Why do so many post-facelift patients have an indentation on the upper mid-cheek and strange jawline skin?

Question

I'm in need of a facelift but concerned about these giveaway complications. Too often I see this strange jaw skin "draw" and a distinct ?suture indentation on the cheek.

Rod J. Rohrich, MD · Answer

The key is to select a Board certified Plastic surgeon who is a true expert in facelifting and understands your specific facial aging and anatomy .  The overdone, over pulled look with indentations is commonly seen with inadequate skin and SMAS release and vector reshaping in the midcheek.   This is prevented by proper mid face and neck reshaping and vectoring of the skin in a different direction from the SMAS .    The role of Fat augmentation is a key part of modern facelifting as well .  Make sure you see the surgeons patients photos with and without animation !

Ronald J. Edelson, MD · Answer

Often the after photos may appear shiny because the skin is dream smooth and the person is wearing makeup. I don’t know what you are referring to as a dent in the cheek but could be an indication that the dissection ended at that spot but that’s just a guess.

Anthony A. Admire, MD, FACS · Answer

Contour irregularities and pulling the tissues in an unnatural position, along with poorly located incisions are understandably concerns for every prospective facelift patient. I would see a surgeon that has numerous before/afters, as well as patient testimonials that can deliver consistently excellent results.

Robert M. Tornambe, MD · Answer

MommyLJ.   Facelift techniques differ, and some techniques offer better, more natural results than others.  Facelifts that pull the skin laterally can create a very unnatural appearance. For this reason choosing an experienced board certified plastic surgeon is the most important decision.  Do your research and ask questions about technique during consultations. Good luck!

Steve Laverson, MD, FACS · Answer

Your reluctance is justified.  Artistic virtuosos of facelift are rare among many performers.  The “lateral sweep” and other visible hallmarks of shortcut approaches are indeed common, and perhaps more detrimental to dignity than normal aging features.  However, you’ll enjoy many years of youth if you find a master and endure a month or so of swelling and distortion that comprehensive natural rejuvenation by skillful re-positioning of soft tissues demands.

Larry Weinstein, MD · Answer

Indentations can be caused by excessive liposuction of the face or removal of fat pads of the face. I never remove the fat pads of the face, they are critical for the youthful look of a face. Also some suture techniques can cause indentations of the face. See a conservative board certified ASAPS plastic surgeon in consultation. Good luck...

Fernando Colon, MD · Answer

These are considerations relating to what facelift technique was usedand surgeon's execution. I find that lifting procedures with a vertical axis of correction often seem more natural in properly selected patients. Atthe end the plastic surgeon you select is the most important factor. Seea few board certified plastic surgeons, get their opinions and look at their before and after pictures. Some practices have patients that volunteer tomeet and talk with potential patients about their experience and results.Best wishes.

Mohsen Tavoussi, MD, DO · Answer

The best way to choose a surgeon for your surgery is to evaluate the prior results. You will notice that majority of surgeons do have very good results. Before and after photos are the best way to start. Best

Tim Sayed, MD, MBA, FACS · Answer

What you may be describing is the so-called "windswept" look that can be a telltale sign of facelift surgery. It is important that the vector of pull on the tissues be set properly for the individual patient to counteract the effects of gravity. Skin is typically removed by pulling the loose skin toward the area behind the ears as well as up toward the hairline; the balance of these vectors coupled with existing wrinkles and deflation of the tissues may conspire to give this "reentering the atmosphere" windswept appearance. Sometimes fat grafting to plump the tissues and/or laser resurfacing to plane down the irregular lines in the skin are needed to optimize the result.

William Portuese, MD · Answer

It is important to choose your facelift surgeon based on producing natural results, so study their before and after facelift photo Gallery which should be extensive and reflective of their work.

Why do so many post-facelift patients have an indentation on the upper mid-cheek and strange jawline skin?

Answers (18)

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