It’s not uncommon for massive weight loss patients to have redundant skin in their face and neck, making them a good candidate for facelift. But because their skin tone is markedly poor, they might need a more extensive facial rejuvenation surgery than someone who is just experiencing the natural effects of aging.
Riverside plastic surgery expert Dr. Tarick Smaili says that facelift after weight loss deals with more jowling and neck skin laxity, thus most patients will need a longer incision from each side of the face that starts from the temple, behind the hairline, then runs around the ear’s contour and reaches the lower scalp or neck.
For an additional contouring, some massive weight loss patients may also require a small incision under the chin.
Aside from the skin, the underlying tissues and muscles are repositioned as well to create a strong support for the new contour, explains Dr. Smaili.
To further rejuvenate the facial contour, Dr. Smaili highlights the importance of redistributing, repositioning, or sculpting the fat from the neck and jowl.
Meanwhile, a recent study published in the Plastic and Reconstructive Surgery journal has suggested that massive weight loss patients generally have severe volume loss in the mid face and mouth area, which is further aggravated by decreased skin thickness.
For this demographic, the researchers have suggested an extensive form of facial fat grafting in which the patient’s own fat is used to correct the flat or hollowed cheeks and other gaunt areas. This technique can also soften the nasolabial folds, or more commonly referred to as laugh lines.
Dermal filler injections can also restore facial volume loss, although the results are slightly firmer than fat grafting due to their more cohesive consistency. However, this trait makes them ideal for correcting deep folds especially the laugh lines and the marionette creases, which laterally circumscribe the chin.
Regardless of the material used as a volumizer, Dr. Smaili emphasizes the importance of microinjections to create discrete layers that will serve as the new soft tissue structure. On the other hand, he warns that “dumping” alone it will lead to “pillow face appearance” and other “stigmata” of the surgery.
While some forms of plastic surgery after weight loss are covered by insurance, facelift is always considered as an elective or cosmetic procedure, so the patients will pay for it. According to surveys, its cost can range from $6,000 to up to $20,000 for a full rejuvenation surgery.