Dear Dr. Di Saia,
I am 35 and have had fullness or jowling at my jawline since my late 20′s. One year ago I had a Lower F/L (SMAS included) which the plastic surgeon said was the only thing that would address the jowling. The clean jawline only lasted for one month and then the jowling returned. In addition to that I developed hypertrophic scaring around the ears. Some doctors have said that I’m way to young to have had a Lower F/L and that due to my thick skin it is bound to fail. While others have stated that the doctor was not aggressive enough. Is this procedure never appropriate for someone my age?
I have not to date performed a facelift on such a young patient. Unless the problem was large enough in magnitude, I would not have operated. To date, I have not seen such a young patient appropriate for facelift. I have offered peels, botox, soft tissue fillers and an occasional blepharoplasty in this age group, but not a facelift.
As you have discovered, surgery involves risk. There needs to be enough potential benefit to make those risks reasonable. I would need to know a lot more before I tried to guess what might improve your current situation.
John Di Saia MD
Originally posted 2005-12-05 19:54:00.