Lower Facelift: Addressing Jowls, Sagging Skin, and the Effects of Ageing

Ageing can bring about many changes in our appearance, with the lower face often showing noticeable signs of ageing, such as sagging skin, deep lines, and the development of jowls. While non-surgical treatments offer temporary solutions, they may not provide the long-lasting results that people desire. A lower facelift, on the other hand, effectively targets these specific areas, helping to restore facial contours and refreshed appearance.

In this blog, Dr Turner Specialist Plastic Surgeon in Sydney will explore what a lower facelift involves, how it differs from other facelift options, and what you can expect if you’re considering this procedure.

What Causes Jowl Formation?

Jowls are the sagging or drooping skin below the jawline, is a common concern as we age, and understanding its causes can help in choosing the most effective treatment.

They are primarily caused by a combination of factors:

• Loss of Skin Elasticity: As we age, the skin loses its natural elasticity due to a decline in collagen and elastin production, leading to sagging of the skin.
• Gravity: Over time, gravity pulls down the skin and underlying deeper tissues (SMAS), contributing to the formation of jowls.
• Fat Redistribution: Aging can lead to a redistribution of facial fat, which may cause areas around the cheeks and jawline to lose volume; creating excess volume in the jowl and nasolabial fold which are unwanted.
• Muscle Weakening: The muscles that support the SMAS and overlying skin can weaken with age, exacerbating the drooping appearance.
• Lifestyle Factors: Factors such as smoking, sun exposure, and significant weight fluctuations can also accelerate the formation of jowls.

What Areas Does a Lower Facelift Treat?

A lower facelift specifically targets the bottom third of the face and the upper neck, making it an ideal for individuals looking to address ageing signs in these areas. The procedure is designed to correct sagging skin, reduce deep wrinkles and folds, and restore definition to the jawline and neck.

Key areas addressed include:

• Jowls and Jawline: By tightening the skin and deep fascial layers, a lower facelift redefines the jawline, reducing the appearance of jowls and providing a sharper jawline.
• Nasolabial Folds: These are the deep creases that run from the sides of the nose to the corners of the mouth. A lower facelift can soften these lines by lifting the sagging tissues that contribute to their formation.
• Marionette Lines: The lines that run from the corners of the mouth down toward the chin can be minimized, giving a more uplifted appearance to the mouth area.
• Chin and Neck: Excess skin and fat under the chin and on the upper neck can be removed or repositioned, smoothing out the area and reducing the appearance of a “double chin” or “turkey neck.”

Do Non-Surgical Treatments Work?

Non-surgical treatments have gained popularity due to their minimal downtime and considered less invasive. Options like injectables, laser treatments, and ultrasound therapy offer solutions for those with very early signs of facial ageing.

However, they have their limitations:

• Temporary Results: The results are temporary, often requiring repeat treatments every few months to maintain the effects
• Limited Effectiveness for Severe Sagging: Only effective for mild signs of ageing, as they cannot reposition deep facial tissues or remove excess skin, which are necessary steps to correct significant sagging and jowl formation.
• Cumulative Cost: Over time, the costs of regular non-surgical treatments may add up, making surgery a more cost-effective option in the long run.

For individuals experiencing advanced signs of aging, such as pronounced jowls, deep wrinkles, and significant skin laxity, a surgical approach like a lower facelift offers more dramatic and longer-lasting results. The procedure addresses the underlying structural changes, not just the surface symptoms, providing a comprehensive rejuvenation that non-surgical treatments cannot achieve.

How Do I Know If I Need a Lower or Full Facelift?

Determining whether you need a lower facelift, or a full facelift depends on your specific ageing concerns and aesthetic goals. A thorough consultation with a qualified plastic surgeon like Dr Turner is essential to make this decision.

Consider a lower facelift if:

• Your primary concerns are sagging skin, wrinkles, and loss of definition in the lower face and neck.
• You are satisfied with the appearance of your upper face, including the eyes and forehead.

A full facelift may be more appropriate if:

A traditional face and neck lift (vertical facelift) is a more comprehensive procedure that addresses aging signs across the entire face and neck regions that are affected by ageing changes. This can include lifting the forehead and brow area, tightening the mid-face region (cheeks), refining the jawline, and improving the neck’s appearance. The traditional facelift involves more extensive surgical techniques like deep plane SMAS modification and longer incisions that may extend into the hairline and behind the ears, which can result in significant and longer-lasting changes.

While both procedures aim to restore a youthful appearance, the lower facelift is ideal for patients with aging concerns limited to the lower face, whereas the traditional face and neck lift is suited for those seeking overall facial rejuvenation. A thorough consultation with a qualified plastic surgeon like Dr Turner is essential to make this decision. 

Is This the Same as a Mini Facelift?

