Why Did My Facelift Turn Out Like This?

Q: Dr. Eppley,  what area of the face is this and what happened? Lost over 100 lbs. went to a doctor for “excess skin removal “ on my face. He recommended a lower facelift. We did not talk much about it but I do know it was not a “deep plane” lift. I am left with this 10 months after surgery. Bulges. I did not have these bulges prior. Loose skin? Sure, but not “bulges”. What can be done? Feel free to be candid. Your reply is for my understanding exclusively. I am very surprised with this happening. Was medically discharged from the practice and am now independently seeking answers. Found you via an excellent online article. Am open to your feedback. What part of the face is this? What happened. Can you help.. Please reply by email if possible. I am sorry but I do not use the text portion of phone. Thank you.

A: The simple answer is that, while a lower facelift helps the neck and jawline which clearly has been useful in your case. it will have  effect for any facial areas that lie above the jawline. Thus what you see is essentially untreated areas from the nasal folds and cheeks that were beyond the scope of the facelift procedure you had performed.

To achieve a midface effect, the incisions would have to run up higher than the ear and along your temporal hairline. They would likely be needed a lower eyelid incision as well. Innocence you needed a more extended type of facelift to deal with your tremendous amount of facial skin laxity from the weight loss.

There was nothing wrong with the procedure you had performed other than your expectations of what you thought it would do and the type of facelift chosen for your concerns was a bit of a mismatch. How that happened I cannot say since I obviously was not involved in those preoperative discussions. There may have been good reasons for a more limited facelift approach to your problem, such as the duration of the surgery and your general health. But in essence the solution was not adequate for the problem.

The question now is how far do you want to pursue this improvement. You can certainly go on and have a mid face lift secondarily after a lower facelift. While everyone is an enamored  today with the deep plane facelift this is not the source of your problem. The location of the incisions controls skin movement and what you need is not going to be accomplished by a traditional lower facelift procedure. As I often say, traditional problems require traditional procedures. But when you have an exceptional problem, which is what happens with a 100 pound weight loss, you need an exceptional procedure to treat it.

Dr. Barry Eppley

Plastic Surgeon