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Los Angeles, CA
The "unoperated" look
I had a midface, lower lid bleph. and neck lift in 2004, but a week after surgery when changing the dressing, I could see that the skin under my chin was not completely attached. The facelift results seemed promising otherwise while I was swollen, except I still saw jowling. As the swelling decreased, my jowls reappeared to look the same as before surgery! Additionally, my neck has continually fallen further with time passing, and a new band on my neck appeared. I was not aging much when I had the surgery (late 40's). My neck and jowls were sagging, an were my main complaint as they gave a sure indication of my aging. My neck/under chin looks worse than before the surgery. There is still too much loose skin, and it is not attached to the underneath of my chin and neck. Dr. says I need more volume (restylane)throughout my face, but that much skin cannot be filled, I think! I don't understand why this result happened. What needs to be done to fix it? I would like to send you some photos. Thank you.
As people age they tend to lose facial volume in addition to losing skin elasticity and having excess skin. Optimal facial rejuvenation requires a balance of skin removal(facelift), volume restoration (juvaderm, radiesse, fat), and skin rejuvenation (laser, radiofrequency, pulsed light). Feel free to email me before and after pictures
I can relate to your disappointment. Although I am older that you (a young 67)I had upper & lower bleph, face and neck lift in January '08. I was very pleased with the results in the first 3 months. Then after the swelling subsided I noticed everything seemed to start sagging again. I still have the neck bands and sagging skin under my chin. Also, I seem to have more "dimpling or puckering" in my chin area which I did not have before. I guess I am just disappointed in the final results so am going to see another PS this coming week to ask his opinion. If he tells me the results are normal then I will let the matter be closed. Also, I have botox and juvederm. Sometimes I wonder if that would have been sufficient without the other surgical procedures! I did not tell anyone about my PS and had several comments from friends telling me how good I looked during the first few months following surgery. I no longer hear those compliments from people who have not seen me since before the PS. Thankfully, I don't think I look worse but I don't think I have adequate improvement after 7 hours of surgery and $16000 later!
The first question is what facelift was performed. Was it a facelift wiht incisions around the ear or just a necklift with incisions below the chin? If no incisions were performed around the ear, this could be the first problem, that skin was not tightened that would most benefit the areas you mention.
The second issue is volume replacement. We prefer LiveFill (nontraumatized fascial fat grafts) for volume enhancement, and usually do this at the time of the facelift.
We now know that the face ages by drooping, but also by loss of volume. For optimal rejuvenation, both should be done.
The third issue was any resurfacing done? This can help tighten further and reduce sagging in areas beyond the reach of tightening, such as the mouth area.
Overall, start by going back to your surgeon and expressing your concerns. You may also want to ask whether further rejuvenation with techniques other than those performed is warranted.
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