6 weeks post op Face/Neck Lift. All good except I am really sad that my jaw line and areas below the corner of my mouth. (photo)

What can be done if anything to have under my chin more chisled and the the areas below the side of my mouth tightened like they were even 5 years ago ! I spent 15k. Happy I look like me but not the me of 10 years ago

Doctor Answers 14

The jowl region generally leads a very pleasing result after a facelift.

I can see why you're disappointed but it's early in the healing process to make a final pronouncement. Generally the jowl area and marionette lines respond quite nicely to a well executed facelift. The retaining ligaments along the line of the jaw need to be completely released however


Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

It is still early in the healing process, but adding volume to the jawline and mouth area will help you achieve the 10-year goal

Thank you for your question. After reviewing your question and photos, I understand you had a facelift 6 weeks ago, which you are generally satisfied with, but are not happy with the results in your jawline and outer corners of your mouth. You also state that you are happy you look like you, but not the you of 10 years ago.

Just a bit about my background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I think I can certainly give you some guidance as facial aging is something I’ve written books and articles about, and have been an information resource on for the media.

In my practice, I always begin my consultations with an explanation of what changes over a timeframe of 10 years when it comes to facial aging. There is certainly a big difference between 40 and 50, compared to 20 and 30, and this has something to do with volume loss. Facial aging is a combination of volume loss and sagging and descent, where volume loss has to do with diminishing bone, muscle, fat, and soft tissue.

There’s also the question of how much structure there is to lift up against. People with weaker bone structure or diminished volume, even if you try to pull, lift and tighten, you won’t get the same look. I think that’s what you're dealing with, though you have addressed the descent by having a face and neck lift.

Now, six weeks is still early in the healing process. The process of wound healing consists of the following phases: (1) the homeostatic phase, where there is a lot of bleeding; (2) the inflammatory phase, which is the first week or so after surgery when we’re removing a lot of the debris from the area; (3) the proliferative phase, which is about a month; and (4) the remodeling phase, which goes on for about a year. It is important to understand that at this point, there is still some healing taking place.

With regard to looking like you did 10 years ago, there’s no need to abandon all hope. We’ve done variations on how to approach this to come up with the best solution for our patients. Some people will combine a chin implant, and a cheek implant at the time of face lifting surgery. It’s important to keep in mind that you can’t always address everything with one surgery, since facial aging has multiple levels.

What we do for our patients in our practice is something called the Y Lift™. The Y Lift™ is a non-surgical facelift that is performed in a very specific way with the help of cosmetic fillers. It makes use of a long-lasting injectable filler such as Juvederm Ultra Plus at the deeper levels to almost mimic facial implants, but at the same time restore contour and volume that are missing. The Y Lift™ works very well on the cheekbones, chin and jawline.

Some people will rationalize that if the surgeon just pulls a bit tighter, things will look better. Keep in mind though that a youthful face doesn’t look pulled - it’s more about balance and volume. Volume placed strategically will probably get you closer to that 10-year point that you want, along with adding the benefit of skin quality improvement with the help of platelet-rich plasma and other modalities.

Remember that with facial aging, the reality is there are certain things that can’t be fully restored to how they were when you were younger, but a lot can be done so you’ll look good at your age. A term I love to use is the “indeterminate age”, and it’s through the achievement of good balance and definition that sometimes people are unable to tell how old you actually are, they just see you as a dynamic individual.

Don’t lose hope yet. Try to get through this healing process first, then discuss what else can be done with your surgeon. I'm sure your surgeon has ideas about how to help you and will, of course, also guide you through this healing process.

I hope that was helpful and I wish you the best of luck!

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Disappointed after facelift

Thank you for a great question and for sharing your photos and experience.  This early after a procedure there is likely still swelling, so a "more chiseled" look may come with more time.  I would also discuss your concerns with your surgeon at your next follow-up.  I hope this helps you!

I recommend consulting with a facial plastic surgeon to further discuss your concerns and options.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

6 weeks post op

Hello,


At 6 weeks post op, it is too soon to evaluate. You may want to discuss revision options or non-surgical adjustments such as the use of fillers, but I suggest that you wait until 6 months post op to truly assess your results.

All the best

Timing of results

Thank you for your question and for sharing your experience and photos with us. At six weeks, I would recommend that you continue to follow-up closely with your plastic surgeon.  Your neck will continue to go through changes over the next several months.

after face lift

Your after pictures show a very nice level of improvement compared to the before pictures.   Be sure to discuss with your own surgeon about how this applies to you, and whether they have any special concerns in your case.

#facelift results

You are still early in your postoperative recovery and I would give yourself more time to heal before you judge the results. The traditional facelift does not rejuvenate your perioral area and fat grafting or fillers can help improve the volume loss that occurs around this area over time. In addition, based on your pictures I would recommend that you start a good skin care regimen that helps keep your skin texture smooth which will enhance your results. Good luck! 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Face lift

At 6 weeks out your face is still healing. Perioral issues are often not corrected with facelifting unless fat grafting or filler product is added.

Dissapointed in facelift

As a rule, facelifts look their best right before all of the swelling subsides and the tissue relaxes, at about 6-8 weeks.  If you need more tightening after surgery consider radio-frequency treatments such as Pelleve.  After 6 treatments there is visible tightening of the treated areas.

Semira Bayati, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 33 reviews

Unhappy with results

Thanks for your post. Try not to become too discouraged yet, as it appears you still have some healing to do. By 3 months you will have a better idea of where you stand. Standard facelift techniques will typically not change your chin or the areas immediately around your mouth.

Discuss your concerns with your surgeon. You may need to address other facets of facial aging including volume replenishment and skin resurfacing. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 12 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.