, the elasticity of the skin decreases to the point that if liposuction was successfully in removing excess fat, you could be left with dimpled, redundant skin. Ideally liposuction, if appropriate, would be combined with the original facelift. However, if not done, I would wait at least 6 months before deciding on a secondary procedure. It is possible that there is still some degree of swelling and fullness in the surgical area which will continue to contract and tighten as the healing process continues. It is very difficult to assess this until at least 3 months have passed after your surgery.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon

Reoccuring jowls and neck laxity after a facelift will likely need revision

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Reoccuring jowls and neck laxity after a face / neck lift likely will need some type of revision.  Liposuction could handle some of these issues, if these issues are related to excessive fatty tissue. The concern with just employing liposuction is the layering of the skin.  With the reduction of fat, the skin will be of relative excess and may or may not redrape the way you would like it to.  Also often the reoccurance is not due to loosening, it is often due to the loss of swelling from the process that was acting to pull back the neck and jowls.  I know that there are certain things that you really need to do for the neck to be properly shaped and formed.  You need to remove all the necessary fat that has accumulated and also you really have to treat the neck thoroughly to pull it tight.  You need to do a corset neck lift and this needs to be done with an attention to detail.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Liposuction To Tighten Jowls After a Facelift

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The rate with which you will continue to age after your facelift procedure is not something that surgeons can predict.  Long-term results will often vary patient to patient depending on ethnicity, hormones, the use of topical therapy and medical grade-skincare, sun avoidance, etc.  If what you are describing is loose skin (not fat) at the jowls and neck, liposuction will do nothing to address your concerns in a way that will make you happy.  Some docs claim that using radio frequency will aid in tightening skin in that area of the face, but I have yet to see a device that yields the type of results that would justify asking price for the procedure.  Having said that, there is probably a facelift revision procedure in your future, as no surgery, treatment or topical can ultimately stop the aging process.  

Robert J. Schwartz, MD
Richardson Plastic Surgeon
4.7 out of 5 stars 16 reviews

Facelift vs Facial Liposuction

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Liposuction will remove fat and is often used in the neck under the chin, the jowl area and sometimes along the jaw line at the time of a facelift or independently without a lift.  A facelift is primarily used to tighten skin and reposition sagging tissue.  If you opted for a facelift and it was part of the recommendations that your surgeon gave you then you should get a great result.  Second guessing as to whether you could have gotten away with just liposuction won’t help much now.  The good news is that the results from the lift will have far more longevity for you.\\ I hope that helps Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

Clarification for your situation

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After a facelift, a follow-up liposuction procedure may help tighten and contour to the jowl and neck area–however, only if the skin retains some elasticity and the lack of definition is due to excess fatty deposits. If the skin has lost form because of laxity, liposuction may not be the most appropriate solution for restoring lost definition. In this case, a neck lift or a second facelift may be the best way to achieve the desired results. The best way to forward is to see a facelift surgeon for an evaluation of the quality of your skin.

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.