Q. At 57, I had a facelift, lateral brow lift and fat transfer for my thin face, sagging neck & jowls, 8 weeks post op, sadly I still have jowls. Incisions are behind my ears only and small incisions above my forehead. My plastic surgeon says surgery was successful. I asked why incisions were not at my temple and he said it’d cause a fishhook mouth and didn’t recommend it. He put Voluma in my chin and there’s still some jowling. What are my options at this point? I am disappointed in the outcome of my surgery.
A. A more contemporary face and neck lift requires a incision along the front of the ear (or over tragus) extending onto the sideburn with a properly performed SMAS elevation to lift the cheek and jowl properly. It is possible that your surgeon used the lateral browlift exposure to suspend the soft tissues of the face including the jowl but I am speculating without examining you or knowledge of his/her technique. The incision behind the ear may help expose the neck region and lift some sagging neck skin but again without examination, it is difficult to know.
The “fishhook mouth” appearance I believe is due to a improper suspension or lift of the SMAS under the cheek skin and not due to the front-of-ear” incision.
More filler in the upper central cheek and over the cheekbone (if required) can FILL the lax or redundant skin envelop but not lift the jowl per se.
You may certainly consider a second opinion (by a Board Certified Plastic Surgeon or ENT Facial Surgeon) but I would recommend first addressing these issues with your surgeon.
I hope this works out successfully for you. All the best! I’ve had a facelift, lateral brow lift & still have jowls. What are my options?
Q. At 57, I had a facelift, lateral brow lift and fat transfer for my thin face, sagging neck & jowls, 8 weeks post op, sadly I still have jowls. Incisions are behind my ears only and small incisions above my forehead. My plastic surgeon says surgery was successful. I asked why incisions were not at my temple and he said it’d cause a fishhook mouth and didn’t recommend it. He put Voluma in my chin and there’s still some jowling. What are my options at this point? I am disappointed in the outcome of my surgery.
A. A more contemporary face and neck lift requires a incision along the front of the ear (or over tragus) extending onto the sideburn with a properly performed SMAS elevation to lift the cheek and jowl properly. It is possible that your surgeon used the lateral browlift exposure to suspend the soft tissues of the face including the jowl but I am speculating without examining you or knowledge of his/her technique. The incision behind the ear may help expose the neck region and lift some sagging neck skin but again without examination, it is difficult to know.
The “fishhook mouth” appearance I believe is due to a improper suspension or lift of the SMAS under the cheek skin and not due to the front-of-ear” incision.
More filler in the upper central cheek and over the cheekbone (if required) can FILL the lax or redundant skin envelop but not lift the jowl per se.
You may certainly consider a second opinion (by a Board Certified Plastic Surgeon or ENT Facial Surgeon) but I would recommend first addressing these issues with your surgeon.
I hope this works out successfully for you. All the best! 
