Unhappy with results of my lower facelift - were my expectations unrealistic?

Question

Female 63 years old 130 lbs White Deep plane facelift 9 months ago. I’m pretty happy with my upper face, but disappointed that I still have jowls. Is my expectation unrealistic?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Generous,

IYour expectation is not necessarily unrealistic, but it’s important to recognize that deep plane facelifts, while highly effective for midface and lower face rejuvenation, can leave some degree of skin descent or asymmetry due to factors such as skin elasticity, healing variability, and natural facial asymmetry.

Secondary facelifts can be a challenge and each surgeon will have his or her thoughts on improvement of your situation.  The goal is improvement and not perfection.  This is what I would consider:
1. Secondary Lift with Skin Re-elevation and SMAS Adjustment
2. CO2 Laser Resurfacing 
3.Volume Correction with Fat Grafting or Filler, if necessary

Seek the opinion of your operating surgeon as well as additional plastic surgeons via an in-person consultation.

Best wishes

Earl Stephenson, Jr, MD, DDS, MBA
ESJ Aesthetics

Gianfranco Frojo, MD · Answer

You may benefit from some additional treatment for the peri-oral area just as an ablative erbium laser.

John Michael Thomassen, MD · Answer

It is not unusual to suffer relapse in this area since it is the most mobile part of the face.  Sometimes a small revision to address the jowl and nasolabial fold can nicely supplement the prior procedure and get you the results you were after.  For example, in your case, a temporal cheek lift to lift the cheek, and tighten the jowl area can be done under local anesthesia to correct these stubborn areas.

Min Hee Ryu, MD · Answer

Hi. Thank you for sharing your inquiry.
Based on your current photos, it’s a bit difficult to determine which is before and which is after the surgery. To better understand your results, it would be helpful if you could share both your pre- and post-surgery photos clearly labeled. This will allow me to provide more accurate advice.
In cases where patients are not fully satisfied with jowl line improvement after a lifting surgery, it’s often due to not combining a neck lift with the procedure, or addressing only the face and neck without performing a submentoplasty. These situations frequently lead to inquiries about revision surgeries.
I hope this response provides some insight.
Thank you.
-Dr. Min-Hee Ryu M.DDeep Plane Facelift

Hasan Duygulu, MD · Answer

Hi . Your expectation is quite realistic as a Deep plane surgery is existing because mostly jawl and nasolabial saggings . However to correct jawl are in heavy neck is difficult , Mostly good results are being achieved .

Ronald J. Edelson, MD · Answer

You still have some laxity of the jowls on one side. That should be correctable with a little skin tightening in that side. It shouid be simple to accomplish some improvement there

Darryl J. Blinski, MD · Answer

Based on the before, and after photos, your results are very limited for such an aggressive surgery. I would recommend a virtual in person consult to discuss secondary options. IBased on the before, and after photos, your results are very limited for such an aggressive surgery. I would recommend a virtual in person consult to discuss secondary options. I recommend a full open, secondary facelift with SMAS plication With Endo laser treatment. Fee $15,000-$20,000. Best of virtual consult with to discuss these options.

Unhappy with results of my lower facelift - were my expectations unrealistic?

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