Facelift Side Effects

What Facelift Side Effects Look Like

Facelift side effects are visible changes in the eyelids, the mouth, the scars, the earlobes, or the facial contour after surgery. A facelift is surgery that lifts sagging skin of the face and neck. These changes show up more often after a skin-only facelift, which pulls on the skin itself. They show up less often after a SMAS facelift, which places most of the tension on the deeper SMAS layer and lets the skin rest with less pull.

The changes described on this page are:

• The windblown effect
• The Joker’s face
• Prominent facial scars
• Scar migration onto the neck
• Pixie ear deformity
• Lumpy facial contour
• Skin recoil and sagging recurrence

The windblown effect

The windblown effect is a narrowed, pulled look at the outer corner of the eye. It happens when the skin of the upper face is pulled too hard while it is being inset. A dual-plane SMAS facelift keeps that pull off the skin. The tension sits on the deeper layer, under the skin.

The Joker face

The Joker face is a pulled look at the corners of the mouth. The mouth is drawn sideways, which is why the result is named for that exaggerated smile. It happens when a skin-only facelift pulls the skin beside the lips, often after the dissection is carried too far toward the center of the face. A SMAS facelift keeps most of the tension on the SMAS. The skin dissection stays on the outer cheek, so the pull does not reach the corner of the mouth.

Prominent facial scars

Prominent facial scars form when the skin flap is pulled tight as it is redraped and inset. A skin-only facelift puts that tension on the skin, and the incision can heal as a wide line. A dual-plane SMAS facelift puts most of the tension on the SMAS, so the incision is under less strain and can heal as a finer line.

Scar migration onto the neck

The scar along the bottom of the ear should sit in the groove where the earlobe meets the neck. If the neck skin is pulled too hard, that scar is dragged out of the groove and onto the neck. That misplaced line is one of the clearer signs that a facelift scar has moved.

The pixie ear

A natural earlobe hangs below the point where it attaches to the cheek. A hang of 5 to 10 millimeters is the range given for a natural earlobe in both men and women. A pixie ear is an earlobe with no hang. It is pulled up to the attachment point, and it looks operated.

A skin-only facelift can create a pixie ear when extra tension from the neck pulls on the earlobe attachment. In a SMAS facelift, that tension is placed on the lateral platysma, the neck extension of the SMAS, instead of on the earlobe. The sideburn and the hairline should also stay where they are, rather than being dragged by the same pull.

Lumpy facial contour

A lumpy contour appears when the deeper tissue is not lifted on its own before the skin is lifted. That is the pattern of a skin-only facelift. A dual-plane SMAS facelift redrapes the deeper tissue first, then lays the skin over that new shape.

Skin recoil and sagging

Skin recoil is the loss of the tight look that is present right after surgery. It is most common when all of the tension was placed on the skin, because skin stretches and then relaxes. A dual-plane SMAS facelift puts the holding force on the SMAS, which is a fascial layer, so the skin is not asked to hold the lift.

How a SMAS Facelift Changes the Pull

Facelift surgery tightens the deeper layer and removes extra skin. Planning the operation includes how far the skin is lifted and where the tension will sit. A facelift that looks operated, in the examples on this page, usually means the tension was placed on the skin instead of the SMAS.

Facelift Side Effects in Brief

These facelift side effects follow a skin-only technique that pulls on the skin. An extended SMAS facelift uses the superficial fascia under the skin to hold the lift, so the skin itself is not pulled tight. When that extra skin tension is avoided, these facelift side effects can be avoided as well.