3 years post-op deep plane facelift - lateral malar pleating when smiling (photo)

Question

Hi, I had a deep plane facelift 3 years ago. I am happy with the results except for a pleating/tethering that is apparent when I smile. This is not visible at all when my face is at rest, however, it is visible on both sides when smiling. When smiling, the areas right above my cheekbones on both sides bunch up a bit, with an almost horizontal line forming along the top of cheekbones. Thank you!

Tanveer Janjua, MD · Answer

This is from excess skin and tethering of the skin to the underlying soft tissues directly or from a permanent suture. The solution is to excise the extra skin following one of the creases and then remove any scar tissue or suture that is holding it back. 
Regards
Dr. J

Bianca Knoll, MD · Answer

this is called a "Smile block". It can be avoided by releasing the tissue and skin beyond the point where the movement seems to stop when smiling. Sometimes it requires  not only releasing but also removal of additional tissue. The tethering will disappear. Additional filler injections into the cheek area after having undergone a deep plane facelift, with the attempt to "maintain" the result, can contribute. I hope this helps.

Arthur Dean Jabs, MD, PhD, FACS · Answer

What you are seeing is the effect of the muscles around your eyes when you smile. this can be helped with a small amount of Botx along the outer orbit as well as skin resurfacing.

Hope this helps

Dr. J

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3 years post-op deep plane facelift - lateral malar pleating when smiling (photo)

Answers (3)

DEEP PLANE FACELIFT PROVIDERS NEAR YOU