A 54-year-old woman looks younger than her age. She had facelift, necklift and fat grafting. However, after the procedure, her nasolabial and marionette lines became deeper. She wants to know how to improve her appearance.
Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, explains that face lifting surgery is to reposition sagging skin, improve jowls, and soften marionette lines and the nasolabial folds. If a patient looks at their pre-operative photos and compare it with their results, there may be some improvement. They must also recognize that at a two-month point, there will be some degree of swelling that may be present. With any surgical procedure, swelling can be a factor of how these areas look for up to six months to a year.
Nasolabial folds and marionette lines may look prominent because of the depth relative to the adjacent height. Dr. Prasad wrote a book a few years ago called “The Fine Art of Looking Younger” and explained the two elements of facial aging: sagging where there is loosening of skin and support tissue, which is addressed with your facelift procedure; and volume loss where bone, muscle, fat, skin and soft tissue resorbs. He has always observed in women that the lower third of the face has a significant amount of volume loss which results in loss of lip definition, vertical lines, nasolabial lines, and mesolabial or marionette lines become deeper. There is indentation of the mandibular notch which makes the jowls looks more prominent.
The lady can have a strategy with her doctor to address volume loss, but she should wait until swelling has resolved before doing volume correction. In Dr. Prasad practice, he lets his patients understand volume loss after a facelift by having them hold the mirror and he lifts the face. Then, he points out to the patient that the mesolabial folds are improved but there is still some depth. He evaluates because when the whole architecture of the face is changed, the perception of the face also changes. Dr. Prasad thinks that there will be options that will help this woman look even younger than her age as she already expressed. She should talk to her doctor and express her concerns and she’ll find solutions that will be satisfactory for her.
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