Would a mini face lift or an smas lift work better for me to suspend the muscle back up?

Question

Hi doctors, I'm 33, and recently undergone a cheekbone and jawline reduction. Although my face is now more narrow , it has cause my soft tissue and muscle to shift forward. When I lift the skin upwards from my temples, it not only looks better but the soft tissue draped over the new structure much better. Would a mini face lift or an smas lift work better for me to suspend the muscle back up? Thank you

Thomas P. Sterry, MD · Answer

Based on your history and the single (smiling) photo you sent, I cannot see the value in a facelift for you.  While it is a terrific tool in the right circumstances, I don't think you will benefit from one.  By the way, in 2016, EVERY facelift should be performed using SMAS manipulation of some kind.  I prefer the lamellar SMAS elevation, but that is what I've found works in my hands.Finally, I should point out that at 33 years old a facelift of any kind would be at best "unusual" and seems aggressive.

Mario S. Yco, MD, FACS · Answer

It is difficult to answer your question with the single photograph you have provided. Please resubmit this question with frontal, side profile and three-quarter views with your hair pulled back so your jaw line can be assessed. Your photo, however, appears youthful and I would allow one year for your facial tissues to settle. I would not recommend surgery based on your photo. Having said that, all facelifts must include a SMAS procedure to be successful.

Miguel Mascaro, MD · Answer

I agree with the input before.  How long ago was your surgery? it can take up to a year or so for swelling to settle and for you to fully heal, specially considering you had cheekbone and jawline surgery.  A lot of the musculature involved in smiling, talking, blinking etc have some attachment to the areas you had surgery on and, therefore, things may take time to completely settle.  Before you make any decisions - give it some time.  Also, it is tough to assess from the picture sent what could (or even should) be done.

P. Daniel Ward, MD · Answer

Hi staying positive,I'm sorry you are having issues. Based on the description alone and without further photos, providing you with some meaningful answers is difficult. Would you be willing to send some other photos?Thanks!

Trevor M. Born, MD · Answer

Dear staypositive11Thank you for your question and photo!  It is difficult to tell from your photo- what would be best. An important note - your recent surgery can take up to a year and a half to fully heal and settle. With Warm RegardsTrevor M Born MD

Dean P. Kane, MD, FACS · Answer

Dear stayingpositive11:Thanks for sharing your photo. You will need a in-person consultation for proper evaluation and recommendations. Following reductive orthognathic surgery, the overlying soft tissues and skin will hang on the new frame. This would be similar to placing your unchanged dress onto a smaller hanger or deflating a balloon. You have several options depending on many factors such as cost, time for recovery, swelling and bruising concerns, side-effects and complications to consider.Thread Lift: The Silhouette Lift will replace the Contour Thread Lift of years ago and suspend the soft tissues of the face. In the right hands, the prior procedure performed well. Like anything else, in the wrong hands, you may be disappointed.Facelift: with so many different names, the facelift includes: 1. elevation, redraping and removal of extra skin leaving scars around the ears2. repositioning the soft tissues and fat of the face and neck. This is performed with variations of a SMAS lift3. contouring of facial volume using fat or fillers to augment flatter or areas which have drooped4. adjunctive options to tighten and suspend the neck muscles, eyelid and brow liftThermiTIGHT: using RF (radio frequency) energy under the skin, this procedure using puncture sites and not incisions actually is found to tighten the skin and superficial soft tissues for a shrinking effect of the lower face and neck. ZO Skin Health therapeutic skin care: retinoids remain the gold standard in non-surgical, topical skin rejuvenation, tightening and pigmentation control. Thereafter, Controlled Depth TCA chemical peels and lasers will further tighten the skinPlease consider a Board Certified Plastic Surgeon with the experience, skills and honesty to treat you right!All the best!

Francis R. Palmer, III, MD (retired) · Answer

Hi, Non smiling photos would help in the evaluation both front and side (profile) views. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties that developed early "jowl" formation.   If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.Hope this helps.

Would a mini face lift or an smas lift work better for me to suspend the muscle back up?

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