Jowls still there! How can I fix this? (Phtoo)

Question

I had surgery 6 months ago, lower face and neck. Looked amazing straight afterwards but my jawline isn’t as sharp anymore, it looks like my jowls are still there and I have a swelling underneath my chin still from lipo. I am due to see my surgeon in the next month but he did seem to think it’s still swelling. Had a problem with the wound behind my ear that wouldn’t heal for the first 3 months so wondering if that could be contributing to slow healing

Stephen Prendiville, MD · Answer

Universally, there is some degree of relaxation of the result at 6 months.  Based on the photos provided, I do not see jowls that would merit further procedures.  You have some degree of inflammation or swelling for a year after the procedure.  Best to discuss with your Surgeon.

Alan Gonzalez, MD, FACS · Answer

Hello @joeyjo1976, thank you for your question. It is not uncommon for patients to experience swelling and slow healing after facial surgery, especially in the lower face and neck. Note that it can take 6-8 more months to completely heal and for the final results of surgery to be visible. I recommend following your surgeon's recommendations for your healing process. Your surgeon knows the specific surgical techniques applied during your procedure and is best equipped to assess your progress and make recommendations for further treatment. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Randal Haworth, MD, FACS · Answer

It is not uncommon for swelling to persist for several months after lower face and neck surgery, particularly in the area of the chin and neck where liposuction was performed. It is possible that the swelling is contributing to the appearance of jowls and a less defined jawline.

The slow healing of the wound behind your ear may also be a contributing factor, as it can indicate that your body is still in a healing phase. This can delay the overall healing process and may prolong the appearance of swelling.

It is important to follow up with your surgeon as scheduled to discuss your concerns. Your surgeon will be able to evaluate the area and determine whether the swelling is still present, or if there is an underlying issue that needs to be addressed. They may also be able to recommend non-surgical options, such as massage or lymphatic drainage, to help reduce the swelling and improve the appearance of your jawline.

If a revision is necessary, your surgeon can discuss the best approach and the expected outcome with you. In the meantime, it is important to continue to follow your surgeon's post-operative care instructions and to be patient as the healing process continues.

I hope this helps,
best of luck !

Donald Groves, MD · Answer

Hello and thank you for your question. After a facelift, you can remain pretty swollen, and this swelling can take a LONG TIME to resolve (months to a year or more to fully resolve). You are still somewhat early post-op after your surgery. Over the coming months and even year- the swelling will continue to improve and eventually fully resolve, any bunching should flatten out as the skin relaxes a little (either partially or completely- you've already started to notice this), and the scar will become less noticeable as it remodels into a mature scar. Although wound issues are uncommon after facelifts, they still do happen, and thankfully most can be treated and heal very well without surgery. I would recommend that you just continue to observe things for now and keep open communication with your operative surgeon. Any revision surgeries, if even necessary, typically are not done until at least 1 year after the prior surgery to allow for the inflammation and swelling to resolve and the skin to relax. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. Based on your photos, a little jowl lipo may be able to help this issue. Regarding the neck, a revision necklift may be the best option as there could be residual tissue beneath the muscle that needs to be removed. This can be done wide awake using local anesthesia and oral medications to help you relax. Patients do incredibly well with this and it avoids the side effects of general anesthesia.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. Since surgery doesn't address the condition of the skin specifically, you may want to consider adding non-surgical skin rejuvenation to put the finishing touch on your lift procedure. RF microneedling is an excellent option for increasing your body’s natural collagen production, restoring your skin’s elasticity and improving its quality and texture. This treatment can also reduce the appearance of jowls and lower face sagging.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your surgical history, assess your concerns, and determine the best approach to help you achieve your aesthetic goals.

I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your surgical history, assess your concerns, and determine the best approach to help you achieve your aesthetic goals.

Selcuk Inanli, MD · Answer

Hello ! Thank you for your question.I have evaluate your case from the information and photos you provided you should definitely consult your surgeon about this situation.
Thank you ! regards

Richard G. Schwartz, MD · Answer

Without knowing the specific surgical techniques use, I can only make some general comments.  The fullness just to the side of the corners of the mouth are difficult to improve with a lower face and necklift.  Sometimes, I use liposuction to reduce the fat deposits there, and sometimes patients will benefit from a move vertical cheeklift to pull up the lower jowl region.  Regarding your neck "swelling",  you should inquire about whether any suturing of the platysma muscle was done to lift the muscle upward as well as surgical trimming of excess fat on the muscle surface.  Also, it is to be expected that there will always be some relaxation and stretching of skin in the first 6 months.

Russell Bramhall, MBChB, FRCS(plast) · Answer

Hello Joey. Thank you for your question. The first thing to do is to speak to your surgeon. It's difficult to give much meaningful advice without having either examined you in person or seen all your pre and post-op photos. However, all facelifts tend to loosen off a little over the first 6-12 months. Most people tighten the deep layer quite a lot and the skin less so over the top. Most of the swelling usually resolves over the first few weeks, which can then make the skin then look a little less tight, though this usually just improves the result and makes everything appear more natural. You'll still have most of the deeper tissue tightness remaining. An 80% correction of the jowls would probably be considered about average, though most surgeons strive to achieve more than this. Regarding the neck swelling, at 6 months after a face and neck lift with liposuction under the chin, almost all of the swelling should have resolved here, though it is true that you may still have a hint of this left. Liposuction will never get rid of all of the fat excess under the chin. It is best considered a fat reduction technique that usually removes around half of the fat sitting superficially just under the skin, but above the platysma muscle. It doesn't usually remove all of this superficial fat. It also doesn't remove any of the deeper fat sitting underneath the platysma muscle. There are techniques to do this, but they all involve a bigger scar under the chin (deep anterior neck reduction, usually combined with a platysmaplasty). There are pros and cons of each of these techniques and your surgeon would be best placed to go through these with you. Good luck with it all anyway! Take care, Russell.

Zoran Potparic, MD · Answer

It is not unusual to have more jowls after lower face lift than expected. Any experienced face lift surgeon would treat this area ruther conservatively to avoid injury of motor nerve to lower lip. Secondary liposuction with small cannula in local anesthesia will take care of residual bulk. Hope this helps.