How Can I Improve My Lower Facial Shape After A Custom Jawline Implant and Mini-Facelift?

Q: Dr. Eppley, I had a mini lower facelift and wrap around jaw implant put in around 2021. Since then, I have struggled with jawline contour irregularities and a face that appears to be sagging more than it was pre-facelift. Interested in a consultation to identify what can be done.

A: While I don’t know what you looked like before this surgery what I do know is:

1) You have classic masseteric muscle dehiscence (see attached picture) in which there is no muscle coverage over the implant. This is primarily the result of the implant design in which it is usually prudent to not extend the implant beyond the posterior border of the jaw angles.

2) Mini facelifts in young patients without any real age-related tissue laxity often up with hypertrophic scarring around the ears…which you have. But putting the jawline implant in at the same time as the mini lift does not allow the more anterior tissues to be properly undermined and redraped posteriorly. (the implant blocks it)  Thus the jaw ssgging that did not exist before the surgery. Jawline implants alone have a powerful effect on jowling and neck sagging and by themselves have a mini lift effect.

The solution is to trim the angle portion of the implant back to the muscle border, close the muscle over it and do a better mini-lift…all of which can be done through your existing facelift scars.

Dr. Barry Eppley

World-Renowned Plastic Surgeon