SMAS Facelift to Improve Jowls?

I had a lower lift done recently. I still have the jowl and a loose neck. Doctor says that is all that can be done. It was a SMAS lift. Does the SMAS lift just need to farther in the face? Can every jowl be lifted?

Doctor Answers 24

Mini SMAS lift?

Since I cannot see your preoperative photographs, it is difficult to make a complete judgment. However, I feel it is safe to say that you had a very "conservative" procedure. In certain circumstances, conservative or mini- is good, in yours it may have been less appropriate.

As others have stated, one surgeon's "SMAS" Facelift may be entirely different and less substantial than that of another surgeon. I would venture to guess that your SMAS procedure probably involved plication of the SMAS, a less effective maneuver than SMAS elevation and imbrication. Likewise, there is persistent jowling present and poor definition of the jawline which could be improved upon by more aggressive liposuction. Lastly the definition in your neck could very likely be improved by liposuction and platysmaplasty.

I would recommend a return visit to your surgeon for starters, and other opinions if you are not satisfied.

Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Facelift to improve jowling and neck fullness

You do appear to have quite a bit of residual fullness in your jowl area. This could be due to inadequate tightening during the facelift or may be from excess fatty deposits that could be improved with liposuction.

As some of the others have mentioned, you may also have persistent fullness in the neck from your submandibular glands. An examination would help determine if this is contributing to your findings at all.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

"Branded" lifts and minilifts

There has been a big move toward 'mini-lifts' and 'lifestyle this or that' and other named lifts.  For some, this is the answer.  Usually, this works best for someone who does not really need a facelift.  However, the result you have is inadequate.  Need to go back and get those jowls moving.  Or see someone else for a second opinion.

Jay Calvert, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 50 reviews

Residual jowls after SMAS facelift

It appears that your jowls and neck were insufficiently treated. The SMAS should be lifted more smooth out the jawline and the neck should be tightened.

Gary D. Breslow, MD, FACS
Paramus Plastic Surgeon
5.0 out of 5 stars 44 reviews

Unhappy After Facelift

Facelift techniques are confusing but the results should speak for themselves.  Your photograph demonstrates a full face, persistent jowls plus or minus prominent salivary glands, and an ill-defined jawline and neck.  Most of these problems can be dealt with with some form of SMAS manipulation along with minute amounts of liposuction.  Your skin tone appears to be excellent, and should help you in the end.  It appears that more aggressive techniques need to be employed; I would suggest a small amount of liposuction of the jowl area and neck/submental area along with a technique to remove some of the bulkiness of your face.  A Lateral SMASectomy whereby a strip of tissue containing the SMAS layer and fat is removed and the edges are approximated, increasing the contour of the area while simultaneously lifting facial fat to a more youthful position.  I would get a few more opinions from experienced Board Certified Plastic Surgeons.  Good Luck.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Face lift

From the picture you still have major jowls, but an exam is needed to rule out a prominent submaxillary gland. You still have los of neck fat also.

ALL JOWLS CAN BE LIFTED WITH A SMAS face lift, in the habds of an experienced Board Certified PLASTIC SURGEON.

Find another Plastic Surgeon.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

SMAS facelifts

It is difficult to tell from this picture especially without viewing your preoperative pictures but I will assume you went to a qualified surgeon. There are many other things that could explain your findings and difficulty in obtaining an optimal result. A prominent submandiblular gland could partially be responsible. Sub-platysmal fat is another possible explanation for the poorly defined neck angle. I would consider a chin implant as this can enhance the projection of the jawline.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Persistent Jowls after facelift

Jowling generally improves significantly after a facelift.  Minilifts, branded lifts, and short recovery lifts generally don't offer the same result as a facelift.  They have their place though and work well for individuals for mild skin excess or tissue.  

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 49 reviews

Second opinion

I recommend you seek a second opinion from an experienced board certified plastic surgeon, based on an inperson assessment.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.7 out of 5 stars 137 reviews

SMAS face lift to lift the jowls

 The SMAS facelift addresses lifting the jowls and re-suspending them up into the cheek area. Fatty deposits in the neck above and below the platysma muscle are also removed along with a platysma plasty to tighten the neck muscles. For many examples, please see the link below to our facelift photo gallery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.