Still sagging after facelift. Is this normal?

I had a facelift 3 1/2 weeks ago. I still have 25% swelling and numbness. As my swelling starts to subsides, I see my face starting to sag on the one specific area that bothered me.. around the marriott area, on my left side of my face. 50% is back. It may be back even more as after my swelling diminishes. Is this normal?

Doctor Answers 10

Early sagging after a facelift.

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I can understand your frustration if the benefits of the facelift are already starting to evaporate. Seeing this sort of a problem early on is rather uncommon. This is something you should discuss with your surgeon.

Sagging after facelift surgery

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Thanks for your questions.  Its difficult to assess without any before and after photographs as there are many variables including the quality of your skin prior to surgery, the type of facelift performed.  Importantly though, you are still in the very early post operative recovery period and its normal for you to see some asymmetry during this healing phase.  For some patients, non surgical treatments such as dermal fillers are still required after facelift surgery as a facelift on its own does not deal with lost facial volume.  Be patient and keep your surgeon informed of your progress.

Swelling After Facelift

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It is perfectly normal to see different changes occur on one side of your face than the other, as each is a separate surgery site. Parts of your face may look distorted until the swelling subsides. The healing process varies dramatically from patient to patient, and the time it takes for all residual issues to resolve is a full year. A facelift is often combined with volume replacement with injectable fillers. Areas that are often injected include the cheeks, marionette lines, and the hollowed areas in front of the ears. That said, please give yourself at least several more weeks of healing time to allow changes to settle before considering further treatments or procedures.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 127 reviews

Post facelift

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You are still in the early postoperative period.  It takes a few months to see the final result.  Also certain areas will not change with a facelit and may require other treatments such as fillers, laser etc.  Follow up closely with your surgeon to see if you are progressing normally.  Donald R. Nunn MD Atlanta Plastic Surgeon

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

There are many variables to your question...

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The answer to your question is not simply black and white. There are many different ways to perform a facelift and the result depends on the anatomy you started with as well as the procedure done and your healing capabilities. Sometimes the marrionette lines need to be filled as well as lifted for a better result. Be sure to discuss your concerns with your surgeon.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Marionette recurrence vs jowl recurrence

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No facelift will permanently remove marionette lines. It is a great technique for resiting jowl sagging and recovering the jawline. I tell all my patients that whilst the facelift MAY improve the nasolabial fold a little, perioral postoperative management will need to include dermal fillers, skin care +- fractionated CO2 laser resurfacing. Like all investments there is an ongoing committment to maintenance to ensure longevity of performance.

Final outcome of facial surgery may take many weeks until all swelling resolves

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Final outcome after facial surgery often takes many weeks, or longer, especially if there has been a lot of swelling, or in faces that are not as thin.   Facelift will help, but not necessarily completely solve marionette line problems, as they involve a complex arrangement of skin attachment and fat compartmentalization along with muscle insertion, and overly aggressive pull can be distorting, and release can damage structures.  You will need to wait this out and keep in touch with your surgeon.  Often the marionette line and nasolabial fold lines require supplemental filler injection to complete the rejuvenation.  Also, it is hard to speak of outcomes with out before and after comparison photos.   I hope that this helps.

Thomas M. DeWire Sr., MD (retired)
Richmond Plastic Surgeon

Marionette lines

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At 3.5 weeks, you are likely still swollen and still healing. Marionette lines may be softened with a facelift, but often fillers like fat or HA's may be necessary to soften them as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Still sagging

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It is too early to judge the results of a facelift.  You will need to wait a couple of months to see the actual results of your surgery.  Early after surgery due to swelling and initial skin tightening, the results may appear to be smoother and tighter than the eventual appearance.  The swelling masks some laxity and the degree of elasticity of the skin will determine how much the skin may relax during the healing process.

Jeffrey E. Kyllo, MD
Seattle Plastic Surgeon
4.7 out of 5 stars 13 reviews

Still sagging after facelift. is this normal?

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It's hard to give you a precise answer without pre and post op pictures,but it is natural to see some wrinkle return as the swelling subsides. there should be a substancial improvment however. as to the marionette lines, it is commom to have to do fillers to this structure after a facelift. If you pull hard enough on the skin to oblitrate this line, the face gets distorted and looks fake.

William Lambeth, MD (retired)
Raleigh-Durham Plastic Surgeon

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.