Ask the Plastic Surgeons

By Wendell Smoot, MD, Reza Sadrian, MD, Carol Hollan, MD and John Smoot, MD

Q. What is the facial area commonly referred to as the “drop zone”?

A. When you reach your early 40s, you may notice you have a “drop zone,” i.e., the skin between your neck and jaw, which was once a taut right angle, is now dropping, or losing elasticity. The aging jaw and neck are a prevalent condition traditionally associated with middle age. Problems not only include sagging muscles and bulging fat, but also include the thinnest, crepiest skin on the body (apart from eyelid skin). A thin ropey material called platysma tends to split into a V-like formation of protruding cords.

In our office, we treat this condition with a variety of less-invasive treatments that can alleviate the problem. We may suggest a Freshlift, liposuction or fat transfer as a means to combat what can be categorized as the first signs of aging in middle-aged patients. A double chin can often be reduced by liposuction and another alternative is injecting fat from the belly into the jaw line area to provide extra volume. This will include the bonus of your own stem cells.

A Freshlift (or mid-facelift) conducted by the physicians in our office is a popular alternative to a full facelift, which can combat the “drop zone” condition. An ideal candidate for this procedure would be someone in their 40s or 50s who is not quite ready for a full face- and necklift, but is starting to notice some sagging in the jowl area. Along with the advantage of a shorter scar, this surgery usually has a quicker recovery compared to a full facelift.

The mid-facelift focuses on a triangular area formed between the two corners of the eyes and the corner of the mouth. It’s an important area because the mid-face involves the muscles that convey emotion. Thus, a sagging mid-face makes the drooping of the mouth and chin more obvious. A mid-facelift improves nose-to-mouth lines, lifts sagging cheeks and flattens the cheek folds around the mouth, creating a younger, softer and rested look.

Some patients who complain of having a fleshy neck, jowls, or turkey wattle can benefit from Corset Platysmaplasty or necklift. It is often performed in conjunction other procedures resulting in a completely refreshed look. Your physician may recommend a combination of these procedures to attain the desired results. We strongly suggest a consultation by a board-certified plastic surgeon when contemplating your options.

John Smoot, MD, is the former Chief of Plastic Surgery at Scripps Memorial Hospital-La Jolla and Wendell Smoot, MD, has been voted by his peers as Top Doctor in San Diego for five consecutive years. Carol Hollan, MD, is San Diego’s first female board-certified plastic surgeon while Reza Sadrian, MD, is one of very few plastic surgeons dually certified in plastic and reconstructive surgery as well as oral and maxillofacial surgery. The practice has over 20 years of tenure in the industry and each is individually board certified by the American Board of Plastic Surgery. Any of the physicians can provide consultations on plastic surgery procedures and/or laser and skincare treatments at their Laser and Skincare Center and can be reached at their offices on the campus of Scripps Memorial Hospital-La Jolla in the Ximed Medical Building by calling (858) 587-9850 or via the web at