Why Did A Facelift Not Make My Face Look Thinner?
Q: Hi Dr. Eppley, I am 3 weeks post SMAS facelift and necklift. I had a friend who had her facelift months before me. She was very thin and her face looked too tight to me (really pulled along the jaw line). I have a round face despite losing 50 pounds with very sagging neck and jowls. I read where you wrote that a facelift will not get rid of a round face. I know know you were right. My dilemma is that it almost appears that I had nothing done. My round face is still….round.
My plastic surgeon says my neck looks like an 18 year olds neck. I am extremely pleased with that and it is tight as a drum. I feel like my face is tight and a little lifted only on the sides near the ears. I still have loose skin around my mouth. Is this normal? Does the SMAS facelift not address the nasolabial folds? I am very disappointed after spending 11k. What should I do now? Should I address this with my plastic surgeon? He proclaims a “natural” facelift is one that is not too tight or pulled. It may be too natural for me.
A: My first comment is that it is only three weeks from your facelift. When you are living it that seems like an eternity. However, when it comes to facial swelling you still have a ways to go. I would not pass final judgment until three months after your surgery.
That being said, you appear to have a mismatch between expectations and the anatomy of a facelift. You actually have exactly what a facelift can achieve…a nice tight neck and jawline. That is all that an isolated facelift can achieve, no more and no less. It does very little to nothing around the mouth area (nasolabial folds and mouth corners) as they are too far away from the point of pull. (which is around the ears) This is a frequent point of expectation and subsequent disappointment if patients are not properly educated from the beginning. In reality, a facelift is a neck procedure and does little for what most patients believe in their ‘face’.
This also explains why a round face can never be changed from a facelift. The source of the round face is not what is treated by a facelift. The round face is largely a function of the size and thickness of the facial bones, muscles and fat layers.
Dr. Barry Eppley