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Facelift Surgery, Achieving a Nice Jawline

February 14th, 2014 Miguel A. Delgado Jr, MD

San Francisco, California-As evidenced by the many different results of facelifts, also known as rhytidectomy, the skill of the surgeon is critical. Beyond ascertaining that the surgeon of choice is Board Certified in Plastic Surgery, you want to know the surgeon’s experience and techniques for facelift surgery.

As a layperson, it can be difficult to know what you are looking for. Observing the surgeons before and after pictures, in many cases, will reveal the quality of work. Arming yourself with good questions can help you determine the level of skill. In addition to asking if the surgeon tightens the underlying muscle (SMAS), uses fat injections in areas that may need volume, ask the surgeon if the effect of the buccal fat pad is taken into consideration in surgical planning. The herniated buccal fat pad is one of the most common missed causes of the jowl. The jowl or jawline is one of the most bothersome areas of the aging face.

Before and After Facelift

This is a 54-year-old, male resident of San Francisco who presented to the San Francisco office at Union Square, California for evaluation of his aging face. He underwent an eyebrow lift and lower lid eyelid lift with a lower facelift. He had buccal fat excision, or cheek fat excision, of his cheeks and he also had 7 cc of fat injected into his right and left upper cheek. He underwent a prejowl chin implant.The lower facelift included a SMASectomy excision, which is excision of the deep tissue to thin his face as opposed to a SMAS plication, which would give more volume to his face. He had liposuction in the jowl region and a complete platysma transection in his neck. He had the eyebrow lift with 11-millimeter elevation bilaterally. His procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the herniated cheek fat that has caused a significant fullness in the jowl location.

The buccal fat pad is an area of fat located just below the cheekbone area, in the mid face. It can be as large as a golf ball or as small as a grape. Fluctuations in weight will cause a change in volume. The effects of aging may also cause the size to reduce. If the buccal fat pad descends or herniates inferiorly, it will add to the size of the jowl. If it is not removed during a facelift, the jowl will only be partially corrected.

It takes an experienced cosmetic plastic surgeon to diagnose and recognize the herniated fat pad in order to get the best result for the jawline.

Removal of the fat pad is most often done from the inside of the mouth. Sometimes during the facelift procedure it may be removed from the outside when the SMAS layer is exposed, however, this can be a little riskier due to the facial nerves in the area.

Right Buccal Fat Pad being removed

Right Buccal Fat Pad being removed

 

Today more  men are seeking cosmetic procedures than ever before, along with facelifts, popular procedures for men are: liposuction, gynecomastia (male breast reduction) and rhinoplasty (nose reshaping).

Dr. Delgado is a highly experienced top cosmetic plastic surgeon who has been in practice since 1988, performing the most up to date facelift procedures. Serving the greater San Francisco Bay area, including Sacramento, San Jose, and Los Angeles. Call or email today for a phone or virtual consultation at (415) 898-4161.

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