A lower facelift and a mini facelift are both aimed at rejuvenating the face, but they focus on different areas and concerns. A mini facelift, also known as a short scar facelift, aims to improve lower face, but also enhance the mid-face or cheek region, and is frequently combined with fat transfer to restore facial volume, enhancing fullness in areas like the cheeks for a more enhanced appearance. It often requires a shorter incision typically just in front of the ears, resulting in minimal scarring and shorter recovery times.

In contrast, a lower facelift provides more significant correction by addressing deeper tissues and removing excess skin. It offers more dramatic and longer-lasting results for those with moderate to severe aging signs in the lower face and neck. Understanding the distinctions between these procedures helps ensure you choose the one that best aligns with your needs and expectations.

How Is Lower Facelift Surgery Performed?

Lower facelift surgery is always performed under general anaesthesia in a fully accredited hospital with the assistance of a qualified anaesthetist. Depending on the complexity of the procedure it takes 3 hours, and Dr Turner recommends patient rest in hospital overnight before being discharged home the next day.

Here is an overview of the surgical process:

• Incisions:Small incisions are strategically placed around the ears and sometimes under the chin, allowing for the removal of excess skin and the repositioning of deeper tissues. These incisions are designed to be discreet and are usually well-hidden within the natural contours of the face.
• SMAS Tightening:The SMAS layer, which lies beneath the skin, is lifted and repositioned to enhance the longevity of the lower facelift results. Tightening this layer not only improves the appearance of sagging but also helps maintain a natural contour.
• Platysma Muscle Adjustment:In cases where the neck shows significant signs of aging, the platysma muscle is addressed as part of a combination lower face and neck lift. This can involve tightening or repositioning the muscle to smooth out the neck and eliminate vertical bands.
• Skin Re-draping:Once the underlying structures have been adjusted, the skin is carefully re-draped over the newly contoured face and neck. Excess skin is trimmed away, ensuring a smooth, youthful result.
• Closing the Incisions:The incisions are closed using fine sutures to minimize scarring, and a bandage is often applied to support healing.

How Long Does a Lower Facelift Last?

The results of a lower facelift are long-lasting, typically lasting between for 7 to 15 years. Several factors influence how long the effects last, including:

• Skin Quality: The elasticity and thickness of your skin play a crucial role in how well the facelift holds up over time.
• Lifestyle Choices: Habits like smoking, excessive sun exposure, and poor diet can negatively impact the longevity of your results.
• Aging Process: While a lower facelift can significantly reverse the signs of aging, it doesn’t stop the natural aging process.

To maximize the lifespan of your facelift, maintaining a healthy lifestyle and following Dr. Turner’s post-operative care instructions are essential. Additionally, incorporating non-surgical treatments and proper skincare can further help prolong your youthful appearance. 

Recovery After Lower Facelift Surgery

Recovery from a lower facelift surgery is a gradual process, with initial swelling and bruising subsiding within the first few weeks. Most patients can resume regular activities in two to three weeks, though complete healing and final results may take several months.

Dr. Turner offers personalized post-operative care, emphasizing the importance of following instructions to manage discomfort, minimize swelling, and ensure smooth recovery. Patients are advised to avoid strenuous activities and heavy lifting during the early stages. Light walking is encouraged to promote circulation.

Following all post-operative care, including protecting the skin from sun exposure, is vital to prevent complications and achieve lasting results.

See our detailed guide on recovery after facelift surgery

Risks and Complications of Lower Facelift Surgery

Like any surgical procedure, lower facelift surgery carries certain risks and potential complications. It is important for patients to be fully aware of these before deciding to undergo surgery. Dr. Turner will discuss them in detail during your consultation, ensuring you have realistic expectations and a clear understanding of the potential outcomes.

Common risks include infection, bleeding, scarring, and temporary numbness or swelling, which typically subside during recovery. Less common but possible complications involve nerve damage, which could affect facial sensation or movement, and reactions to anaesthesia. Rarely, patients may experience hair loss at incision sites, skin discoloration, or delayed wound healing, leading to more noticeable scarring. Adhering to post-operative care instructions is essential for minimizing complications and ensuring a smooth recovery.

See our detailed guide on risks and complications after facelift surgery

Next Steps

If you’re considering a lower facelift, scheduling a consultation with Dr. Turner, a specialist in facial aesthetics, is the first step. Dr. Turner is dedicated to helping you achieve your aesthetic goals with personalized care and expert advice.

• Schedule a Consultation: Contact us at 1300 437758 or visit drturner.com.au to book your appointment.
• Prepare for Surgery: Follow any preoperative guidelines provided, such as avoiding certain medications and arranging for post-surgery care.
• Plan for Recovery: Set aside time for rest and healing and arrange for assistance during your initial recovery phase if needed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional to determine the best treatment options for your individual needs.