One year post SMAS facelift - how can I fix the jaw and under chin area? (Photos)

Question

I am 53 and had an SMAS facelift Over one year ago. I am unhappy with the jaw and under chin. I have a band of loose skin like a pouch. I complain to the surgeon he told me to manage my expectations and to massage my neck. I hate the way it looks what can i do?

Mehmet Ozdemir, MD · Answer

It is truly disheartening to feel that your concerns are being dismissed after undergoing such a significant procedure, especially since your photos clearly show a "pouch" of residual skin and platysmal banding that a standard SMAS facelift should have ideally addressed. While "managing expectations" is part of the process, a year out from surgery, massage will not resolve what appears to be a lack of deep structural support or an incomplete platysmaplasty (the tightening of the neck muscles). To get the crisp jawline you were expecting, you likely need a neck lift revision that focuses specifically on the submental (under chin) area, involving a direct incision to tighten the midline muscles and remove that excess skin "pouch" that is currently draping over the jaw. I would recommend seeking a second opinion from a surgeon who specializes in deep-plane neck lifts or revision work, as they can more effectively address the deeper fat and muscle layers that seem to have been bypassed in your initial surgery.

Semih Yildiz, MD, FEPOBRAS · Answer

At one year, massage alone usually will not change a true band or pouch of loose skin. In my experience, the photos suggest residual neck and jawline laxity, but an exam is needed to tell whether this is skin, platysma banding, fat, or deeper neck anatomy.
Depending on the cause, options may include a revision neck lift, platysmaplasty, lower-face revision, or carefully selected submental liposuction if fat is the main issue and skin tone is good. I would seek an in-person second opinion from a facelift/neck-lift surgeon and bring your operative details if available.

Carl Truesdale, MD · Answer

Thank you for your question. Based on the photos you shared, you appear to be an excellent candidate for a deep plane face and neck lift. This procedure is designed to address the deeper structural components of the face and neck rather than simply tightening the skin alone, allowing for a more natural, balanced, and longer-lasting result. A deep plane facelift would help reduce the appearance of jowling, restore support to the lower face, and soften the nasolabial folds by repositioning the descended facial tissues back to a more youthful position. At the same time, the deep plane neck lift component improves the underlying muscles and deeper tissues of the neck to create better contour and definition along the jawline and beneath the chin. This approach is especially beneficial for reducing the bulky or heavy appearance under the neck while improving overall facial harmony and rejuvenation. By addressing both the face and neck together, the results appear smoother and more cohesive without looking overly tight or pulled. Overall, these procedures would provide a refreshed, more youthful appearance while still maintaining your natural facial features.

One year post SMAS facelift - how can I fix the jaw and under chin area? (Photos)

Answers (3)

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