What's the best treatment for prejowl sulcus after a facelift didn't work?

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Really sorry that had such a negative experience. In general, especially when evaluating a young 40 year old with not particularly advanced skin laxity and jowl formation, I typically suggest nonsurgical, no downtime, and relatively inexpensive approaches, particularly the use of injectable volumizing fillers to sculpt, contour and straighten the jawline.  Although the photos provided do not allow for adequate assessment, it is likely that the injection of a volumizing filler, such as Voluma XC or Restylane Volyme, at the posterior angle region of the jaw would not only straighten the jawline and reduce the anterior jowls, but would secondarily even tighten and pull up somewhat the region below the jawline leading on to the neck. As the jowl problem still exists despite the surgery, the use of a volumizing filler can still be tried.  I'm sure, especially after your recent disappointing surgery, that you will appreciate that unlike surgery, which typically engenders prolonged downtimes and recoup periods, the results of nonsurgical volumizing filler treatments are typically immediate and engender an immediate "Wow!" response. Make sure that you consult with a board certified aesthetic physician, and be certain to ask to see his/her personal before and after photos. Best of luck.

The decision to proceed with a minilift was made between you and your Surgeon and the best advice I can give you is to discuss your concerns with him in order to achieve a mutually beneficial outcome.  Please remember that at least a year is recommended prior to major interventions after surgery. Objectively speaking, the pre-jowl sulcus is not  a major issue in the photos that you have provided.  It may not hurt to seek other opinions, but make sure that you see a Surgeon who specializes in faces.  

Thank you for your pictures and questions. It seems like in your previous reviews of your procedure, you were very happy with the results, but now, not so much? "Guys, he is no joke the best plastic surgeon in Georgia if not the world!!"It would be helpful to know more details about your surgery. The problem with many facial cosmetic procedures that are billed as "mini" or "minimally invasive" or "lunchhour lift" or "weekend lift" or whatever other term is en vogue, is that these procedures are shortcuts on surgery. They are lesser procedures with lesser downtime and less sculpting below the skin, and guess what that gets you? Less results or at least results that do not last as long. If I were you, I would consider going to a plastic surgeon who is board certified by the American Board of Plastic Surgery and discussing your concerns and the possible options available to you.Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

The best treatment for a pre-jowl sulcus is a pre-jowl implant that augments that area.  This implant can be placed under local anesthesia

Hi and welcome to our forum!
A facelift will lift the cheeks, but as the distance from the problem area to the incision increases, its effect decreases. Correction of the prejowl sulcus usually involves the use of a filler, fat injection, or the use of an implant, depending upon the severity of the deformity.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...