Unsuccessful SMAS face, necklift with fat grafting and upper/lower bleph? What should my next steps be? (Photo)

Question

I am at 11 months post surgery and feeling less than satisfied with my overall results including under eye scarring/discoloration, eye bags, unevenness of fat grafting, draping of skin, smile impact (my cheeks don't allow me to smile normally), continued edema and jowls. Why should my next steps be?

Gianfranco Frojo, MD · Answer

I would perform a revisionary facelift/necklift to tighten and lift the deeper structures of the face. Sometimes more tightening/lifting is required depending on what the original surgery was/how aggressive the surgeon was. These are all my own opinions based on the photos provided. I would recommend seeing an actual plastic surgeon who has great training (in a 6 year plastic surgery residency or 3 year plastic surgery fellowship) and experience in facial aesthetic surgery (usually completion of a 1 year aesthetic fellowship after the other years of actual plastic surgery training.)

Gurkan Kayabasoglu, MD · Answer

I'm sorry, but your neck is the most unsuccessful part. The placement of your platysma muscles is not very appropriate. Corset platysma technique should have been done. From you only fat was removed. Fat filling with facelift surgery should not be performed on patients with heavy and voluminous cheeks. If you had a nice "deep plan facelift", there would be no need for fat injection. Fat tissues sometimes live and sometimes not. I think the fat on your smaller side may have lived less. For this reason, "deep plan facelift" surgery can be planned again and these problems can be solved. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the seminar invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me. With all respect.

Zoran Potparic, MD · Answer

It takes an average of 12 months for result of such an extensive surgeries to settle and mature. In some areas and in some patients, even longer. Yes, you do not have perfect result (hard to say without good preop photos to compare) but you should wait at least few more months before considering any surgical corrections. In person, second opinion consultation, with a board certified plastic surgeon with expertise in face/neck lifts, is recommended. Good luck.

Ronald J. Edelson, MD · Answer

That’s a tough one. I can see the fat that was retained in your cheeks. It may continue to absorb with time. It’s possible that some of the fat could be scraped out from inside your cheeks. Otherwise it could be scraped out with a redo of your facelift. I’ve removed fat injections from the eyelids before. It’s a lot tougher than it might seem. I have scraped filler out from going inside the mouth successfully. That would be the first thing I would do.

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! Sorry to hear that you're not satisfied with your result. Options at this point would be waiting a few more months to see if any further swelling may improve as results sometimes take 12-15 months to appear. If only a SMAS lift was performed, you may want to consider a deep plane facelift which is very powerful for repositioning skin and the jowl area. Under eye correction may require a lower blepharoplasty with fat repositioning to eliminate excess skin and smooth contours. Further fat grafting may be needed to improve irregularities. If you're comfortable with it, discuss your concerns with your primary surgeon to see what may be done. Hope this helps you!

Unsuccessful SMAS face, necklift with fat grafting and upper/lower bleph? What should my next steps be? (Photo)

Answers (5)

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