How to Effectively Resolve Skin Sagging After Facial Contouring Surgery, Part 1

Hello,
I am Dr. Park Jun-Hyung, a doctor who loves facelift surgery.
Welcome to The Plan Plastic Surgery Clinic.

It is a well-known fact that people who have undergone double-jaw surgery or facial contouring procedures experience facial sagging faster than others.
Today, I will discuss how to address common symptoms following such surgeries, like cheek sagging and marionette lines.
Moving forward, I plan to share a variety of information on facelift procedures, lifting techniques, and anti-aging solutions.

Double-jaw surgery and facial contouring surgeries are primarily performed to create a smaller facial appearance for most patients.
In the case of double-jaw surgery, it involves moving protruding upper or lower jaws backward.
For facial contouring surgery, it is performed to reduce the size of the face by removing bones, particularly for individuals with prominent cheekbones, square jaws, or slightly rounded chin tips.

Double-jaw surgery – A procedure to reposition protruding upper and lower jaws
Facial contouring surgery – A procedure to trim and remove contour bones at the edges of the face

verall, all facial contouring surgeries involve removing a portion of the bone or cutting it away entirely.
Simply put, it’s similar to releasing some air from a partially inflated balloon, which leaves the balloon slightly deflated.
Additionally, undergoing contouring surgery or double-jaw surgery does not reduce the volume of the soft tissues attached to the skin.
Since both surgeries fundamentally involve the removal of bone, it’s undeniable that, over time, the remaining soft tissues tend to sag faster compared to those who have not undergone surgery.

During surgery, the periosteum is separated upward to access the internal structure, reducing the surface area where the periosteum can reattach. This contributes to faster sagging.
Furthermore, the supportive ligaments are severed and lifted, and they tend to reattach slightly lower than their original positions. This is why facial contouring and double-jaw surgeries often result in accelerated sagging of the skin.
One common complaint from patients who undergo contouring surgery is that reducing the cheekbone often results in sagging in the midface.
Similarly, reducing the jawline may cause fat from the posterior region to shift forward, creating noticeable jowls.

To address this effectively, it is crucial to properly sever the supporting ligaments in the cheekbone and chin areas and elevate the overlying skin and SMAS layer upward.
If detachment is limited to the outer layers or the ligaments are not severed, it becomes challenging to pull back the sagging midface or jowls.
Additionally, when a chin reduction surgery is performed, the reduced volume in the chin area often leads to sagging below the chin, which is a typical outcome.

For younger individuals who have not undergone facial contouring surgery, there is typically no need for an incision under the chin.
However, even among younger individuals who have had facial contouring surgery, sagging under the chin can occur when viewed from the side.
In such cases, a submental incision can be made to suture the sagging muscles upward, providing sharper angles to the chin area.
There are also various methods to address issues like mid-face sagging or jowls.

These methods range from non-surgical approaches to surgical ones, such as facelift procedures.
Among non-surgical methods, the most common include contouring injections, which reduce soft tissue volume, or treatments like Ultherapy and Shurink which use heat to tighten tissues for a more compact appearance.
Slightly more invasive methods include thread lifting.

However, thread lifting is not a fundamental solution as it doesn’t remove the stretched skin but merely adjusts its position.
When the issue lies in excess skin, merely repositioning without removing it won’t yield significant results.

Additionally, popular procedures like fat removal or contouring injections may inadvertently damage critical lifting tissues, such as the SMAS layer (superficial musculoaponeurotic system), which is essential during facelifts.
Therefore, individuals who have undergone extensive fat removal or contouring injections may find that their SMAS layer is thinner, potentially complicating future surgeries.

After facial contouring surgery, the most definitive solution is undoubtedly a facelift.
This procedure involves making incisions to remove excess skin and SMAS, dissecting the SMAS layer, severing the supporting ligaments, and lifting it to sculpt an accurate and aesthetically pleasing contour.
It is considered the most effective and reliable method.

At The Plan Plastic Surgery, we prioritize the beauty of each patient.
If you have any questions or need a consultation, feel free to reach out.
We are committed to helping you regain your beauty and confidence. Thank you.