Need a Redo After MACS Face Lift Jowls Not Lifted? (photo)

   There are so many varieties of facelift, and MACS facelift can lift the jowls as readily as any other variety.  Perhaps the dissection was not extensive to get the appropriate pull or the sutures were not tight enough.   In general, you should be able to accomplish your goal with the MACS lift.  Kenneth Hughes, MD Los Angeles, CA

You have persistent heavy jowling after a facelift - MACs lift or other technique - this indicated that the zone of adhesion creating the jowling was not adequately addressed, nor was the SMAS layer of the face sufficiently resuspended. 

After studying your photographs, I do understand why you wish to further improve your facelift result. For you revision surgery, I would recommend a somewhat more assertive jowl and neck lifting procedure. I would recommend a deep-plane or high-SMAS lift which should provide significant benefit with excellent longevity, especially when combined with conservative fat grafting.

In the search for less invasive operations miniaturized procedure seven introduced. Unfortunately, they often times lead to disappointing results is a restrict the options for the surgeon.

If you are not happy with the results following your facelift, then either the expectations were not properly agreed upon prior to surgery, and/or the incorrect procedure was performed, and/or the correct procedure was performed incorrectly.  I would recommend discussing the details with your surgeon and possibly seeking additional opinions to determine what your options are at this point. 

Mario J. Imola, MD, DDS, FRCSC.

It's fairly clear that your jawline, nasolabial folds, etc. are not quite lifted enough which should not be the case at 6 months postop. A proper lift can be done by any of the techniques mentioned and could actually be done with a proper short scar-SMAS type lift. For a dramatic improvement of your lower face, jawline, and  anterior neck and diminutive chin a genioplasty would provide for a permanent chin augmentation without the potential problems associated with silastic implants while tightening your neck muscles and changing the bony contour of your jawline for the positive. Just something to think about.

The beauty of plastic surgery is the opportunity to tailor a procedure to the individual needs and goals of our patient.   Each patient's anatomy is different, as are their goals.     With facelifting, we choose from a multitude of options to achieve the best result.

With this said, I would not recommend a revision MACS lift, as it did not give you a desireable result the first time.   Another important variable is appropriate timing.    It is important not to redo a whole facelift until the scar tissue has  had time to settle and soften.     If there is a lot of inflammation and scar tissue encountered, complication rates could escalate.

 

I wish you a safe and healthy recovery.

Yes a redo full lifting is the next step for you. Seek additional second opinions in person from boarded PSs in your city. 

 Aestheically speaking, from the photos provided, there remains what appears to be a significant excess of fatty tissue along the nasolabial folds all the way down through the jowls.  This excess fat must be removed to re-shape the face during any Facelift or gravity will continue to pull the excess tissues towards the mouth.  

 Similarly, there appears to be excess fat below the chin and along the neck and the chin otself appears a bit weak.  Chin Augmentation with a Chin Implant along with micro-lipo of the neck and face might be considered.  Shaping the Cheeks with a filler (I prefer Perlane) would create a soft, feminine and naturally attractive face.  I would need to see how much actual excess skin remains before recommending a minimally invasive Face Lift to tighten the SMAS and remove skin.

It is too bad that you did not have a better outcome to your surgery. There is a lot of marketing on TV and on the Internet for these "MINI" facelifts. Often they do not produce much improvement. I would wait another 6 months to let the final swelling go away and then consider having another consultation to see what your options would be.

Diana L. Elias MD